Covid-19 Inquiry Module 4 Report: Government Response

Gregory Stafford Excerpts

Tuesday 27th October 2026 Westminster Hall

[Gregory Stafford (Farnham and Bordon) (Con)]

It is a pleasure to serve under your chairmanship, Mr Stuart. I congratulate my hon. Friend the Member for Christchurch (Sir Christopher Chope) on securing this debate. He has pressed this issue for many years under Conservative and Labour Governments and he deserves credit for his persistence.

I want to begin where the inquiry did: with success. Baroness Hallett described the UK’s vaccine development as one of the success stories of the pandemic, and I am proud of the leading role that the Conservative Government played in that. They backed vaccines early and, at risk, set up the vaccine taskforce under Kate Bingham. On 2 December 2020, the UK became the first country in the world to approve the Pfizer vaccine. In 2021, some 132 million doses were given—the largest vaccination programme in our history. The credit belongs to the scientists, the NHS workers, the pharmacists, the 360,000 volunteers who signed up for trials and the public.

The inquiry’s report is not only a story of success, though. Its five recommendations set out what must be done better, and the Government’s response, published on 16 October, needs scrutiny. The Government agreed with recommendation 4, which is about having faster access to health data so that the MHRA can monitor vaccine safety, but say they will need “significant investment over time”. There is no timeline or funding promise.

Reports to the yellow card scheme rose by 75% between 2020 and 2022, which shows that people are willing to report. The system must be able to act on what they tell it. As my hon. Friend the Member for Christchurch said, recommendation 5 is where the response is weakest. The inquiry said the Government

“must reform the Vaccine Damage Payment Scheme as soon as possible.”

It set out a minimum of four reforms: raise the £120,000 payment, at least in line with inflation, and uprate it annually; introduce multiple levels of payment, according to the degree of injury; and provide fair transitional arrangements.

As my hon. Friend the Member for Bromsgrove (Bradley Thomas) said, the Government’s response gives no date, no figure and no commitment to any of those recommendations. Meanwhile the cost of administering the scheme rose from £8.9 million in 2022-23 to £29.2 million in 2025-26. It cost around £83 million across four years. By my reckoning, awards over the same period came to about £31 million. A scheme that spends more than twice as much on administration as on compensation is not working for taxpayers or the claimants.

My right hon. Friend the Member for Louth and Horncastle (Victoria Atkins) ordered a review of the scheme before the last election, and I wish it had concluded sooner. But this Government have now had more than two years. I concede that on this occasion, the Government kept their word and responded within six months, but a response delivered on time is not the same as a response that commits to anything and, as I say, there is still no timetable. As my right hon. and learned Friend the Member for Kenilworth and Southam (Sir Jeremy Wright) so eloquently put it, vaccine confidence matters. The best way to protect it is to show that when something goes wrong, the state stands behind the person. The vaccine programme was a success. Let us make sure that the system built around it is worthy of that success.

I have a number of questions to ask the Minister. First, will the Government set out a timetable for their review of the vaccine damage payment scheme and the reforms they intend to make? Secondly, which of the inquiry’s four minimum reforms will the Government commit to? Thirdly, will they look again at the 60% threshold, set performance targets for processing claims and bring administration costs under control? Fourthly, will they strengthen the yellow card scheme with funding commitments and a date for the health data framework? Fifthly, will the Minister meet with my right hon. Friend the Member for Tatton (Esther McVey), who has been seeking a meeting for a long time? Finally, will the Minister bring forward proposals before Second Reading of the Bill introduced by my hon. Friend the Member for Christchurch, which, as he mentioned, is scheduled on 15 January? My hon. Friend and I look forward to hearing the Minister’s response.

Prostate Cancer Screening

Gregory Stafford Excerpts

Monday 26th October 2026 Westminster Hall

[Gregory Stafford (Farnham and Bordon) (Con)]

It is a pleasure to serve under your chairmanship, Dr Murrison. I congratulate my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk (John Lamont) on securing the debate and speaking on behalf of the Petitions Committee. I thank all Members who have spoken powerfully and in a considered manner, whichever side of the argument they are on, and the 100,000-plus people who signed the petition, including the 198 from my constituency. My thoughts go out to all those in my constituency and across the country who are affected by this terrible illness.

In November 2024, I supported Cancer Testing South—run by one of my constituents—at a free screening event in Bordon. I took a PSA test myself. It was quick and simple, and it gave me peace of mind. It showed how important it is to make testing accessible and to reach men who might never otherwise consider it.

[Rebecca Smith]

Will my hon. Friend join me in congratulating Plymouth Argyle football club on its commitment to work with the Chestnut Appeal by running community diagnostic events annually before football matches?

[Gregory Stafford]

I thank my hon. Friend for the work of her constituents in that important area. I must also recognise the previous Government’s work, particularly that of my right hon. Friend the Member for Richmond and Northallerton (Rishi Sunak)—whose commitment has continued beyond his time in office, as we have seen today—and that of my noble Friend Lord Cameron of Chipping Norton and my right hon. Friend the Member for Braintree (Sir James Cleverly). With Prostate Cancer UK, we as the Conservative Government committed £42 million to launch Transform, the largest prostate cancer screening trial in the world.

I welcome some of what the current Government have done, but important questions remain about access to testing, identifying men at highest risk and how evidence will translate into policy. First, on PSA testing guidance, as raised by my hon. Friends the Members for Hinckley and Bosworth (Dr Evans) and for Huntingdon (Ben Obese-Jecty), the guidance setting out the right of men over 50 to request a PSA test was withdrawn earlier this year. The Government say that policy has not changed and attribute the concerns to “misinformed media coverage”, yet a written answer in September confirmed that no impact assessment was undertaken because there was

“no change in policy to assess.”

If the policy had not changed, why was the guidance withdrawn? And how was it established that the change had no impact without an assessment? On 21 October, the Government said that

“officials continue to work with NICE”,

which does not clarify whether the changes to the clinical knowledge summary were discussed. Prostate Cancer Research has asked the Department to confirm that higher-risk men can still access a PSA test once informed of its risks and benefits. As of 14 October, it has had no reply. Will the Minister confirm clearly that those men can access testing?

Secondly, on support for those at the highest risk, I of course respect the committee’s independence while it reviews the evidence, but the Government can take practical steps in the meantime. Prostate Cancer UK has called for GPs to inform black men and men with a family history of their elevated risk and to offer them a PSA test. What will the Government do to improve access for such men now, rather than leaving them to wait years for the wider review?

Thirdly, on identifying BRCA2 carriers, an estimated 13,000 men carry that variant, yet most have never been tested and do not know. The Telegraph reported that only about 1,500 men will be invited for testing next year. How will the programme reach the wider population whom it is meant to benefit? The committee’s consultation document stated:

“DHSC analysts are undertaking an exercise to estimate the cost of identifying new BRCA variant carriers.”

Has that work been completed? Will it be published? What will the Government do to identify men who carry the variant without knowing it?

Fourthly, on Transform and the NSC model, the committee will work with SCHARR—the Sheffield centre for health and related research—to update its modelling in the light of the trial’s findings, in particular for black men. It will also examine risk algorithms and biomarkers, including the Stockholm3 test, and whether family history can be more tightly defined. That work of course matters, but its impact depends on how quickly findings inform decisions and whether the public can see what is happening.

Will the Minister commit to publishing by January of next year a dated programme for updating the model, covering the biomarker review and family history work, and reporting to this House every six months? Will she set a named decision point for black men, tied to the results of Transform’s first stage so that reconsideration does not default to the next scheduled review in 2029? What evidence will trigger a change to that model, and will independent experts be given access to it on terms similar to those NICE offers for medicines so that the assumptions can be tested?

Finally, I have some questions about how the value of screening is judged. Since April, NICE has been able to approve a medicine for advanced prostate cancer at up to £35,000 per quality-adjusted life year—a threshold raised as part of the trade deal with the United States. The screening committee judged earlier detection against a figure of £20,000. Why does the NHS now appear to value treating late-stage prostate cancer more highly than preventing it? Will the committee’s forthcoming methods guide bring the two thresholds into line?

In conclusion, I recognise the committee’s concerns about the harms of population-wide PSA screening, including overdiagnosis and treatment, and the uncertainties in the evidence for black men.

[Nigel Huddleston (Droitwich and Evesham) (Con)]

We have heard several times today about the importance of making informed decisions, but we cannot make informed decisions unless we are properly informed in the first place. Therefore, while there are some valid concerns about risk, the most important duty we and the Government have is to do everything we can to raise awareness so that people can make important, informed decisions. That is our duty, and I commit to doing so on behalf of my 357 constituents who signed the petition.

--- Later in debate ---

[Gregory Stafford]

My hon. Friend is a great champion for his constituents, especially on this issue but on others as well. He is absolutely right that while the committee is making its evidential findings, there is nothing to stop the Government promoting a number of these ways to make sure that those at highest risk are getting treatment as soon as possible.

Cancer Research UK has highlighted the risks too. As my hon. Friend said, screening must be evidence-led, but Transform exists to address the limits of existing evidence, and improvements in testing and MRI-led pathways offer ways to improve how men are assessed, as many Members have mentioned. Uncertainty must not be the end; it must lead to research and progress, not delay.

The former shadow Health Secretary, my right hon. Friend the Member for Daventry (Stuart Andrew), set out the position of His Majesty’s Opposition last August. He said we would

“back the latest evidence and research to ensure patient care remains at the heart of testing guidance.”

That is clearly the right approach: act where the evidence supports it, accelerate research where questions remain, and be clear about when decisions will be made. Men must not be disadvantaged by circumstances beyond their control. One may have no family records because his father died young, for example; another may simply want to discuss his risk with his GP. As my right hon. Friend said, no man with potential prostate cancer symptoms should be denied a test because of poor family records.

To conclude, His Majesty’s loyal Opposition support targeted screening for men at highest risk, Transform and the committee’s evidence-led approach. But we need clear guidance from the Government on PSA testing, practical support for men at the highest risk, a credible plan to identify BRCA2 carriers and a dated timetable for the model, with independent scrutiny of it and transparency about how Transform will shape policy. I hope the Minister will address those questions directly now; if not, will she write to me and set out clearly what patients can expect next?

Oral Answers to Questions

Gregory Stafford Excerpts

Tuesday 20th October 2026 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

[Gregory Stafford (Farnham and Bordon) (Con)]

Step-down beds in community hospitals, such as the Chase community hospital and Haslemere hospital in my constituency, are vital. Unfortunately, neither of those two hospitals is being used for that purpose at the moment. At the same time, delayed discharges have hit an all-time high under this Government. More than 14,000 patients a day are stuck in hospital for two weeks or more after being declared fit to leave—that is up 12% since July last year. Behind every one of those numbers is someone who wants to be at home and an acute bed that another patient desperately needs. Why are the Government failing so abysmally at getting people out of hospital and into care at home?

[Karin Smyth]

As the hon. Gentleman knows, the situation deteriorated massively under the 14 years of Conservative government. He is well aware of the fragmentation of all our services. He knows how the system was fragmented and what happened under those reforms. He knows that is why we are trying to change it. He is absolutely right, though, that people being in beds in hospitals or in parts of the system where they should not be is not good for their health or their outcomes. That is why it is part of our three shifts, and that is fundamentally why the Prime Minister is very clear that we will raise social care up the agenda and ensure that people are treated more in their homes and in community services where they live. I welcome his support for our shift to neighbourhood care and to better care closer to home.

Smoke-free UK

Gregory Stafford Excerpts

Thursday 15th October 2026 Westminster Hall

[Gregory Stafford (Farnham and Bordon) (Con)]

It is a pleasure to serve under your chairmanship, Ms Vaz. I congratulate my hon. Friend the Member for Harrow East (Bob Blackman) and the hon. Member for City of Durham (Mary Kelly Foy) on securing this debate. I thank my hon. Friend for his tireless campaigning on this issue over many years.

Smoking remains the single largest preventable cause of cancer, and the prize for tackling it is enormous: fewer deaths, shorter waiting lists and a healthier country. We on the Opposition Benches will support action that works and will hold the Government to account on the delivery of it. As has been mentioned, common ground has been found on this subject throughout the House. I am glad to put on record my party’s appreciation and my thanks to the Government for carrying a Conservative Bill over the line when what was for most of us a rather unexpected general election interrupted progress.

Let me start with that record. The ambition for England to be smoke-free by 2030 was set under a Conservative Government in 2019. The Khan review, commissioned by a Conservative Health Secretary, called for investment in a Smokefree 2030 programme, a rising age of sale, vaping as a substitute for smoking, and stop smoking support at the heart of the NHS. In 2023, we committed an extra £70 million a year to local stop smoking services, more than doubling annual spend to £138 million. Swap to Stop gave almost one in five smokers in England a vape starter kit alongside behavioural support. We put stop smoking advisers in maternity units and introduced incentives for pregnant smokers to stop, and smoking at time of delivery is now at an all-time low. We also began targeted lung cancer screening.

Before the election, as I said, we published the Tobacco and Vapes Bill. I served on the Bill Committee alongside the hon. Members for Falkirk (Euan Stainbank) and for City of Durham, so we remember the cross-party consensus that there was for most of that Bill. The outcome was that anyone born on or after 1 January 2009 will never be legally allowed to buy tobacco. We are proud of that and want it to work, but a law on the statute book does not cut smoking rates by itself. What happens next is what counts, and I want to raise five points with the Minister.

The first is about the target. The Office for National Statistics tells us that 9.8% of adults, or about 4.9 million people, smoked in 2025. That was down from 10.6% the year before. Of course that is welcome, but smoke-free, in definition, means below 5%. On this trajectory, unfortunately, the 2030 target will be missed. I do not say that to point-score, but candour matters. Canada has set a target of under 5% by 2035, and Belgium and the Netherlands a target of under 5% by 2040, with interim targets and goals for young people. If the Government accept the Office for National Statistics figures and that the 2030 target will be missed, they should say so, set a new date and publish an outline plan. Cancer Research UK and ASH both want a new road map and tobacco control plan. Will the Minister commit to one, and when?

Secondly, on support to quit, ASH has warned that hospitals stop smoking services are being squeezed as ICB budgets are reduced. The Government promised opt-out cessation support in routine hospital care. So where is it? The national cancer plan lists implementing the Act as a key action and promises to fund stop smoking services, but it says very little on the delivery. A target without a funded service is an aspiration, not a policy.

That support must also reach the people who need it most. In the Tobacco and Vapes Bill Committee, I noted that manual and routine workers are 2.6 times more likely to smoke than managers. ASH now points to social housing, the economically inactive, people with no qualifications and those with poor mental health. How will the Government ensure that these gains are shared?

Thirdly, on enforcement and proportionality, Ministers are bringing in a ban on free samples from 29 October; a marketing and sponsorship ban from June of next year; wider standardised packaging, flavour and design rules; licensing; planning permission requirements for vape shops; and extended smoke-free places. All of that regulation lands on trading standards and councils. In the Bill Committee, my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson) asked trading standards witnesses whether they would have the resources. I warned that online and cross-border sales are the hardest to police. A rule that is not enforced is not really a rule. So what extra resources will trading standards receive, and when?

Rules must also be proportionate. The Government have taken wide powers to extend smoke-free places. The amendment my hon. Friend tabled to the Bill to limit them to places with a provable significant risk to public health was unfortunately rejected. In Committee, I asked the then Minister for a firm commitment on outdoor hospitality; unfortunately, essentially saying that it might not be the right time is not a decent response. Pubs and restaurants are under all sorts of pressures. Will the Minister therefore confirm that they are not in scope in terms of their outside seating?

Fourthly, on vaping, we have always backed vaping as a route out of smoking for adults, as the hon. Member for Newcastle upon Tyne East and Wallsend (Mary Glindon) said. In Committee, I said that what worries me most for our children is vapes. However, the Government can hold both positions at once, and the disposable vape ban, in force since June last year, was a step towards that. ASH suggests that disposable use has fallen significantly, which is encouraging. Yet, Ministers have said little about what they have found from that.

As the Government review planning rules and business rates for vape shops, protecting children must be foremost. For example, on flavours, I urge the Minister to look hard at restricting the names that appeal to children—we talked about unicorn milk and the like endlessly in Committee—before removing options that help adults quit. I would also ask the Minister to revisit the case made by my hon. Friend the Member for South Northamptonshire (Sarah Bool) for exempting mental health settings from the vape vending machines ban.

Finally, on lung health, respiratory disease is the third most common cause of death in the UK, yet there is no modern service framework for it. My hon. Friend the Member for Sleaford and North Hykeham tabled an amendment to the Health Bill requiring one within 18 months. Unfortunately, Government Ministers rejected it. Asthma + Lung UK has called for exactly that kind of mission for lung health. The Government have also committed to a full roll-out of lung cancer screening by 2030—a programme that the Conservative party started. Is it on track and is it funded?

I want to close by paying tribute to a constituent, Yolanda, a volunteer for Cancer Research UK in my community, who has given her time to raise awareness of these issues. She lost her husband, and I put on record my condolences and my thanks. It is people like her working across our constituencies who remind us why the delivery of this is so important and why it matters.

Will the Minister publish a new target and plan? Will she fund hospital stop smoking services and deliver opt-out support? Will she resource trading standards, rule out the hospitality element, report on the disposal vapes ban and reconsider a framework for respiratory disease? We all want this Act to succeed and I will support her in any way I can to deliver it.

Youth Suicide Prevention and Mental Health Support

Gregory Stafford Excerpts

Tuesday 13th October 2026 Westminster Hall

[Gregory Stafford (Farnham and Bordon) (Con)]

It is a pleasure to serve under your chairmanship, Mr Wishart. I thank the hon. Member for Blaydon and Consett (Liz Twist) for securing this debate and for the courage and dignity with which she, and indeed all hon. Members, have spoken.

We know that record numbers of young people in England are asking for help, and too many of them are waiting months, if not years, to receive it. In March, nearly a million under-18s had an active referral. We need to do better. Like so many hon. Members, I pay tribute to the families who have turned their grief into action. My hon. Friend the Member for Epping Forest (Dr Hudson) mentioned 3 Dads Walking and the £1.5 million they raised after losing their daughters. I also think of organisations such as Samaritans and YoungMinds, and many other national and local charities. I pay tribute to bereaved families in my constituency, some of whom I have worked closely with.

That brings me to Papyrus. Last month, it entered into administration, its HopeLine 24/7 went silent and 120 jobs were lost. A young person in crisis tonight cannot call the line that was built for them. The administrators cited rising demand, higher costs and falling reliable funding, and the Samaritans and Shout have warned of further pressure on charities working in an “extremely challenging financial environment”. The suicide prevention grant fund, which was launched under the previous Government, gave £10 million to 79 organisations between 2023 and 2025. Papyrus was shortlisted for £625,000 from that, and in the previous round it received over £150,000 for HopeLine 24/7.

The Government chose not to renew that fund, and said they had no plans for another—I know of no replacement of comparable scale. I suspect that the Minister may point to money for suicide prevention pathfinders in the men’s health strategy, but that is much less than the fund provided, and it is not a helpline. Then there are the costs: since April 2025, charities have faced additional burdens, including increases through employer national insurance contributions. The Government cannot withdraw funds and raise costs, and then express surprise when charities struggle. Colleagues from across the House have previously asked whether the Government would consider if their own evaluation of the fund found that it had worked. I ask the Minister: did that evaluation take place, and what was its outcome?

The previous Conservative Government had a record to be proud of: the first Suicide Prevention Minister, the first cross-Government plan in 2019, the five-year strategy, the national suicide surveillance system in 2023 and the Online Safety Act 2023, which requires companies to remove illegal content that encourages suicide and made encouraging self-harm a criminal offence. On 8 September, Ministers reaffirmed the Government’s commitment to a strategy. The call for evidence on the wider mental health strategy closed in July, but we are waiting for an outcome from the Government.

Given the time, I will close closer to home. Following the death of a man in Farnham in 2022, my constituent, Mr Clarke Senior, who served in Bosnia, Northern Ireland, the Gulf and Kosovo and lives with disabilities sustained in the line of duty, got involved with the veterans’ charity Legend on the Bench. In December, I will be attending the unveiling of three suicide prevention benches across Farnham, sponsored by the University for the Creative Arts and the Waverley borough and Farnham town councils, with more to follow in Bordon and Haslemere.

I say to the Minister that the good will of a community and a bench cannot replace a trained and manned help line, so I have four questions for her. First, will the Government restore a dedicated, 24-hour youth suicide helpline? Secondly, will they review their decision to close the suicide prevention grant fund, publish their evaluation and move from 12-month to multi-year funding? Thirdly, what assessment has been made of the impact of higher national insurance contributions on the sustainability of youth suicide prevention charities? Fourthly, what progress have the Government made on the suicide prevention strategy, will they renew it when it expires in 2028, and will the Minister give firm dates for the mental health strategy?

I know that many people watching this debate will be affected by this, and if anyone needs more help, the Samaritans are still available on 116 123. A young person in crisis tonight needs a line to call, and that is what Papyrus gave them. We on this side of the House will continue to support any efforts to improve support and to challenge policies where they fall short.

Pharmacies: Government Funding

Gregory Stafford Excerpts

Wednesday 9th September 2026 Westminster Hall

[Gregory Stafford (Farnham and Bordon) (Con)]

It is a privilege to serve under your chairmanship, Mr Betts. I welcome the Minister for Public Health and Patient Safety, the right hon. Member for Kingston upon Hull North and Cottingham (Dame Diana Johnson), to her new role and congratulate her on her appointment.

I also congratulate my hon. Friend the Member for Leicester East (Shivani Raja) on securing this most important debate. She spoke very powerfully about the pressures facing community pharmacies and I want to build on her speech by discussing what is happening both in my constituency and nationally.

In Farnham and Bordon, we have access to 15 community pharmacies, which collectively dispense around 142,000 prescriptions every month and deliver around 6,500 flu vaccinations. The Government’s 10-year plan wants more healthcare to be delivered in the community, which is an aim that I think we all support. At the same time, however, the Government appear to be making it harder for those very pharmacies to deliver such care and to remain sustainable.

The reality is that community pharmacies are being asked to do more while facing rising costs. We have seen higher national insurance contributions, increases in the national minimum wage, rising business rates and persistent inflationary pressures. At the same time, pharmacies are dealing with medicine shortages, higher procurement costs and disruption to international supply chains. The financial picture is impossible to ignore. Funding for community pharmacies in 2025-26 was actually £800 million less in real terms than it was in 2015-16. In the last year alone, the number of NHS-prescribed items dispensed by pharmacies and the service volumes increased by 2.3% and 17% respectively.

As the hon. Member for North Somerset (Sadik Al-Hassan) has already highlighted—he was echoed by a number of Members around the Chamber today—the Government’s own independent economic analysis in March 2025 identified a funding gap for pharmacies of £2 billion a year, and trade bodies that have spoken to me identify a structural funding problem. Of course, we on this side of the House welcome additional funding, but pharmacy is not made sustainable by giving with one hand and taking with the other. We need to ensure the long-term viability of community pharmacy and I am very sceptical that the Government’s approach will achieve that.

I turn now to Pharmacy First, which is an excellent example of what can be achieved when we make better use of the skills and expertise available within our NHS. My right hon. Friend the Member for Richmond and Northallerton (Rishi Sunak) is absolutely right to be proud of his Government’s record on this matter. Created and implemented by the last Government, Pharmacy First shows what NHS reform should look like—the right professional, with the right responsibility, delivering the right care in the right place. It should be a game changer and I pay tribute to my right hon. Friend for its introduction.

Pharmacy First recognises that patients with seven common conditions can be safely assessed and treated by qualified pharmacists without there always being a requirement for a GP appointment. However, the scheme is currently limited and not as expansive as it is in Scotland, where it covers up to 30 common conditions. I would like the Government to move rapidly to expand Pharmacy First elsewhere. We should be ambitious about the skills and clinical expertise of our pharmacists.

[Shockat Adam]

Does the hon. Member agree that another opportunity for Pharmacy First—indeed, a generational opportunity—is independent prescribing? That would really unlock the potential of pharmacies and help patients, but it requires both a vision and adequate funding.

[Gregory Stafford]

I entirely agree with the hon. Gentleman. I think that we can use pharmacists and pharmacies much more creatively and in a manner that would in no way put patient safety at risk. In fact, it would allow patients more choice, and free up GPs and other health professionals to do other parts of their job, so he is right.

Community Pharmacy England’s 2026 pharmacy pressures survey makes the scale of the challenge facing pharmacies clear. Drawing on responses from nearly 4,000 pharmacy owners and staff members, it found that 75% of pharmacies are currently losing money, while only 14% reported being profitable. There is little value in providing additional funding for services without recognising the wider cost and workforce pressures facing the sector: 30% of pharmacies have reduced their opening hours and 76% report an impact on patient care, including longer waits and delays in accessing medicine.

That brings me—briefly—to the issue of business rates and the wider cumulative costs facing pharmacies. A pharmacy might occupy a storefront on a high street, but it is not simply another retailer; it is part of the national health service and is an essential provision in our community. As the hon. Member for Strangford (Jim Shannon) outlined, pharmacies are also part of our national resilience. The Government want pharmacies to take on more responsibility, but they face rising costs that have been caused by the Government.

Pharmacies need to be properly considered within the system and not treated simply as another high street retailer. The same issue applies when we consider national insurance increases, and indeed the national living wage. These cumulative increases are having a real impact. Unlike a high street retailer, a pharmacy has contractual obligations to the NHS and a moral responsibility to its patients, so it cannot just increase prices or stop providing a service like other businesses could. As my hon. Friend the Member for South West Hertfordshire (Mr Mohindra) rightly put it, the Government have to recognise the cumulative impact of these terrible decisions when considering future policy.

[Jim Shannon]

I want to underline a point I made in my speech: some of my community pharmacists back home are using their own money to subsidise their pharmacy and keep the business going—because of their compassion, their understanding and their concern for their customers and patients.

[Gregory Stafford]

The hon. Gentleman is entirely right, and his point goes to the heart of the debate. Pharmacies are businesses that must make a profit, and pharmacists must pay their staff and make sure that they can feed their own families, but they are also public servants. They are people who have decided to work in our national health service to provide for our patients, and the Government should recognise that.

The hon. Member for Leicester South (Shockat Adam) mentioned independent prescribing. If properly supported, it will give patients quicker access to treatment, but it brings greater clinical responsibility, greater governance requirements and greater pressure on pharmacists’ time. Given the limited capacity that we have already talked about, I want to ask the Minister three questions on independent prescribing. Does she believe the sector is ready? Does it have the workforce and the capacity to do it? What additional funding and support will be provided? We also need clarity on the timetable. Pharmacists have trained to prescribe, and they should be able to use that skill.

That brings me to the pharmacy workforce, because none of these reforms—independent prescribing, Pharmacy First or any other idea—will work without a sufficiently large and properly supported workforce. We have heard from right hon. and hon. Members about recruitment and retention pressures, including concerns about the number of full-time equivalent pharmacists. At the same time, the demands placed on existing staff are increasing. We cannot continue to add responsibilities to community pharmacy without considering whether there are enough people to deliver them safely and effectively.

The previous Conservative Government’s NHS long-term workforce plan included an ambition to increase pharmacist training places by 29%, taking them to around 4,300 by ’28-29. That ambition will clearly not be met under this Government, and we are still waiting for the long-promised NHS workforce plan. Despite my asking the then Secretary of State for Health, the right hon. Member for Ealing North (James Murray), in July when the plan was coming out, we still have no answer.

Finally, I will move on to medicines supply. Pharmacies are facing global supply chain disruption and rising medicine costs, with repeated price concessions adding further pressures. They cannot absorb these pressures indefinitely, so what are the Government doing to mitigate the impact of geopolitical disruption on medicine supply and prices, and what assessment has the Department made of the financial burden that these pressures are putting on community pharmacies? They are being felt by pharmacies across my constituency, including Vaughan James and Lalys in Farnham, Chase and Headley pharmacies and Day Lewis in Haslemere, and Grayshott pharmacy, all of which have contacted me about the issues that I have raised.

In conclusion, community pharmacy has a crucial role to play in the future of our NHS. We all want to see care delivered closer to people’s homes. Pharmacy First has shown what can happen when we give pharmacists greater responsibility and trust them to use their expertise, but ambition needs to be matched by capacity. The Government cannot say that community pharmacies are central to the future of neighbourhood healthcare while making it harder for those pharmacies to remain financially sustainable. I urge the Government to recognise the cumulative impacts of their policies on businesses, to look again at the treatment of business rates for community pharmacies, to ensure independent prescribing is properly supported, to protect the supply of medicines, and to provide clarity on when the NHS workforce plan will be published.

The fact is, we cannot ask pharmacies to take on more responsibility and deliver more NHS care while simultaneously making it harder for them to survive. The Conservative party believes that community pharmacy is absolutely central to the future of the NHS. If the Government agree, they must make sure that pharmacies have a future, too.

[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.

Health Bill (Sixteenth sitting)

Gregory Stafford Excerpts

Committee stage
Thursday 16th July 2026 Public Bill Committees

[Dr Johnson]

Not necessarily, no, but this one does, because the Government clearly made a promise before the election. The former Secretary of State was clear that it would be one of his first acts—that is what he said—and it has not happened, so in this case we need to hold the Government to account. It is our job to hold them to account on their promises, and I am afraid that they are failing on this one.

To sum up, the Government need to get their act together, because otherwise more and more vulnerable people will come to unnecessary and potentially fatal harm. I look forward to hearing the Minister’s plans to accelerate the delivery of the Government’s promise—and fast.

[Gregory Stafford (Farnham and Bordon) (Con)]

It is a pleasure to serve under your chairmanship, Dr Huq. I welcome the Minister back from her son’s graduation —I hope it went well.

I rise to state my support for new clause 47, which would require the Secretary of State to publish a clear roll-out plan for fracture liaison services across England and report annually to Parliament on progress towards universal coverage by 2030. It is not about creating a new target, because the target already exists: both this Government and the previous Government committed to achieving 100% fracture liaison service coverage by 2030. The question before us, as proposed by the shadow Minister, is simple: how will that promise be delivered, and how will Parliament know whether meaningful progress is being made?

Fracture liaison services are one of the most evidence-based interventions in osteoporosis care. They systematically identify people aged over 50 who suffer a fragility fracture; assess their bone health; initiate treatment where appropriate; and monitor patients to reduce the risk of subsequent fractures. Given that around half of patients who sustain a hip fracture have previously broken another bone, those services represent a vital opportunity to intervene before a life-changing injury occurs. The human cost is considerable. Osteoporosis affects millions of people, particularly older women, and fragility fractures can result in a loss of independence, reduced mobility, social isolation and significant pressure on health and social care services. The National Institute for Health and Care Excellence estimates that around 180,000 fractures each year in England and Wales are attributable to osteoporosis.

There is also a compelling economic case: the Royal Osteoporosis Society estimates that investing around £30 million in fracture liaison services could prevent approximately 74,000 fractures over five years, including 31,000 hip fractures, saving the NHS around £665 million and freeing up some 750,000 bed days. Few preventive interventions offer that combination of better patient outcomes and substantial savings for the NHS.

The Government frequently point to their commitment to universal coverage by 2030, but as the shadow Minister pointed out, progress has been achingly slow. When the Secretary of State appeared before the Health and Social Care Committee last week, I questioned him on that issue directly. While he confirmed that the Department remains committed to meeting that 2030 target, which was first established by the previous Conservative Government, no plan—or indication of when a plan would come—was given. A commitment alone is not a delivery plan.

There are also growing concerns that the Government have overstated the progress that has already been made. The Royal Osteoporosis Society has confirmed that more than 97% of the fracture liaison services counted by the current Government were already in place before the change of Government. So, rather than that representing any significant expansion in national coverage, this Government have gone slow. I think it is therefore very reasonable—to answer the question from the hon. Member for Bury St Edmunds and Stowmarket—for Parliament to be entitled to ask what additional progress has actually been made since the commitment was reaffirmed.

New clause 47 would also require the Secretary of State to publish an assessment of access in every integrated care board area. It would also require annual milestones, because, at present, there is no publicly available timetable showing where the services will be established, or which areas will be prioritised or progressed between now and 2030.

Crucially, the new clause would require the Government to set out how integrated care boards will actually be supported. Ministers rightly point out that fracture liaison services are commissioned locally by integrated care boards, but if the responsibility for delivery rests locally while responsibility for national targets rests with central Government, there clearly needs to be a well-thought-through national framework explaining how those boards will be supported through funding, guidance, workforce planning and accountability.

This is, therefore, a straightforward request for transparency, accountability and, most importantly, delivery. If Ministers are committed to achieving this by 2030, they should have absolutely no objection to publishing a plan that shows how they intend to get there. For those reasons, I support the new clause.

[Karin Smyth]

I will partly agree with the Opposition to start off with: they are absolutely right that osteoporosis is a really important issue, particularly for older women. The hon. Member for Farnham and Bordon outlined some of the economic case, but crucially, it is a strong health issue. I worked and campaigned on this issue in opposition myself, because it predominantly affects older women. It also very much fits into our 10-year health plan regarding prevention. That is why we have also, for example, increased access to DEXA—dual-energy X-ray absorptiometry—scanners.

It is rather disappointing, though, for a subject on which there is obviously so much agreement to be used as a political back-and-forth here today. Let me be clear. I think some of the comments show why some of this has got a bit confused, including for people who genuinely care about this rather than just wanting to make it a political issue. Again, it is entirely the Opposition’s job to oppose the Government, and I do not have any problem with that, but there is a serious issue here about how this is monitored.

We are absolutely committed to having coverage across the country by 2030, as the Secretary of State has recently said. That is why we are rolling out more DEXA scanners and so on, but with the clustering of ICBs, 92% of the country is now covered across those clusters.

Health Bill (Seventeenth sitting)

Gregory Stafford Excerpts

Committee stage
Thursday 16th July 2026 Public Bill Committees

[Gregory Stafford (Farnham and Bordon) (Con)]

It is a pleasure to serve under your chairmanship, Ms Lewell. I had written a 25-page speech for this debate, but to the disappointment of my researcher—and probably the delight of this Committee—I do not intend to read out all 25 pages. [Interruption.] There are cries of “Shame!” from my own side, but I accept that there are a number of amendments and new clauses to get through. My stated objection to the puberty blocker trial is also well known and on the record, so I do not wish to detain the Committee for too long.

I want to pick out five areas where I think there are problems. They are why I support new clause 66, tabled by my hon. Friend the Member for Sleaford and North Hykeham. My first point can be summarised as: “Don’t repeat a mistake to find out whether it was a mistake.” Thousands of children have already received puberty blockers through the former Tavistock pathway, and my view is that, before exposing a whole new cohort, the Government should complete the long-promised data linkage study to establish what happened to those children. That is probably the core argument.

Secondly, if the Government rightly say that the drugs present an unacceptable safety risk, how can it be ethical to give them to children in a trial? It must still be an unacceptable safety risk, whether it is for the general population of those who wish for it or for the people in the trial. The Government banned routine prescribing because of the safety concerns, yet propose administering the same medicines in a research setting. That is a complete contradiction of the ban.

Thirdly, clinical equipoise does not exist in the evidence if the evidence already points to significant risk and uncertain benefit. The Cass review concluded that the evidence base for puberty blockers is weak and that concerns remain over bone health, fertility and neurodevelopment. A trial should not proceed unless there is genuine uncertainty that justifies exposing children to those risks.

Fourthly, children should not bear the burden of answering questions that the NHS should have answered itself. The failure to collect the robust, long-term evidence from previous patients, including through the data linkage trial, should not be remedied by recruiting another generation of vulnerable children. Ethical research requires exhausting the existing evidence first. Finally, even the medicines regulator—the MHRA—had sufficient concerns to halt the trial. The MHRA intervened to pause the pathways trial over safety and wellbeing concerns, reinforcing the idea that the scientific and ethical questions remain unresolved. A pause should lead to a complete reassessment, not simply restarting as soon as possible.

[Dr Johnson]

Does it concern my hon. Friend that the person who raised the concerns about the trial then recused himself from further involvement in it?

[Gregory Stafford]

It did. If memory serves, that question was raised—although I cannot say more because it was in private. I do have concerns that the professor who was in charge and raised those concerns at the MHRA was recused. I cannot discuss the details of that, but it could show that there was a bias in the selection of the people who were pushing the trial forward. I am not saying that there was bias, but I think that, on an issue of such importance, the perception of bias is almost as bad. We need to be very careful about that.

Either way, I think the trial is wrong for the five reasons I have outlined. The key reason is the moral and ethical issue, and my hon. Friend the Member for Isle of Wight East raised it in both the Health and Social Care Committee and the Chamber: it is clearly morally wrong to experiment on children just for the sake of experimenting. The fact that there is no evidence does not mean that we should put children through a trial to see whether the evidence exists.

--- Later in debate ---

[Gregory Stafford]

Unlike that of the hon. Member for Guildford, my constituency covers both Surrey and East Hampshire, so I welcome the focus that new clause 72 places on our local area. Constituents regularly raise with me their concerns about seeing an NHS dentist. As I have announced a number of times in this Committee—although I have not checked today, so may not be true any more—there is not a single dentist in my constituency taking on adult or child NHS patients at the moment.

For many people, the challenge is not simply one of convenience; it is about being able to access timely care when they need it. Good oral health is an essential part of overall health, and we cannot allow dentistry to become an afterthought in our healthcare system. The ability see a dentist for routine check-ups, preventive care and urgent treatment helps to reduce pressure elsewhere in the NHS by dealing with problems before they become more serious.

The new clause rightly highlights the need both for urgent appointments and for improved access to routine NHS dental care. Prevention is at the heart of a sustainable healthcare system, and regular access to dental services plays an important role in achieving that. I welcome the accountability that the new clause seeks to introduce. In places where there are persistent challenges in accessing services—so-called dental deserts—local communities deserve transparency about what action is being taken and why improvements have not yet been delivered. As I have mentioned before, the spanking new dental surgery in Haslemere hospital has sat entirely unused since it was built, and, as far as I am aware, there are no plans to use it. That seems like a shocking waste of money and, more importantly, a shocking waste of a dental surgery that could be treating patients in Haslemere and the wider area.

The hon. Member for North Shropshire always wants to place the blame with the Conservatives, and does not seem to feel the need to challenge the Government, but I gently remind her that there was a Liberal Democrat Minister in the Department of Health and Social Care for five years, and apparently they did absolutely nothing to raise this issue.

Although this issue is particularly important for Surrey and East Hampshire, it reflects a wider challenge facing communities across the country. Residents should not have to struggle to find an NHS dentist, and ensuring that provision is adequate must remain a priority. I hope the Government take that on board.

[Karin Smyth]

Welcome to another rerun of the 2010s —happier times for the Opposition. Sometimes they do not remember what happened, and I have to remind them—and every now and then, they remind us. This is a really important issue, not only for the hon. Member for Guildford, who tabled new clause 72, and the hon. Member for North Shropshire, who moved it, but for all our constituencies. It has been a huge priority for this Government.

The Secretary of State will continue to have a duty to promote a comprehensive health service in England. In addition, clause 4 provides for an amended duty for the Secretary of State to reduce inequalities in access to services across England. However, we also recognise that practical action is needed to secure access to urgent and routine NHS dentistry care. As the Committee has discussed, that is why the Government have prioritised a number of improvements over the past two years.

Last year, ICBs commissioned additional urgent dental care appointments, and there is now an urgent care safety net across the country. In April 2026, we introduced a requirement for NHS dental practices across England to deliver a set proportion of their contract as urgent care. Supported by increased payments for dentists delivering that care, that made it easier for patients to get prompt support through the NHS. We are committed to reforming the NHS dental contract by the end of this Parliament—something that could have been done at any point in the past 14 years. As a first step, the package of reforms we introduced earlier this year will address some of the pressing issues that dentists and dental teams have been experiencing. Those reforms will help to prioritise those with the greatest need, supporting a shift away from clinically unnecessary check-ups.

The Government are already making progress on improving access to NHS dentistry across England, including in Surrey and East Hampshire. I hope that hon. Members can see how legislating for one area in particular conflicts with the Secretary of State’s duties to promote a comprehensive health service for England as a whole, and risks creating health inequalities in other regions. For that reason, I ask that the hon. Member for North Shropshire withdraw the new clause.

--- Later in debate ---

[Dr Johnson]

If the hon. Gentleman reads new clauses 81 and 82 together, he will see that one of them would require doctors not to go on strike, because they are involved in the clinical decision making across the piece, while the other would make provision for staff across the NHS to be on minimum service level provision. That is something that I maintained under the previous Government as well: I do not think that doctors should go on strike, in the same way that the police and the military do not go on strike.

Medical professionals are key to the functioning of a hospital in a way that means they should not go on strike. Other staff within the hospital provide an extremely valuable and important service, but often several individuals provide that service, so it might be possible to say, “We can have three here rather than five today and still deliver most of the service.” Fundamentally, I do not think that it is morally right for doctors to go on strike, because in effect they are saying to people, “We know you’ve been waiting for your knee replacement for a year and we know your knee hurts, but we’re not going to do your knee replacement today, because we’re going to go on strike for more cash.” I just do not think that that is right. [Interruption.] I will take an intervention from my hon. Friend the Member for Farnham and Bordon.

[Gregory Stafford]

My hon. Friend has just sat down. I was not sure whether she had finished her speech or was willing to take an intervention.

[Dr Johnson]

I will take an intervention.

[Gregory Stafford]

Well—I just say carry on, that’s what I say!

[Dr Prinsley]

Will the hon. Lady take another intervention, Ms Lewell?

--- Later in debate ---

[Dr Johnson]

For generations, it has not needed to be the law: doctors did not go on strike, because they recognised what would happen to patients if they did. Now that we know that doctors will go on strike, the landscape has changed. Consultants—I should say that I am an NHS consultant—have just balloted to go on strike, which will be fundamentally unsafe. The Government have a duty to keep people safe; first and foremost, that is the Government’s job. Doctors going on strike is fundamentally unsafe and should not happen. I agree with the hon. Member for Bury St Edmunds and Stowmarket that morally it should not need to be the law, but I think the evidence suggests that it does.

New clause 82 would make it

“an offence for medical practitioners to undertake strike action”,

and would provide for the Secretary of State to repeal any necessary clauses of other employment regulations in order to do so. New clause 81 concerns the minimum service levels provided across the NHS. There are staff who provide an important and valuable service but whose jobs may not be clinical; for example, services may be able to run with slightly fewer porters if they want to go on strike.

I hope that no member of NHS staff would want to go on strike. I hope they would want to make sure that patients were getting care, and I hope they would recognise that, in a universal service, they are essentially causing harm to the patients around them, who are their friends, their neighbours, the people who live on their street and the people who would look after them. However, the evidence suggests that that is happening, so I am afraid that these new clauses are necessary. We need to put a minimum number of staff in place to support the doctors, and doctors should be at work to make sure that patients are safe.

[Gregory Stafford]

Hopefully, this is a pleasure postponed. I rise to support new clauses 81 and 82, tabled by my hon. Friend the Member for Sleaford and North Hykeham. As legislators, we have a moral duty to ensure that patients are protected during times of disruption in the NHS. Nobody disputes the fact that NHS staff work incredibly hard. They absolutely do. The dedication shown by doctors, nurses, paramedics, midwives and all those who keep our health service running deserves enormous respect. Having worked in healthcare for pretty much all my career, including for professional organisations such as the Royal College of Occupational Therapists, I know at first hand how hard they work.

Equally, we need to recognise that the NHS is not an ordinary service. Working for it is not like being a shop assistant, a bin collector or a tax inspector; in its importance to the health and safety of this nation, it is more akin to being a police officer or a member of our armed forces. It is an essential public service. When people are at their most vulnerable, whether that is because they are waiting for an operation, procedure or intervention or because they are in the process of having those interventions, they must have confidence that the care they rely on will still be there.

The right to strike has to come with responsibilities. In the NHS, the consequences of industrial action are real: cancelled operations, delayed treatments, missed appointments and increased pressure on emergency services. When I raised some of these issues with Sir Jim Mackey when he appeared before the Health and Social Care Committee, he could not tell me, hand on heart, that people have not died because of these strikes. I suspect that they probably have. For patients awaiting cancer treatment, for someone requiring urgent surgery or for families relying on maternity services, the impact can be deeply serious and potentially even deadly.

There is a moral obligation, both on NHS doctors and on us as legislators, to ensure that we have a universal, 24-hour, seven-day-a-week service that is free at the point of use that patients can and should expect to rely on. I therefore support new clause 81’s minimum service requirements and new clause 2’s the removal of clinicians’ ability to strike. We must ensure that our NHS staff are supported, protected, paid appropriately and given the resources they need to do their job, but the corollary is that they should remain on the job to serve our constituents.

[Karin Smyth]

There have been interesting discussions on these new clauses. I recognise that the intention behind them is to reduce the impact on patients and NHS budgets when doctors take industrial action. That is an objective that we all support, but I do not agree that the new clauses are the best way to achieve it.

I respect the shadow Minister’s professional background and the strong moral case she set out to explain why she does not feel it is appropriate. For a long time, as she says, doctors did not go on strike, but something changed in the industrial relations landscape roughly 10 years ago to start that process, that change of culture and that frustration that led doctors to strike. I listened with interest to the former Health and Social Care Secretary, the right hon. Member for Godalming and Ash (Sir Jeremy Hunt), reflecting on this issue recently—we’re all subject to podcasts these days, aren’t we? He spoke about those relationships at the time, and I think we should learn from that; it is very helpful to have those recollections. But something changed, and this has been the result.

I pay tribute to my hon. Friend the Member for Bury St Edmunds and Stowmarket and many others of his vintage, if I can say that—

--- Later in debate ---

[Dr Johnson]

The Minister will remember the evidence given earlier in Committee by my right hon. Friend the Member for Godalming and Ash, in our first sitting. As our longest-serving Health Secretary, my right hon. Friend focused much of his tenure on patient safety, and yet, as he made clear:

“We are the world champion at doing inquiries and reports. Unfortunately we are also the world champion at allowing those reports to gather dust without anything actually happening.”—[Official Report, Health Public Bill Committee, 16 June 2026; c. 30, Q52.]

One clear example of that so far is the Hughes report. Twenty-nine months ago, Professor Henrietta Hughes published a report outlining redress for thousands of victims of the pelvic mesh and sodium valproate scandal. Time and time again, I and other hon. and right hon. Members have asked this Government when they plan to respond. Every time, the answer is, “Soon”, “At the earliest opportunity”, or, “We’re working on it”, but warm words are not enough to secure patient safety. Can the Minister confirm when she intends to publish the Government response to the Hughes report?

Many patient safety recommendations prompt questions about the effectiveness of the Care Quality Commission, the national care regulator. The former Health Secretary claimed that it was not fit for purpose, and yet the Government have decided to bring HSSIB—Health Services Safety Investigations Body—within the CQC, as well as to add other measures, including events management. We need urgent steps taken to revive the CQC to ensure that it is fit for purpose to uphold patient safety.

I will keep my remarks brief, because we have a lot to get through, but the Government need to respond to the Hughes report. Too many people, predominantly women, but men also, are waiting for the answers. They want to know what the Government are going to do. This Government have been in office for more than two years, with the report published shortly before that. Those people need an answer. In future, new clause 85 would mean that that delay cannot happen again, because the Government would have to respond to any future reports on patient safety issues within a set timeframe of six months, to ensure that we cannot have situations where people are waiting far too long for the answers that they need and deserve.

[Gregory Stafford]

I declare that I am a member of the all-party parliamentary group on patient safety. Patient safety cannot be something that is discussed only after a tragedy has occurred. It requires a culture of accountability, transparency, and most importantly, action. That is why the new clause is such a sensible and important amendment to the Bill. It would not dictate the outcome of every review or every recommendation, but it would require the Government to respond properly. The new clause would create a straightforward expectation that when experts have identified changes that could improve patient safety, Ministers cannot simply leave those recommendations unanswered. The new clause pushes that forward, as recommended by my right hon. Friend the Member for Godalming and Ash. There must be a clear process and a clear timeline.

Such a process and principle are closely connected with new clause 98 and the Government response to the Hughes report on those harmed by sodium valproate and pelvic mesh. Those are deeply serious issues involving people who have suffered life-changing consequences and have spent years seeking recognition and redress. Last week, I think, at the Health and Social Care Committee, I questioned the current Secretary of State on this matter, and his answer was equivocating, dissembling and, I am afraid to say, frankly unacceptable to those patients who have suffered from both those. He could not even tell me whether the response would be published by the end of the recess—we probably have two hours until recess, so unless the Minister is going to tell me otherwise, I suspect it is not coming before the recess.

It seems shocking—perhaps even a slap in the face to those victims—that the Secretary of State could not even give an answer on that issue. However, they received some positive news on Tuesday evening, when the right hon. Member for Makerfield (Andy Burnham)—presumably the incoming Prime Minister—raised this issue in the House during the debate on the remaining stages of the Public Office (Accountability) Bill. I hope the Minister has had the chance to speak to the right hon. Member—unlike the rest of us—so that she understands his priorities and when redress is coming. If her new boss has given his stamp of approval, Labour MPs on the Committee should have no problem supporting these Opposition new clauses.

--- Later in debate ---

[Helen Morgan]

Amendment 77 is a probing amendment in the light of our previous discussions in Committee about the extensive powers that the Bill transfers to the Secretary of State. It would make all secondary legislation under the Bill subject to the affirmative procedure. I do not intend to press it to a vote, but I hope that the Minister will take into account the concerns that we have raised during these proceedings about the sweeping powers that the Secretary of State is taking on board.

[Gregory Stafford]

I heard the Liberal Democrat spokesperson say that she will not press the amendment, but I would be sorely tempted to vote for it if she did so. This important amendment sums up a number of our concerns about the Bill, and the commencement amendments to follow are also appropriate.

As the hon. Member will not press her amendment, however, I will not speak for long, save to say that I have enjoyed the past few weeks on this Committee. I hope that the Minister is still in place when we return in September. If she is not, I wish her very well and thank her for all her hard work, not just in this Committee, but in her role over the past two years.

[Karin Smyth]

I will respond to the hon. Gentleman in a moment, but first I will address clauses 68 to 72, as well as amendment 77, which was tabled by the hon. Member for North Shropshire.

Clause 68 will allow the Secretary of State, by regulations, to make provision that is consequential on this Bill. Amendment 77 would amend that provision. The Government recognise the importance of parliamentary scrutiny of the significant changes proposed in the Bill. While the Bill contains some new regulation-making powers, the majority are existing powers that have been amended in the light of the abolition of NHS England. They will therefore be uncontroversial and consequential, so we consider it proportionate for the same parliamentary scrutiny arrangements to continue to apply in respect of those powers.

However, where we are introducing new regulation-making powers, we have carefully considered what parliamentary scrutiny arrangements should apply. For example, any regulations that are made to facilitate the single patient record will be subject to the affirmative procedure, because we understand the importance of debating that issue in both Houses. Furthermore, any statutory instruments made under clause 68 that amend, repeal or revoke provisions made by primary legislation will be subject to the affirmative procedure and will need to be debated and passed by both Houses. I hope that the hon. Member for North Shropshire agrees that a blanket requirement for the affirmative procedure would be disproportionate. She said that she will not press amendment 77 to a vote, but I hope that what I have said provides her with the reassurance she was seeking.

Clause 69 is a standard clause that appears in Bills that provide for the expenditure of public money. It simply provides for any expenditure incurred by the Secretary of State as a result of changes made under the Act, once it has received Royal Assent, to be paid out of money provided by Parliament.

Clause 70 sets out the territorial extent of the Bill. While most of its provisions extend only to England and Wales, some are UK-wide. The clauses in the Bill largely apply to England only, and in previous sittings we debated the consequences for Wales, Scotland and Northern Ireland, and any issues relating to devolution, as and when they have arisen. Amendments to other legislation made by this Bill will have the same territorial extent as the legislation that will have been amended.

Clause 71 sets out when provisions in the Bill will come into force once it has received Royal Assent. As is usual, the clause provides the Secretary of State with the power to commence the majority of the Bill’s clauses on a date to be set out in regulations. It may also be appropriate to bring different provisions in the Bill into force at different times, and the powers in clause 71 will allow for that. The powers will also enable the Secretary of State to make saving or transitional provision in connection with the coming into force of any provision, which will enable the commencement of the Bill to operate smoothly and efficiently.

Under clause 63, as the Committee has heard, the Care Quality Commission will be able to take action to bring proceedings against a health and social care provider for a serious breach of regulations. However, that provision will apply only to new offences. To ensure that we can act to prevent cases falling through the gaps, we are committed to bringing in the measure as soon as possible after Royal Assent, while respecting the routine two-month window, as is set out in the Bill.

Clause 72 is self-explanatory and provides that, once passed, the Bill may be cited as the Health Act 2026. I commend the clauses to the Committee.

Before I conclude, I put on record my thanks to you, Ms Lewell, and to the right hon. Member for Herne Bay and Sandwich (Sir Roger Gale), my hon. Friend the Member for Ealing Central and Acton (Dr Huq) and the right hon. and learned Member for Kenilworth and Southam (Sir Jeremy Wright), for guiding this Committee—[Hon. Members: “Hear, hear.”] I also thank the Clerks for everything that they have done behind the scenes. This is the first Bill that I have taken through a Public Bill Committee, and the work really is quite legion. The Clerks’ expertise is second to none and a delight to see closely.

Equally, I thank the officials in the Department of Health and Social Care and the lawyers, some of whom have worked on several Committees over the years. Again, I have learned so much from them and their expertise. It is a dedicated team, and their hard work and expertise on Bills over many years is good to see. I thank them for their support in making this Bill go forward.

I thank the hon. Members for Farnham and Bordon and for Sleaford and North Hykeham for their kind comments and good wishes. I also thank members on both sides of the Committee for their contributions over the past few weeks. Despite the heat, I, too, have enjoyed our discussions. I think that we have given the Bill a very good airing and there has been constructive engagement and scrutiny. They have given us lots of food for thought, which we have taken careful note of, regardless of whether we have taken up the amendments.

Health Bill (Fifteenth sitting)

Gregory Stafford Excerpts

Thursday 9th July 2026 Public Bill Committees

[Dr Johnson]

I will be relatively brief. New clause 15 would require the Secretary of State to lay before Parliament any trade negotiation requiring NHS spending or funding exceeding £100 million, in the form of regulations subject to the affirmative procedure. New clause 76 would require the arrangements between the United States and the United Kingdom on pharmaceutical pricing to be laid before the House to be voted on.

A key concern is costing. There have been various estimates of the additional cost of medicines. The former Secretary of State, the right hon. Member for Ilford North (Wes Streeting), said that he would not change or cut the NHS budget to pay for that increased cost. Will the Minister tell us the estimated extra cost of medicines, and where that money will come from, if not from the DHSC budget?

[Gregory Stafford (Farnham and Bordon) (Con)]

It is a pleasure to serve under your chairship, Ms Lewell. Like the shadow Minister, I will be relatively brief. [Interruption.] It was not clear whether that was a sound of appreciation or disappointment from the Minister. I will assume that she receives everything I say with the same noise and grace.

Yesterday, the Secretary of State appeared before the Health and Social Care Committee—on which my hon. Friend the Member for Isle of Wight East and I sit—and was questioned at some length by the Chair, the hon. Member for Oxford West and Abingdon (Layla Moran), about the UK-US trade deal. It was striking that the Secretary of State appeared unable to answer the basic question of whether an impact assessment could be presented to the Committee—under whatever terms of secrecy or confidentiality the Department wanted to place on it—to allow us to assess the costs, as the hon. Member for Winchester outlined, and, one would hope, the benefits.

The Secretary of State was very clear that there were benefits, but he was unable to outline what they were. He cited commercial confidentiality, which I do understand; there will be commercially confidential elements to the deal. What was really striking, however, was that even though the Select Committee was very happy to receive the information under whatever strictures he wanted to put on it, so that we could scrutinise it, it was not given. That is serious cause for concern.

I understand what the hon. Member for North Shropshire seeks to achieve through new clauses 15 and 76, but there are some problems in their drafting. There will be commercially confidential elements to the deal, so laying it before the House essentially completely unredacted, as new clause 15 would require, might pose real problems. Likewise, I assume that the intention of new clause 76 is to focus specifically on the UK-US trade deal as currently formulated.

[Dr Prinsley]

Much of the conversation around those trade deals relates to pharmaceuticals from the United States. Our patients should be able to access the best available treatments, whatever deals we cook up. We must support innovative research based in our own country, particularly clinical trials for new medicines. To do that, we need to support clinical academics—the doctors who work in universities and organise research. Does the hon. Gentleman acknowledge that the number of clinical academics fell under the previous Conservative Administration? Most clinical academics are now very senior, and we are not recruiting replacements effectively. We need to look after our home-grown pharmaceutical industry so that we do not need such trade deals.

[Gregory Stafford]

I certainly agree with the hon. Gentleman’s penultimate point: we need to support home-grown clinical academics and the life sciences industry in this country. As he has drawn me down that line, I declare that my wife works in the life sciences industry in the UK. I entirely agree with him on that point. However, if he is saying that a corollary is that we should not do pharmaceutical trade deals with other countries, I do not agree, because UK patients need the best medicines no matter where they come from. If that was not what he was saying and I am putting words into his mouth, I apologise, but that is how it sounded to me. I agree that we should support the home-grown, but obviously we need access to medicines from around the world.

That brings me to my concerns about new clause 76. I understand why the hon. Member for Winchester supports it, but the way it is written means that, for the lifetime of the Act, any trade deal with America would have to follow those strictures. Although I accept that he does not like the current deal or the incumbent in the White House, it seems odd that we are singling out in statute, and putting a stricture on, one country over every other. I still probably would not have voted for it, but the new clause might have been more acceptable had it referred to any trade deal with any country, or even a group of countries—I know he is a big fan of one particular group of countries. That might have made it difficult. It would be dangerous essentially for the Bill to put a stricture on a trade deal with one specific country—especially one that is probably our strongest ally. I think that sits very badly.

[Sojan Joseph]

Does the hon. Gentleman agree that the existing constitutional arrangements already provide mechanisms, ministerial accountability and parliamentary scrutiny? Singling out one country is a politicising measure, and it will have long-term consequences for our relationship.

[Gregory Stafford]

Yes, I agree entirely with the hon. Gentleman. It would be a very slippery slope to write that into legislation. I understand the motivation—as I often do—behind Liberal Democrat new clause 76, but I do not think its drafting is appropriate in this context, and I cannot support it.

[Joe Robertson]

As my hon. Friend the Member for Farnham and Bordon said, we on the Health and Social Care Committee heard from the Secretary of State yesterday. These new clauses were obviously drafted in advance, but the timing of their consideration is rather good.

We had the opportunity to ask the Secretary of State, who sits right at the top of the Department, some fairly basic questions about the deal that will apparently see the NHS pay 25% more for US drugs than it does currently. We asked, for example, how much it will cost. The Chair of the Select Committee, the hon. Member for Oxford West and Abingdon, skewered the Secretary of State within minutes. A short while later, once the Secretary of State had had the chance to reflect on her queries, I had the opportunity to ask some even more basic questions. I asked not what the figure was, but whether one even existed or whether any analysis had been done. We ended up going backwards.

We parliamentarians and the public still do not know the answers to some basic questions, even though a deal has been done. Do we know how much it will cost? Does a figure exist? Has an analysis been done? Are we talking about a figure or a bracket? On what basis was the deal agreed? We received absolutely no answers at all to those questions. To conclude, I posed a fairly obvious question: how on earth can we strike a deal to pay 25% more for drugs that we already get without knowing how much it will cost? No answer was given to that question either.

It is no wonder that these fundamental questions have effectively come in the middle of the Bill’s passage. This is not the place for them, but in the absence of basic answers, I can see why the hon. Member for Winchester and others have raised these issues. I will ask the same questions of the Minister. If her boss cannot answer them, perhaps she can, as the Department has had 24 hours to reflect. How much will the deal with the US cost? Are there—even if the Government do not want to disclose them—a figure and an impact assessment?

If the Government can confirm that a figure or bracket exists, why are they not willing to discuss them? If the Government can confirm that some sort of impact assessment has been done, when did it happen and why are they not disclosing it? Until we get those answers, so that people can see the fundamental considerations on which the Government base their decisions, this is a fairly unappealing way of going about securing investment for life sciences.

The Secretary of State talked about the benefits of this deal, and I am sure that there are benefits. I do not disagree with the principle of paying more for drugs if it has benefits for research and development—I understand and support that principle—but I want to be able to see what those intended benefits are, in some form of document or analysis. I do not want bare statements that say, “Research and development is good.” We all know that; I want to see the cost.

New clause 15 would also set a cost threshold of £100 million. The Government are not in a position to confirm whether the US deal would qualify under clause 15. It would at least force the Government’s hand. I suspect that the sum is far higher—into the billions—but we do not know. We are left to sit and speculate, despite the Secretary of State’s appearance before the Health and Social Care Committee. He must have expected that question to be asked. He was flanked by the permanent secretary of the Department and the chief executive of NHS England. By the way, he was a Treasury Minister prior to becoming the Secretary of State just two months ago. We had all the key people in the room to give some sort of indication about cost and benefit, yet none was forthcoming.

Although I cannot back the new clause, because I do not think statute is the right place to ask these questions, I completely understand why it was tabled. She will not accept the new clause, but could the Minister at least answer some of the questions that parliamentarians and the public are asking?

--- Later in debate ---

[Dr Johnson]

I should say that I am a member of the Education Committee. As the hon. Member for Winchester says, new clause 28 would extend the powers of the first-tier tribunal so that, when determining an appeal, it may order that EHCPs must include health and social care needs and provision, rather than just making recommendations on those matters.

It is clearly important that children with special educational needs get the support they need. We are all very aware, from our inboxes, that that does not always happen. I do not know whether putting this into legislation would make it happen, or whether it would need much more work than one clause, but clearly it is a very important aim and I support the principle of it. I would be grateful for the Minister’s comments on how she thinks this could work in practice and whether it is legislation or a more widespread plan that is required.

[Gregory Stafford]

I rise briefly to speak on this as well. I should note for the record that I am the vice-chair of the all-party parliamentary group on special educational needs and disabilities.

The hon. Member for Winchester, on behalf of the hon. Member for Oxford West and Abingdon, made the case very strongly. I am a member of the Health and Social Care Committee, and we took evidence as he described. The lack of a statutory obligation in the current EHCP process is a fundamental problem. We need to ensure that the health elements are put on the same footing as the social care ones. As I am sure is the case in every hon. and right. hon Member’s constituency inbox, the number of children who are receiving or require support with special educational needs and disabilities, and the frustrations with the process both locally and nationally, are rightly something that we, as parliamentarians and policymakers, need to get a grip on.

Health Bill (Fourteenth sitting)

Gregory Stafford Excerpts

Committee stage
Thursday 9th July 2026 Public Bill Committees

[Helen Morgan (North Shropshire) (LD)]

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

It is a pleasure to serve with you in the Chair, Dr Huq. The new clause would require the creation of a health data charter, and includes measures to protect data so as to ensure privacy and reasonable usage.

Patients should be in control of their data. As we have discussed in previous sittings, we do not think that the Bill goes far enough to provide reassurances in that regard. Everyone agrees with the need for the single patient record, but there is genuine risk—one that I do not think anyone in this room wants—that it could be derailed over very understandable and reasonable data privacy concerns. Sufficient guardrails and transparency are key, especially for secondary uses of health data. As we have discussed on many occasions, trust is essential for the system to succeed.

That is why we have tabled this new clause on a health data charter that would set out guiding principles for data sharing across the national health service, including for the single patient record. It would be led by data experts, as well as, importantly, clinicians and patient representatives. Ensuring that the voices of doctors and patients are heard is central to building trust and the widespread use of any data-sharing systems or technologies.

[Gregory Stafford (Farnham and Bordon) (Con)]

It is a pleasure to serve under your chairmanship again, Dr Huq.

New clause 6 raises an important question on how we govern health data, which one of the greatest assets of the NHS. The development of the single patient record platform and database, and the wider use of the linked NHS data, present enormous opportunities.

When used responsibly, healthcare data can support much more personalised care, improve NHS planning, accelerate medical research, enable earlier diagnoses and help develop new medicines and treatments. It can also improve efficiency and strengthen the evidence base for healthcare decisions. However, those benefits can be realised only if the public have the confidence that their data will be used safely, ethically and transparently. Public trust must be the foundation of any successful health data policy.

NHS health data is currently overseen by NHS England, following the merger of NHS Digital into that organisation. With the Government proceeding with the abolition of NHS England and the transfer of its functions elsewhere, it is right that we consider future governance arrangements. In principle, I agree that an independent body may be needed to ensure and maintain the security, integrity and responsible stewardship of NHS data. There is definitely scope for an independent body to oversee the management and regulation of the public’s health data. That proposal places patient privacy at its heart, and would strengthen safeguards against misuse, give patients greater control over how their information is used, and provide meaningful mechanisms to opt out of certain forms of data sharing. It also promotes the use of anonymisation and trusted research environments, allowing valuable research to take place while reducing the risk of inappropriate disclosure. We have discussed inappropriate disclosure by a malign actor, or even inadvertent disclosure, during debate on other clauses.

The Liberal Democrat new clause also seeks to address a concern that has attracted significant public attention: where commercial organisations derive substantial value from NHS data, the NHS itself should share in that benefit. Although we did not support a number of Liberal Democrat proposals because of the inadvertent implications of their drafting, I still have sympathy with the overall thrust of what they were trying to achieve. There is a strong argument that the value generated from the data contributed by NHS patients should help to support future patient care and research.

Transparency is another important feature. Publishing data-sharing agreements, increasing openness around decision making and consulting the public on significant new data initiatives would help to strengthen public confidence. The proposed trust would bring those principles together by overseeing data use, monitoring compliance with governance standards, ensuring transparency and, where necessary, suspending access for organisations that misuse their data.

Of course, any new governance framework must avoid creating unnecessary bureaucracy or delaying important research. To reassure the Committee that the framework would not create a block or dampener, or insert inertia into the system, will the hon. Member for North Shropshire tell us what evidence she found when drafting the new clause? If we are going to do something like this, the oversight should be proportionate, and it should complement, rather than duplicate or frustrate, any existing regulatory responsibilities.

Ultimately, the new clause has potential benefits. It would establish a clear social contract for NHS health data, which would hopefully protect privacy, support research and innovation, maintain public trust and ensure that patients and the NHS share in the benefits arising from the responsible use of a very valuable national asset. In terms of what it could be used for, that data is probably second to none in the world, but I am concerned about adding extra bureaucracy and inertia to the system, when we want a vibrant life-sciences industry that is able to use the data for the benefit of British citizens and patients. What does the hon. Member for North Shropshire think would happen in that case?

[Joe Robertson (Isle of Wight East) (Con)]

It is a pleasure to serve with you in the Chair, Dr Huq.

My hon. Friend the Member for Farnham and Bordon has set out the arguments clearly; I will just add some of my own views. As he stated, the single patient record provides a unique and special opportunity to improve efficiency across the whole health and social care space and to empower patients, but it faces significant challenges. As I said in an earlier sitting, perhaps one of the biggest challenges is ensuring that it means something in practice. In a previous debate, the Minister helpfully clarified that the data currently held on a great variety of databases and electronic record-keeping systems in the NHS will remain on those wide and disparate recording systems. It seems that the advantages will be realised only if those systems are able to speak together and are fully interoperable.

I know from a previous time in my career that, in reality, many such systems are not interoperable or are only part-interoperable, and that, even where they do speak to one another, the data is collected and recorded in different ways. Simple things—someone’s name, their age or the principal field of the issue for which they are presenting to a clinician—are recorded, but because the systems are not standardised, that data cannot be transferred between them easily.

The advantages of the single patient record will be realised only when all those systems are unified in some form, but the Bill does not address that directly. I am not necessarily suggesting that it should, but I do not see the Government acknowledging anywhere that systems are contracted and provided by private providers through procurement processes at a local level, and asking, “How do we knit that all together?” It seems that somebody somewhere will have to produce some gateway software or system to allow the single patient record to be accessed. If every other existing system needs to be able to feed into that, the public sector will have a huge role, and the private sector will sit behind it to try to deliver that. It seems a huge project that could be fraught with difficulty, it could take many years before the single patient record is established, regardless of when the Bill is passed—although I am sure it will be passed fairly soon.

New clause 6 seeks to address another significant issue with the single patient record: security and the control of data. The single patient record, if fully realised, will make it easier for data to be accessed and shared. Its very purpose is to ensure that systems and services are more integrated and data flows more freely, to avoid the ridiculous situations in which a GP fills out a patient note but cannot share it with a secondary care provider, so must print it out for the patient, or attach a PDF to an email, so that somebody at the other end can input it to their database.

One issue with making it easier to share data—including personal data of the most intimate kind—is that once it has been accessed by bad-faith operators, it is easier for them to run riot and cause an awful lot of damage. It is also much easier for wider access to be shared accidentally, because the whole system is lubricated by the single patient record. I therefore understand the reason for the health data charter as a cure for potential ills.

New clause 6(3)(b) states that the charter must

“include the primary goal of protecting people’s privacy and their data from exploitation”.

That is a fantastic goal that we all support, but I do not necessarily agree that the measure will achieve that. It is an added layer of bureaucracy. My hon. Friend the Member for Farnham and Bordon asked a rhetorical question about the bureaucracy and effectiveness. I endorse that question and hope that the hon. Member for North Shropshire will answer it.

I am minded not to support the proposal, though I agree with what it tries to achieve. If the Minister does not support the new clause, will she explain how its aim of protecting people’s privacy will be delivered by the Bill? There seems to be great scope for the undermining and abuse of privacy, not just deliberately by bad faith actors, but inadvertently.

A second issue aim of the charter is the balance between the security of personal data and the recognition of the value of anonymised data gathered by the NHS for research and development. Fully anonymised data that cannot be unpicked through reverse engineering is of huge value, both commercially and for the public good. Commercial value and the public good are not necessarily opposed to each other; in fact, they often come together. The NHS should be able to exploit the value of that anonymised data—“exploit” is probably seen as a negative word—for the public good. How do we balance that with people’s right to privacy?

Again, there is the possibility of inadvertently using for a wider public good data that was intended to be anonymised but in which people can be identified. The charter tries to get to the heart of that issue as well, which I welcome. Indeed, new clause 6(4)(a) states that the sovereign health data trust will

“hold continuous oversight of all health data and oversee the trusted research environment”.

The Minister may not agree with the new clause, but how will the Government’s proposals balance the security of an individual’s personal data while exploiting, for the public good, the value of the huge depth of anonymised data that the NHS holds and will hold? It could be used to drive so much innovative research and development, for the benefit of health delivery not only in this country, but across the world. Such a valuable commodity has commercial value that could deliver financial benefit to the NHS. I think we all agree that we have not yet exploited that area to the fullest. There is an opportunity to do so with the single patient record—if it is done properly, with all the necessary safeguards.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

As my hon. Friend the Member for Isle of Wight East just said, new clause 6 seeks in essence to ensure that we have good data security and control, with which I agree. Trust is important, data security is important and supporting research with anonymised data is a good thing to do.

What would the new clause do? First, it would establish an independent body known as a sovereign health data trust. In essence, that is a group of people who have been put together. The new clause does not say how big the group would be—I do not know whether the hon. Member for North Shropshire had its size in mind—but it describes a group of people with

“a diverse range of backgrounds…and…health data experts, clinicians and patient representatives.”

Are the first group intended to be laypeople, rather than experts? What does the hon. Lady mean by a “diverse range of backgrounds”? Does that relate to protected characteristics, or is she looking for a farmer from Northumberland and a lawyer from Islington, because they have different backgrounds? It is not entirely clear what she means, so I would be grateful if she clarified that. Additionally, however big that group is, who would decide how it is composed and by what criteria? Who would be responsible?

The sovereign health data trust would be charged with creating a health data charter. That leads me to my second question: what is a health data charter? In essence, a health data charter—as defined in the new clause—must

“set out the fundamental principles and responsibilities for assessing whether a data sharing partnership is in the interest of the public and the NHS”,

and, as my hon. Friend the for Isle of Wight East said,

“include the primary goal of protecting people’s privacy and their data from exploitation, while promoting trust in data systems and the handling of health data”.

That is important, because we have heard in the media several examples of data being put up for sale or leaked, and the problems caused by that.

The charter must also

“ensure patients have control of their data, including providing relevant opt-outs”.

I am glad to see that bit about relevant opt-outs. We have talked about the importance of the record being shared not as a whole, but in pieces. Things such as obstetric or sexual health ought perhaps to be consented to separately. Patient control of the data is important. How would the hon. Member for North Shropshire deal with safeguarding issues in the control of data, particularly in relation to children?

The new clause sets out that the charter must

“provide that all health data is held anonymously and accessed through a trusted research environment”—

which seems reasonable—and must

“set out ways to retain and protect the value of health data in England, including providing measures to invest a share of the income generated from new medicines or treatments developed with that health data to be invested back into the NHS”.

Earlier this week, the hon. Member for Lichfield and I discussed the important value of the NHS data—I think he said that it was the most valuable dataset in the world, and he might well be right. I was a bit confused by that part of the new clause, because we talked earlier this week about the Health Services Safety Investigations Body being able to sell time and training and share expertise, including with private sector organisations overseas. The Government changed that in the Bill, so that they would only be able to retain costs and not make any money for the Treasury. When we put amendment 56 to a vote, the Liberal Democrats abstained. I do not know what the difference is between using NHS data for research and the HSSIB using their expertise for training overseas organisations. I would be grateful to understand that.

The charter must be

“designed in such a way to render it interoperable with the European Health Data Space”.

The European Health Data Space regulations were introduced in March 2025. We are in a transition period, and they will be implemented in 2027 and 2029. It should be interoperable in technical terms

“through the promotion of Findable, Accessible, Interoperable and Reusable (FAIR) data principles”.

What is the European Health Data Space? Essentially, it is a single patient record for Europe. Its instructions say member states may—I underline the word may—offer

“an opt-out option for the cross-border exchange of electronic health data under EHDS.”

I do not understand the Liberal Democrats’ argument for that, because they have made a strong argument throughout Committee stage that data needs to be shared carefully. They advanced some clauses that will ensure that data is held in the United Kingdom and that we use British tech where possible. New clause 6 would make us interoperable with the European system and presumably move us towards European systems.

[Gregory Stafford]

I do not mean this as a cheeky point, but is it not the case that clearly, as with everything, the Liberal Democrats think that the European Union can do no wrong? They do not see the same problems of data that they have expressed in other clauses because they want to rejoin the European Union. Therefore, they conceive that it can have no possible harm to British subjects.

[Dr Johnson]

Indeed. When reading it, it is ironic to me that they seem comfortable with data being shared across the EU but not across our own country. It did not make complete sense to me, but the hon. Lady for North Shropshire may be able to tell us more about that in her summing up.

What else will the sovereign health data trust group do? It will have

“continuous oversight of all health data and oversee the trusted research environment”.

Having oversight over “all health data” is quite a big job. Again, what sort of resources does the hon. Lady think that will entail, and what does she have in mind in terms of the cost and bureaucracy of that? It would also

“have power to recall or restrict an organisation’s access to data if it has reason to believe that the data is not being used for public or patient benefit.”

What is the threshold for that? A lot of these organisations will be working in a commercial environment; if they receive a letter, potentially from a competitor, saying there is a concern, does that meet the threshold? What would the threshold be?

Having decided that the data might not be used for public benefit, what investigatory powers does the hon. Lady envisage the trust having to establish whether that is the case or not? What if it does receive some concerning correspondence, it does the investigation under the investigatory powers that it has been given, it decides that it does not think it is being used for public or patient benefit, and it restricts the organisation’s ability to access data? That will potentially have a significant financial penalty and it may affect patients’ access to healthcare, too. What right of appeal would the organisation have? Who would they appeal to and how would it work? On the wording, commercial activity may well benefit patients, which is sometimes forgotten.

The next thing the data trust will have to do is

“ensure that all data sharing arrangements with a non-NHS organisation are transparent, with all health data contracts entered into by a public body made publicly available”.

I would like some more detail about that. Would that include anonymously provided data? What effect would that have on the research environment and the integrity of research done under commercial arrangements? What about the costs? Would any costs be shared and what effect would that have on future commercial negotiations when the Government are trying to get the next organisation to look at the data? What level of detail made publicly available in the contract would need to be provided?

The trust would need to publish minutes of their meetings, which seems reasonable. It would need to

“ensure all health data collection and sharing initiatives are preceded by public consultation, involvement and awareness.”

Do the Liberal Democrats really intend for all data collection to go through public consultation? If, as we talked about regarding corridor care, the Government wanted to know how many people are waiting more than 24 hours in A&E, would they have to do a public consultation to collect that data? It seems overly bureaucratic.

[Gregory Stafford]

Is that not part of the problem with the wording of the new clause? It is not clear, from the new clause, what is NHS data and what is the patient’s data, and who owns which bit of it. The problem with the drafting of the new clause is that it appears to cover every single piece of data held by the NHS, whether it directly relates to a patient or not. Additionally, if the Government were to collect any other sort of data, even if on an aggregate basis, it would come under this. That would be totally unworkable and put an enormous burden of bureaucracy on the health service.

[Dr Johnson]

My hon. Friend is, as ever, correct. I would be interested in whether the hon. Member for North Shropshire has made any estimates of personnel time or cost that the proposal would entail.

In summary, the new clause would create an unelected committee removing democratic control. Essentially, it is asking a committee of unelected individuals to write and implement policy, which is the job of the Minister. That should be under ministerial control.

--- Later in debate ---

[Dr Johnson]

I want to briefly discuss these new clauses because I think that they are important, particularly because they were tabled by the hon. Member for Worthing West (Dr Cooper), who is an expert in the field. New clauses 11 and 24 relate to directors of public health. We know from the Government that prevention, and therefore public health, is extremely important. New clause 11 says:

“Each integrated care board must, for the purposes of exercising any public health functions directed by the Secretary of State, appoint a lead director of public health.”

New clause 24 sets out the requirements and functions of directors of public health—what such an individual will do.

Currently, every local authority must have a director of public health, which is set out in statute. They focus on three areas: health protection, health improvement and healthcare public health. They take the evidence in relation to their population, produce a vision, develop aims, deliver those aims and then produce a report annually to say how they are getting on with that process. The National Health Service Act 2006 says that that must be done across an upper tier or unitary local authority area, and that directors of public health must provide advice about public health to any ICBs that overlap with their area. ICBs also have a legal duty to seek advice on protecting public health when they are exercising their functions.

I think that we all agree across the Committee that public health is important, but I do have some questions. Unfortunately, the hon. Member for Worthing West is not a member of the Committee, so she is not able to respond to any questions today. We have talked in this Committee about the representation of local authorities on ICBs and the fact that Government cuts of 50% have led to a merging of ICBs in a somewhat haphazard fashion, which means that there can be a clash between different areas.

I guess that my question for the Minister would be this: if this clause were to come into force and the ICBs that are no longer coterminous with the local authority upper-tier or unitary authority areas, would there be a duplication of work? My other concern would be that it would lead to a situation where there might be one director of public health with a vision to go one way, and another with a direction to go the other way. If that happened, how would the negotiation process work? I think this measure was brought in with good intent by a lady who is an expert in the field, but I have more questions than answers about how the clause will work in practice.

[Gregory Stafford]

It is very important that we consider these new clauses and amendments carefully, not least because, as my hon. Friend has just outlined, the hon. Member for Worthing West, who tabled them, has considerable expertise, being a public health consultant herself. I have the pleasure of sitting with the hon. Member on the Health and Social Care Committee and she brings her expertise to every single sitting. I am sure that the Minister has welcomed her questioning when she has appeared before that Committee.

It is really clear that, if we are going to make a success of the Bill, public health in all its guises needs to be at the forefront of our thinking about how we achieve better patient outcomes, better health and, more specifically, the Government’s stated aims in the 10-year plan to, first, shift care closer to home and, secondly, focus more on prevention rather than treatment. I am sure that across the House we agree with that ambition and therefore I can totally understand why the hon. Member for Worthing West has tabled these new clauses.

I suspect that the new clauses are also a reaction to something that we have already discussed in this Committee, which is the dislocation and now the separation of local authorities from ICBs, with the removal of their statutory functions on those boards, to be given to strategic mayoral authorities. Some of those strategic mayoral authorities exist but, as we have discussed at some length in the Committee, many of them do not exist and might never exist. I can see why the hon. Member for Worthing West is trying to ensure that the vital work of directors of public health in local authorities for their population areas is somehow safeguarded and included in the Bill.

That being said, I have some reservations about how these new clauses are currently drafted. My hon. Friend the Member for Sleaford and North Hykeham has already outlined many of them. Although strengthening public health leadership is an essential objective, new clause 24 defines the statutory role and legal status of directors of public health in this context without providing sufficient clarity about accountability or governance, or about how these new powers would interact with existing NHS and local authority structures. Potentially, there is a risk of creating overlapping responsibilities, blurred lines of accountability and additional bureaucracy at a time when integrated working should be simplified rather than made more complex.

Obviously, the hon. Member for Worthing West is not here to answer my questions. I ask the Minister this: if these new clauses are not pressed to a vote, or if they are but are not accepted by this Committee, how can she reassure me and the hon. Member for Worthing West that public health will still be at the forefront of the Bill, and that the removal of local authorities from ICBs will not have the impact that I think the hon. Member, who tabled these new clauses, is concerned about?

[Karin Smyth]

Further to that point, I absolutely want to assure my hon. Friend the Member for Worthing West, who is not a member of this Committee, and indeed the members of this Committee that the Government fully appreciate the important role of public health professionals. They bring critical expertise in population health intelligence, epidemiology and community co-design, and those capabilities are integral to the role of ICBs as strategic commissioners.

On new clause 11, there is already a statutory duty on ICBs to seek advice, and a statutory duty on local authorities to provide public health advice to ICBs. However, that does not mean that ICBs should be required to employ a director of public health directly. Local authorities already employ a director of public health and we expect ICBs to work collaboratively with their local authority partners and not to duplicate their work.

NHS England recently published the strategic commissioning framework and guidance for ICBs on strengthening the public health advice, both of which are clear that ICBs should work with local public health teams and stakeholders to draw upon their expertise to ensure a strong evidence base for commissioning decisions.

As the responsibilities of ICBs for commissioning NHS public health services grow, we expect them to continue to draw on the skills and expertise of local authority directors of public health, as well as other specialist public health expertise, including screening and immunisation leads, and the UK Health Security Agency. I absolutely agree that public health expertise is essential for ICBs to commission effectively and we have set out how they will access that; the basis for all this is of course the joint strategic needs assessment. However, I do not believe that it is necessary to require an ICB to appoint a lead director for public health in order to have access to such advice.

On new clause 24, as the Committee is aware, local authority directors of public health are advocates for the health of their population. They have a professional leadership role across the three domains of public health: health improvement, health protection and healthcare public health. Their work spans organisational boundaries. Although they are employed by local authorities and appointed jointly with the Secretary of State, their role is designed to bridge local government and the NHS. They are also required to provide objective, evidence-based advice, without political interference, and they are expected to be suitably qualified and regulated public health specialists who take a population-wide perspective to health outcomes and health inequalities.

At the heart of their role is their statutory responsibility to prepare an annual report on the health of their local population. That crucial document underpins the plans of health and wellbeing boards and, through them, the ICBs. Directors of public health are also required to be members of health and wellbeing boards, which will be the central mechanism for partnership working between local authorities and ICBs in the new neighbourhood health system. As such, directors of public health will be well placed to help to shape ICB system-wide plans and strategies on public health issues going forward, something that we discussed earlier in the Committee.

There is a statutory duty on ICBs to obtain appropriate and expert public health advice, and a legal duty on local authorities in turn, carried out by the director of public health and their team, to provide public health advice to ICBs. Beyond those requirements, the NHS, including ICBs, is of course free to employ its own senior public health professionals.

The proposed new clause risks creating some significant ambiguity around accountability and risk, constraining rather than enhancing the independence of directors of public health, which I am sure is not the intention of the hon. Member for Sleaford and North Hykeham or of the Committee. I hope I can offer reassurance to the hon. Member and indeed to the Committee that we are proud of our strong and coherent public health system, that this Bill does not alter its importance and that we will continue to champion the role of directors of public health and ensure clarity in the new architecture. I ask that the new clause be withdrawn.

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[Gregory Stafford]

I rise to support a lot of what my right hon. Friend the Member for Melton and Syston said. Across the Committee, I think we all agree that corridor care and care in other inappropriate settings should have no place in the NHS. No patient should be assessed, treated or left waiting in a corridor, in a cupboard or anywhere else because there is nowhere for them to go.

We owe it to patients and our constituents to be honest about the scale of the problem and be serious about ending it. That starts with measuring it properly, because if we do not collect the data, publish the evidence and track progress, inappropriate care settings risk becoming normalised. In May, nearly 3,000 patients were in corridor care, which was a 2.5% increase from the same time last year. In the same month, 50,000 patients waited in A&E for more than 12 hours, which was a 17% increase from the same period last year.

The Government continually miss their target on the 12-hour wait. I am not making a political point; this is a serious problem, and successive Governments are still struggling to ensure that it does not happen. We all know from our casework and our inboxes, and some of us know through personal experience or from loved ones, that too many patients are experiencing unacceptably long waits in A&E after a decision has been taken to admit them. That is bad for patients, bad for staff and bad for the wider functioning of our hospitals.

New clause 56 in the name of the hon. Member for North Shropshire acknowledges that the causes of delays extend far beyond the emergency department itself, and I will touch on that in a moment. Challenges in social care, discharge processes, step-down provision and workforce capacity all contribute to bottlenecks that leave patients waiting longer than they should. Although there might be legitimate questions about the precise mechanisms proposed in the new clause, I do not think there is any disagreement among the Committee about the principle that patients deserve timely access to a hospital bed and that excessive admission delays should not be accepted as the norm.

That is why I fully support new clause 84 in the name of my hon. Friend the Member for Sleaford and North Hykeham. Publishing data on avoidable deaths associated with waits of more than 12 hours would help to ensure that we, as a Parliament and as policymakers, remain focused on outcomes for patients, not just performance indicators. I am particularly persuaded by the proposal to publish that information at ICB level, notwithstanding the concerns raised by my right hon. Friend the Member for Melton and Syston, which I agree with entirely. It would at least give some allowance for those making decisions to look at the local variation and ensure that it is identified, however less local that will become.

Hopefully, good practice will be able to be shared between different areas, and the areas that face the greatest challenges will be able to receive both appropriate scrutiny and appropriate support. Of course, collecting and publishing data will not by itself reduce waiting times, but we cannot effectively tackle a problem that we do not properly measure. Sunlight is often the best disinfectant in these cases, and greater transparency can be a powerful driver of improvement.

At the heart, new clause 84 recognises the simple truth that every statistic represents a person, a family and a life, and if avoidable deaths are occurring as a consequence of prolonged A&E waits, we should have the courage to measure them, publish them and learn from them. That is why I support the new clause. As has been touched on in other speeches, and as I mentioned earlier, the issue of corridor care does not sit in isolation. In fact, it is not a cause of the problem; it is the symptom of many other problems within our health and social care network.

[Dr Prinsley]

When I was a young doctor—a registrar—in the 1980s, we had 300,000 beds in our health service. By the time I was a senior doctor in the 2020s, we had 140,00 beds—less than half the number of beds we had before. When I was a young doctor, corridor care did not exist; I had never heard the term. The hospitals were simply big enough. Does the hon. Member agree that the many years of decline in the total number of beds in our hospitals is an extremely important factor in the fact that we do not have enough beds for the patients sitting in the A&E departments?

[Gregory Stafford]

I respect immensely the hon. Gentleman’s experience. He described being a young doctor, but he is still a very young doctor/politician now. Of course, capacity is an essential part of this. He is a clinician, so I will not lecture him on this, but my suggestion would be that it is not about just capacity within hospitals. The Government’s shift is to try to get people out of hospitals and into community settings as much as possible, so it is capacity within the whole system that needs to be looked at. Going back and putting loads more beds into hospitals would not somehow solve this problem or create a healthcare system that is aligned with what the Government want, which is hopefully treating more people at home. On his general point, I accept that the more capacity there in the system as a whole, the more likely we are to solve some of the problem.

That neatly moves me on to my next point, which is about the whole-system approach to this. As hon. Members have mentioned, we have a potential problem with ambulances waiting in carparks, and unfortunately, trusts gamify the system when targets are put in place—they do not admit people through the door because it will hit their targets. As my right hon. Friend the Member for Melton and Syston mentioned, that has a knock-on effect for the people sitting in the ambulances and those who are potentially not receiving an ambulance because the capacity is not there. Likewise, at the other end of the system—though I suppose it is both ends of the system—social care needs to improve significantly. I am deeply disappointed that the Government have pushed another social care review that is probably not going to report until 2028, which is kicking the can down the road. I think it is essential that we get social care correct.

[Liz Twist (Blaydon and Consett) (Lab)]

Some excellent points have been made about corridor care; I know that all of us want to see that improved. It is a serious issue for all of our residents, and the Minister and others will be working hard to do all they can to address it. May I gently point out the irony of colleagues on the official Opposition side raising all these issues now as if they have had a Damascene conversion, when they had 14 years to try and address them? I remember raising these issues in the House when my party was in Opposition. We are not undermining in any way the concerns about corridor care, because we all care deeply about it. [Interruption.]

[Liz Twist]

I just gently wanted to make that point.

[Gregory Stafford]

I am grateful to the hon. Member; she makes an interesting point. She talks about irony, and I respond in the same manner as that which she intervened on me with a gentle response, which is to ask why, if everything was going so swimmingly well, she and the rest of her colleagues got rid of the Prime Minister?

[Joe Robertson]

I am grateful to my hon. Friend for giving me an opportunity not to chunter from a sedentary position and to remark that this tedious rhetoric about the last 14 years—when all the public want to do is hear about plans for the future and how they will work—is the reason why we are in the state that we are. Will my hon. Friend continue and address the points that the public want, which he had already begun to do?

[Gregory Stafford]

My hon. Friend is absolutely right. The public do not want to hear about the last 14 years or the rhetoric around them.

[Liz Twist]

rose—

[Gregory Stafford]

I will give way to the hon. Lady after I finish my sentence, if I may. The public want to know what the solutions are. I think we could look back through history at successive Governments since prehistory and say, “They got some things right, and they got some things wrong.” What the public want to know now is what the current Government will do. 

On the point about social care, I was not a member of the last Government, but I stood on an election manifesto commitment, as the Labour party certainly did and I think most political parties did, that essentially said that the Dilnot review had decided how we were going to deal with social care, and we were going to get on with it. It strikes me as very strange that the last Secretary of State, the right hon. Member for Ilford North (Wes Streeting), decided to have another review; he has said himself in interviews since he resigned that it looks like the stalling on social care means that we will not get any movement on it before another general election. I do not think the public should put up with that.

[Karin Smyth]

As the hon. Member was not here at the time, perhaps it eludes his memory, I remind him that it was a coalition Government agreement to move forward with Dilnot, which had cross-party support. As soon as the coalition finished in 2015 and the Conservative party had dumped their friends in the Liberal Democrats, almost immediately after that election, it also dumped all pretence around the Care Act 2014 provisions at the time. We are where we are. I just wanted to help his memory.

[The Chair]

Order. I think we are moving a little out of scope here. Could we bring it back to the contents of the Bill?

[Gregory Stafford]

I will do that. As I have already said, no party has necessarily covered itself in glory with this issue. It might have taken us four years to dump it; it took the Chancellor of the Exchequer less than two weeks.

[Liz Twist]

I want to touch on the point made by the hon. Member for Isle of Wight East in his intervention. We absolutely agree that the public are concerned with what we do for the future. We are talking about a specific Bill here. There is a huge concentration of effort in getting those figures down. We absolutely agree that people want to look to the future and whether this is the way to do it.

[Gregory Stafford]

I look forward to the new Prime Minister coming in and, I hope, providing a position where the hon. Member is able to achieve some of that. [Interruption.] I note for Hansard that that received acclamation across the Committee Room.

Getting back to the Bill, as you have suggested I do, Dr Huq—I take your suggestions very seriously—the social care element is extraordinarily important. It is important to ensure that people do not enter the secondary care system if at all possible, especially through attending A&E. When I worked on the Getting It Right First Time programme, our accident and emergency reports put forward some interesting methods that could potentially help with that. Some of that has been implemented and some has not, but I recommend all hon. Members look at that report, because it contains a number of interesting proposals.

This is not only about stopping people entering the system, but about ensuring that people come out of the system in a timely manner, freeing up the capacity we have just talked about. In my constituency, Haslemere hospital had 16 step-down inpatient rehabilitation beds. Unfortunately, last year, that service was “temporarily paused”—that is how it was described, but it has been over a year now, so it has essentially stopped. That service is not happening in my constituency, which is down to the fact that it was a GP-run service and the trust could no longer get a GP who was willing to run that service.

Haslemere hospital and the Royal Surrey NHS Foundation Trust that runs the hospital have some really fantastic ideas, very much in keeping with the Government’s push towards neighbourhood health, and I fully support those proposals, but it is a shame that we have had 16 beds sitting empty for more than a year, which could have been used for rehabilitation. We as a body politic should be looking at how we can improve and expand our step-down/step-up capacity, so that people do not have to go into acute settings.

I turn briefly to the specifics of new clause 12. I am concerned about subsections (3) and (4), which talk about a tribunal system. I do not quite understand how that would work. The way it is set out almost gives it an adversarial, inquiry-type, case-by-case element. It would include patients, bereaved or affected families, and frontline NHS staff. I can see how that kind of body might work if one was investigating a failure around a single patient or at a single trust, but I would be grateful if the hon. Member for North Shropshire could expand on how she sees the national report coming forward and then a group of people being selected to interrogate it. It is also not clear what would be the consequences of the interrogation, or otherwise, once it has happened.

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[Dr Johnson]

I think we are going back full circle to the hon. Gentleman’s intervention on my hon. Friend the Member for Farnham and Bordon, when he suggested that the problem was that beds had historically been closed. Now he is making the point that there were clinical reasons why that happened, not just managerial reasons. I think that is an important thing to note.

Moving on from capacity, we also need to look at the workforce. I would be grateful if the Minister could tell us how soon “imminent” is in terms of the workforce plan. There was also a point picked up earlier—I cannot remember who picked it up; it might have been the hon. Member for North Shropshire—about discharge from hospital and pharmacies. One of the challenges that I find as a clinician is that hospital pharmacies often close relatively early, which means that it is more difficult to discharge patients in the evening. That is something for the Minister to look at. There is also, of course, the importance of social care, and ensuring the provision of social care beds both to prevent admission and to get people out of hospital as quickly as is safely possible.

That is the background to this group of new clauses. New clause 12, in the name of the hon. Member for North Shropshire, would require a report on corridor care to be produced six months after the passage of the Act, and then every 12 months, containing data at the hospital, trust and ICB level on the number of individuals receiving care in an inappropriate place. That seems sensible data to collect, but I believe the Government may already to be collecting it; the Minister may be able to enlighten us on that. The report would also set out the steps taken in that year to reduce the number of patients in inappropriate care spaces, the plans for the coming year to reduce that number further—as I said, it is going up at the moment—and the funding allocated to that. There is some sense to that. Then the Secretary of State would have to give evidence in front of a panel, called the “corridor care tribunal”, which would include patients, affected families and impacted NHS staff, who would be selected by Healthwatch and NHS royal colleges.

I have just a couple of points on that. One is that Healthwatch will be abolished by the Bill, which would make that challenging—perhaps the new clause would need to be redrafted. Also, I am a member of the Royal College of Paediatrics and Child Health and an NHS consultant paediatrician and, as far as I am aware, the royal colleges are independent of the national health service. They are separate; they are connected in terms of training, standards and advice, but I believe that they are organisationally independent. I am sure that the Minister will correct me if I have got that wrong.

I wonder whether the hon. Member for North Shropshire has considered whether the Health and Social Care Committee, which is elected and politically balanced, might be the right body to scrutinise those Government plans. My hon. Friend the Member for Isle of Wight East, who is a member of the Select Committee, is not here now, but—

[Gregory Stafford]

I am, too.

[Dr Johnson]

Sorry; I forgot. I am sure that my hon. Friend the Member for Farnham and Bordon will tell me if I am wrong, but that is an elected Select Committee, with political balance, that is set up specifically to scrutinise the work of the Department of Health and Social Care. If the Department is working to try to reduce the number of patients receiving corridor care, and to measure it, it seems to me that the right organisation to scrutinise that work is already in place: the Health and Social Care Committee. I therefore think this measure would be a duplication. However, I understand the need to get patient voice into the picture; that is why it is unfortunate that the Government are choosing to abolish Healthwatch, which I think would do that very effectively.

New clause 56, also in the name of the Member for North Shropshire, talks about A&E waiting times. I will start by saying that we all want A&E waiting times to be shorter—we all want people to be seen quickly and do not want patients to suffer—so the intent behind this proposal, to get people seen more quickly, is obviously a good one.

However, the new clause would require, within six months, provision to be made requiring

“every patient to be admitted into an Accident and Emergency Department within 12 hours of approval of their admission being made.”

I have a question about the wording of that, because my understanding is that someone is admitted to A&E when the decision is made to admit them to A&E and they become an A&E patient. I wonder whether the hon. Lady intends it to mean admission to an appropriate bed, whether in the trust or elsewhere. Usually, people waiting in corridors or in A&E are waiting for admission to the ward, rather than for someone to make a decision.

New clause 56 would also require the Secretary of State to establish and implement an A&E scheme to help trusts to achieve that requirement, and provides that the scheme must consider creating safety nets, step-down beds and a dedicated workforce plan for A&E—it will be nice to see the workforce plan, which the Government are supposed to have written—and mandating the presence of a “qualified clinician” in the waiting room. Will the hon. Member for North Shropshire tell the Committee what she means by a qualified clinician? Does she mean a consultant, a senior nurse or a healthcare assistant? What sort of qualifications does she think that they must have? The Secretary of State must also have regard to Baroness Casey’s report, but that is not due to be written in time for the new clause, which creates a little tension. However, again, I agree with the principle that social care is important in this context.

In summary, the principle of new clause 56 is good and important, but I think that there are some issues with the drafting of it. New clause 84 in my name, which has been well covered by my colleagues, would just require the publication of data. In her speech earlier, the hon. Member for North Shropshire gave a figure of 15,000, but I looked back at Hansard and last night she said that the Royal College of Emergency Medicine reported that long waits caused 15,860 deaths. That figure tells us what a serious problem this is. Being able to measure that figure and, I hope, see it falling would be a helpful step.

Ordered, That the debate be now adjourned.—(Emma Foody.)