Health Bill (Thirteenth sitting)

Helen Morgan Excerpts

Tuesday 7th July 2026 Public Bill Committees

[Dave Robertson (Lichfield) (Lab)]

It is, as ever, a pleasure to see you in the Chair, Ms Lewell.

Healthwatch was established, at least in part, as a response to the Mid Staffs scandal. Mid Staffs came up three times in our evidence sessions, and the hon. Member for Winchester mentioned it just now. That scandal matters to everyone, but it has a particular resonance for my role in Parliament. Many of my constituents were harmed by the failing at Mid Staffs. I was born in that hospital, and I speak as a Staffordshire MP. None of us should ever forget what happened or allow it to be swept aside without examining it. There were a great many failings at Mid Staffs over a long period. Oversight was just not in the room when decisions were being made.

Staffordshire county council’s health and care overview and scrutiny committee clearly did not do that job. The Francis report stated:

“The arrangements for public and patient involvement, and for local government scrutiny in Stafford, were a conspicuous failure.”

The report recommended some changes to ensure that Healthwatch, which was in the process of being set up at the time, was funded properly. In that light, the framing of this debate is important and timely. Healthwatch has been going for well over a decade. It is right that we now examine its impact, as it is a significant part of patient voice within the NHS.

Despite the very best efforts of a great many hard-working staff and an army of committed volunteers across the country, the quality of local healthwatch organisations is pretty changeable. Over the past few weeks, I have spoken with right hon. and hon. Members from across the House. The feedback that I have received has ranged from, “My local healthwatch team is brilliant— I work with them really closely and they have really helped out with a huge amount; they deliver great things in my constituency” all the way to, “I have some pretty significant concerns about their impact.” In a couple of cases I heard, “What is Healthwatch? I have never heard of it.”

[Helen Morgan (North Shropshire) (LD)]

We heard in evidence that the reason for that variability was a lack of funding. Would the hon. Gentleman support our new clause 78, which tries to deal with the lack of funding and ensure a consistent service from Healthwatch across the country?

[Dave Robertson]

Funding Healthwatch is really important, but to address the issue properly, we must make sure that Healthwatch is in the rooms it needs to be in. Funding needs to be part of the process that ICBs follow. I will touch on that later, so the hon. Member will hear further thoughts on the matter.

Local healthwatch organisations across all our constituencies have an important role. At the local level, they are geographically bound to counties. In constituencies like mine and that of the hon. Member for North Shropshire, those geographical areas are huge. The health disparities within my constituency, with two towns that are 4 miles apart, one with a significant mining—

--- Later in debate ---

I am not in any way down on the hard-working Healthwatch staff and committed volunteers. They work hard to achieve things for their communities, but they are not given the structures needed for visible action and change. Yes, changes to Healthwatch will come, which will be a challenge and come with risks, but I am impressed that, by moving the responsibility for patient voice to the room with the commissioners, so that one of their key responsibilities is to listen to patient voice, the Bill gets over the barrier of remoteness. It puts patient voice in the heart of the room and in front of the people making decisions. As we have seen for more than a decade, there are many hard-working people, and thousands of recommendations are not necessarily being acted on—as Opposition Members said in long speeches this morning. We need to get patient voice into the room with the decision makers.

[Helen Morgan]

Will the hon. Gentleman give way?

[Dave Robertson]

I will make some progress. There are concerns that if we roll some responsibilities into ICBs or councils, the Department needs to make sure that the issue does not get pushed to the side and that the funding does genuinely remain for patient voice. I am reassured that there will be a patient experience directorate within the Department. That will bring decision making and the patient voice into the Department while also keeping an eye on what is happening with those ICBs and ensuring that they have standards to hit.

The Department needs to ensure that it is sharing good practice and keeping oversight of local authority commissioning of social care. The CQC is starting to do that, and there are some positive indicators. There is obviously more work to do, and we need to stay on top of it because, as I said earlier, there are risks whenever there are changes to healthcare. I am reassured that bringing the patient voice into the room with decision makers is the right way to enact change.

--- Later in debate ---

[Karin Smyth]

I thank my hon. Friend for making the intention of her comments clear to the Committee. It is right that we need to build trust in patient voice and experience. We will pick up on that in our debate on local healthwatch branches, because that is perhaps where Members of Parliament are particularly important.

At a national level, there are many voices and organisations continuing to review the issue and challenge the Government, including through reports, meetings with Ministers and in Parliament, highlighting the good work that they do and numerous Committees. Health Ministers appear before the Public Accounts Committee, the Health and Social Care Committee and Lords Committees; I have appeared before the Science, Innovation and Technology Committee. That is an important way of ensuring that the Department and the new experience directorate will be accountable.

I recognise the important contribution that Healthwatch has made in capturing patient insight and informing the design and delivery of services, but we do not believe that new clause 78 is necessary. It is inconsistent with the purpose of the Bill. I am aware of the views of the hon. Member for North Shropshire, but the Government’s policy is to abolish Healthwatch and ensure that patient and public voice is more directly connected to decision making. It would therefore not be appropriate or consistent to legislate for a specific funding level for organisations that would no longer exist, or to constrain how funding is deployed to support the new arrangements.

[Helen Morgan]

For the record, I tabled amendments to delete those clauses, so there was consistency of intention.

[Karin Smyth]

I am just computing that in my brain. Can I seek clarification on that?

[Helen Morgan]

I tabled amendments to delete the clauses that will remove Healthwatch, but they have not been chosen for debate, because we can just vote against those clauses standing part. New clause 78, which would ensure that Healthwatch is funded properly, was tabled alongside amendments to ensure that Healthwatch is retained.

[Karin Smyth]

I understand. I am grateful to the hon. Member for that clarification, but her new clause represents an incomplete picture of Government funding for Healthwatch. A £14.15 million grant has been provided to local authorities for local healthwatches, and that is only part of the overall funding; a larger proportion is rolled into the wider local government financial settlement, and because that is not visible as a distinct line, headline figures often understate the total funding available. All of this funding is not ringfenced.

--- Later in debate ---

[Dr Johnson]

As I understand it, the objectives of the Bill are to replace the local healthwatch with a less independent, internalised gatherer of patient experience feedback. The objectives appear to be featuring feedback more centrally in strategic decision making, getting people into the room and simplifying the patient landscape.

There are things that I do not understand about that. If the problem is that those who commission or deliver the services are not listening adequately to the people who gather the patient experience information, why not invite the independent individual who has gathered that information into the room? Why ask someone in the room to gather the information and risk the independence? Why not compel more listening?

The Minister talked about who is accountable for action. My understanding is that it is the healthwatches’ job to gather the patient experience and present it to Healthwatch England and the decision makers. It is not their job, as I understand it, to make decisions on how care is delivered or to deliver that care differently. Does the Minister intend that to change?

The Minister also talked about strengthening the impact of Healthwatch, but I do not understand how this change will do that. We have heard how its independence allows Healthwatch to go on telly, talk to Members of Parliament, Select Committees, radio stations and others, and publicise its findings. If it is within the Department, will it be able to do so as freely? I suggest that it will not.

The other thing that I do not really understand—perhaps the Minister can help us with this—is the organisation. At the moment, it is done in local authority areas. It will now become the job of the local authority and the ICB to commission feedback, but we have already heard how the 50% cuts to ICB budgets have led to ICBs merging into larger conglomerates. Those do not necessarily overlap with the strategic mayoral authorities in the way the Minister eventually wants. What geography does the Minister want the feedback to be gathered over? How does she see that working? Will it require further restructuring? The hon. Member for Lichfield talked about the importance of localism and how different areas of his constituency have different health needs. How does the Minister think that that will work under her new plans?

The Minister said that one benefit of the new process is reaching vulnerable individuals, but what is to stop Healthwatch doing that? Ultimately, if we have Healthwatch doing things now that are independent and respected across the House—I am sure your local healthwatch is also excellent, Ms Lewell; Lincolnshire’s certainly is—why not strengthen that voice? Why not say to those who are providing that service, “We’re going to give you more resources,” or “We’re going to ask you to deliver it in a slightly different way,” or “We’re going to ask you to focus on particular populations,” or even, “We’re going to invite you into the room with the ICBs so that they can hear you and listen carefully”?

Why not compel those making the decisions and delivering the services to listen to Healthwatch, rather than replacing it? It was not Healthwatch’s job to listen to them, but to gather the information and present it, and that is what it has done. Can the Minister explain how removing its independence is going to help? I simply do not understand it.

[Helen Morgan]

I am very grateful to serve under your chairship, Ms Lewell. My hon. Friend the Member for Winchester has made some general points about Healthwatch and the importance of an independent patient voice; I will not reiterate them, because he made them very well, but I want to speak specifically about local healthwatches and the benefits that they bring.

I find it quite difficult to hear in this room, so I hope the hon. Member for Lichfield will correct me if I have misunderstood the gist of his speech, but I was frankly astonished by the suggestion that if local managers had heard about the problems at Mid Staffs or at Shrewsbury and Telford hospital NHS trust, the concerns raised in those extremely serious scandals would have been addressed. The reality is that the management of both providers knew exactly about the concerns in those trusts, and they did not address them. That is why we have Healthwatch.

The hon. Member for Lichfield may be aware that my parents live in Stone, which was in the Mid Staffordshire constituency at the time. My mum was a clerk to Staffordshire county council, and I recollect very strongly that the health scrutiny committee at that council questioned the trust about its appalling mortality rate and was constantly reassured that there was nothing to see here. It absolutely failed to mark its own homework. The suggestion that my constituents Kayleigh and Colin Griffiths, who fought for the Ockenden report on Shrewsbury and Telford, did not first try the local services is, I think, missing the point.

With the Ockenden report on Nottinghamshire a couple of weeks ago, we also saw that the hospital trust commissioned several reports into its own maternity services, which found that it was failing. Instead of acting on them, it brushed them under the carpet and commissioned another. The suggestion that providers are capable in the current culture of dealing with those issues does not, I am afraid, hold true in the way it should across every trust.

[Dr Prinsley]

Is it the hon. Member’s belief that that is something that Healthwatch would have been able to deal with, support and prevent?

[Helen Morgan]

The hon. Member will know that Healthwatch was introduced almost as a direct consequence of the Francis review of Mid Staffordshire, so that was certainly the intention. I have discussed the variability of healthwatch organisations across the country and the fact that they are not as well funded as was originally intended. Although I take the point that they have not effectively delivered that alarm-raising service in every case, if they were properly funded and used in the way that they were envisaged to operate, they would be able to spot such issues.

[Dr Prinsley]

rose—

[Helen Morgan]

I am going to go on and give some examples. Central to the value and success of the Healthwatch network is its local focus and the fact it is centred in communities. Where it has worked well, that has allowed Healthwatch to earn trust and build relationships, especially with harder-to-reach communities, as we have discussed. I take the Minister’s point that we know about those harder-to-reach communities, but the reality is that we are not engaging with them, and that is important.

--- Later in debate ---

[Dr Johnson]

Is there not a third issue: that the local authority and the ICB will no longer have congruent areas and will therefore look at different populations?

[Helen Morgan]

The hon. Lady raises a good point. I do not want to revisit an earlier part of the debate, but it is certainly relevant that where there is not a local authority representative on the ICB and there is not a mayor in place, and the ICB’s area is not coterminous with the local authority boundary, that adds another element to the issue of the separation out of Healthwatch. Does the Minister agree that the independent and locally rooted Healthwatch cannot be replaced by processes that sit within the NHS system? Will she please reconsider the change? There is concern on all sides of the House, given the value that Healthwatch brings to the service.

[Edward Argar]

Clause 65 and schedule 10 focus on local healthwatch arrangements. As I said when speaking to the previous group of amendments, Healthwatch is respected and trusted at a national level, and that is even more the case at a local level. I fear that the Government seek to remove something that works, that is effective and that ensures a strong patient voice in the system.

It simply does not work to have integrated care boards take on those responsibilities, as they will be marking their own homework rather than being the independent patient voice. It is a little like the discussion the Committee had during the previous grouping on HSSIB, in which it turned out that the CQC will be able to investigate itself, but the chief executive of the CQC would decide whether any protected disclosures could be published during that investigation. That measure brings things entirely within the system and removes the independent voice, which is exactly what this clause also does.

The ICB is the voice of the NHS system, not the voice of the patient. We need the grit in the oyster that is provided by an independent voice talking to the ICB. Being in the room with an ICB will not mean that the patient voice is heard more loudly or clearly, or that it will be acted on—it is probably more likely to mean that it is not. As an example from my constituency, the ICB did conduct a consultation exercise on the proposed closure of St Mary’s birth centre in Melton Mowbray, the response to which was overwhelming: the patient voice said that they did not want that to happen. That response was fed into the ICB, but the ICB did what I fear it planned to do all along and closed the centre. Given that that voice in the room came from a consultation exercise led by the ICB, it seemingly did not make a jot of difference to the outcome or decision, or to whether the patient was heard.

On the impact of local authority scrutiny panels, the NHS ICB in Melton previously recognised the need for increased GP provision in the town due to the increasing size of the town and the long waiting times, but just recently decided to reverse that position and say that it did not see the need for that. Members of the scrutiny committee, across all parties, were absolutely clear that they disagreed with that decision, but did that get listened to or make a jot of difference to the ICB? No—the ICB did what it was going to do anyway and changed its mind.

My concern is that we will see less grit in the oyster and patient voice, and more managerialism in the NHS ICB system. We heard from the hon. Member for North Shropshire and the shadow Minister about the challenges there would be, even were that patient voice to happen. Given the Government’s 50% cuts to ICB budgets, which are already impacting frontline services, ICBs will not be able to take on additional responsibilities without the funding that they need. That is quite apart from the principle that they should not be marking their own homework. I fear that “system knows best” will become the default.

We have also heard about the geographical challenges. Given that mergers and acquisitions are getting even bigger, ICBs are moving further and further away from what was conceived: for them to have the same geographical footprint as the upper-tier local authority providing social care, to ensure that the two organisations spoke to each other and were better integrated. Removing the representative from the local authority that provides that healthcare from the board, even if they are replaced with a mayor, does not bring about the reconnection with social care provision that is so central. Removing the voice of general practice or primary care from the ICBs again moves that independent challenge away from the system.

I fear that this is a fragmentation of those links at a local level and the weakening, if not silencing, of a patient voice that can challenge publicly and ensure that what patients need to have said is genuinely said. Being in the room does not mean that that voice is heard or acted on, as shown from the examples I have spoken about: there is a consultation exercise, the view is reflected on, and the ICB does what it was going to do anyway and does not change its position. I have genuine concerns about the loss of an independent patient voice in a local context.

The Minister will correct me if I am wrong, but I think she made the point in her opening remarks that we have lacked not recommendations and suggestions for changes but action to fix the issue. But it is not for Healthwatch to take action to fix the issue; it is for the ICBs and the NHS to act on those recommendations. We are proposing to give the bits of the system that have failed to take action and fix the issue not just the responsibility that they already have but the responsibility for reflecting patient voice. The one bit that is working—where patients’ voices are heard—is the bit that we are getting rid of. We are not seeking to fix the bits that have real pressure and genuine levers to compel an ICB to act on those recommendations when they are made independently, rather than simply marking its own homework.

As with my reflections on clause 64, I genuinely fear that in this weakening of patient voice, particularly at a local level, the patient will be the loser because the system will continue to do what it wishes to do. It will do its consultations, and it may have a director of patient experience at an ICB level, but they will be working for the ICB; they will not be there as an independent voice to challenge the ICB—including publicly—on what it is doing.

I hope that the Minister reflects further on the real diminution, if not the neutering, of patient voice that comes with some of these arrangements. As always, I look forward to her reflections when she winds up.

--- Later in debate ---

[Karin Smyth]

I thank the hon. Lady for her comments. The purpose of the new clauses is to support our life sciences and medicine sector, in order to make that more streamlined. She will be aware of the proposals about the negative and affirmative procedure. If there were particular issues of scrutiny, normal parliamentary rules and processes would apply if Members wanted to raise any particular issue.

Question put and agreed to.

New clause 91 accordingly read a Second time, and added to the Bill.

New Clause 92

Medical Devices Regulations 2002: mutual recognition agreements

“(1) The Medical Devices Regulations 2002 (S.I. 2002/618) are amended as follows.

(2) For regulation 1A (Schedules) substitute—

‘1A Schedule

Schedule 2A has effect.’

(3) In regulation 2 (interpretation), in paragraph (1)—

(a) in the definition of ‘mutual recognition agreement’, in paragraph (a), for ‘country listed in Schedule 2’ substitute ‘country specified in a list published by the Secretary of State from time to time’;

(b) in the definition of ‘third country conformity assessment body’, for ‘established in a country which is listed in Schedule 2 and designated in accordance with a relevant’ substitute ‘designated in accordance with a’.

(4) Omit Schedule 2 (mutual recognition agreements).”—(Karin Smyth.)

This new clause would amend the definition of “mutual recognition agreement” in the Medical Devices Regulations 2002 (as it has effect in England and Wales, and Scotland) so that agreements are defined by a list published by the Secretary of State, rather than a Schedule to the regulations.

Brought up, read the First and Second time, and added to the Bill.

New Clause 93

Consultation about medicines and medical devices regulations

‘(1) Section 45 of the Medicines and Medical Devices Act 2021 (consultation) is amended as follows.

(2) In subsection (1), for “a provision of Part 1, 2, 3 or 4” substitute “Part 1 or 3”.

(3) After subsection (1) insert—

“(1ZA) Before making regulations under Part 2 or 4 the relevant authority must—

(a) carry out a public consultation, or

(b) consult such persons as it considers appropriate.”

(4) In subsection (3), at the beginning insert “Where a public consultation is carried out”.

(5) In subsection (4), in the words before paragraph (a), for “subsection (1)” substitute “subsection (1ZA)”.’—(Karin Smyth.)

This amends the duty to consult in relation to regulations about human medicines and medical devices. It gives the option of consulting such persons as the relevant authority considers appropriate instead of a public consultation.

Brought up, read the First and Second time, and added to the Bill.

New Clause 94

Medicines and medical devices regulations: parliamentary procedure

‘In section 47 of the Medicines and Medical Devices Act 2021 (regulations: procedure), for subsection (3) substitute—

“(3) Regulations under Part 1 are subject to the draft affirmative procedure.

(3A) Regulations under Part 2—

(a) are subject to the negative procedure if they contain only provision of one or more of the following descriptions—

(i) provision made in reliance on section 6(1)(a) (fees);

(ii) provision amending the meaning of ‘appropriate practitioner’ or ‘approved country health professional’ for the purposes of Part 12 of the Human Medicines Regulations 2012 (see regulation 214 of those regulations);

(iii) provision amending any of the following provisions of the Human Medicines Regulations 2012—

• regulations 217C(3) or 217CA(3) (original pack dispensing for products containing relevant substances: definition of ‘relevant substance’),

• Schedule 13 (prescription only medicines for which community practitioner nurse prescribers are appropriate practitioners),

• Schedule 15 (requirements for specific products subject to general sale),

• Schedule 16 (patient group directions and vaccine group directions),

• Schedule 17 (exemption for sale, supply or administration by certain persons),

• Schedule 18 (substances that may not be sold or supplied by a pharmacist without a prescription in reliance on emergency provisions),

• Schedule 19 (medicinal products for parenteral administration in an emergency), or

• Schedule 21 (medicinal products at high dilutions);

(iv) provision amending regulation 250 of the Human Medicines Regulations 2012 (restrictions on persons to be supplied with medicinal products: exceptions) for the purpose of changing the products to which any exception from time to time provided for by that regulation applies;

(v) provision that is consequential on provision of a description mentioned in any of sub-paragraphs (ii) to (iv);

(b) are subject to the made affirmative procedure if they—

(i) contain only provision that is made in reliance on section 7 (emergencies),

(ii) contain a declaration that the person making them considers that they need to be made urgently to protect the public from an imminent risk of serious harm to health, and

(iii) are not within paragraph (a);

(c) are subject to the draft affirmative procedure if they are not within sub-paragraphs (a) or (b).

(3B) Regulations under Part 3—

(a) are subject to the negative procedure if they contain only provision made in reliance on section 12(1)(a) (fees), and

(b) are subject to the draft affirmative procedure if they are not within paragraph (a).

(3C) Regulations under Part 4—

(a) are subject to the negative procedure if they contain only provision of one or more of the following descriptions—

(i) provision made in reliance on—

• section 17(1)(a) (fees), or

• paragraph 9 of Schedule 2 (supplementary provision about civil sanctions);

(ii) provision amending or revoking regulation 1ZA of the Medical Devices Regulations 2002 (expiry of certain provisions) or consequential on such provision;

(b) are subject to the made affirmative procedure if they—

(i) contain only provision made in reliance on section 18 (emergencies), and

(ii) contain a declaration that the person making them considers that they need to be made urgently to protect the public from an imminent risk of serious harm to health;

(c) are subject to the draft affirmative procedure if they are not within paragraph (a) or (b).”’—(Karin Smyth.)

This changes the parliamentary procedure for certain regulations from the draft affirmative procedure to the negative procedure. The changes all relate to regulations about medicines and medical devices (although the procedural provisions relating to certain other matters are restated in the amendment).

Brought up, read the First and Second time, and added to the Bill.

New Clause 95

Medical devices etc: parliamentary procedure for certain fees regulations

‘In Schedule 7 to the European Union (Withdrawal) Act 2018 (regulations), in paragraph 12—

(a) in sub-paragraph (1) for “relate to altering the amount of a fee or charge to reflect changes in the value of money” substitute “fall within sub-paragraph (1A)”.

(b) after sub-paragraph (1) insert—

“(1A) Provision falls within this sub-paragraph if it relates to—

(a) altering the amount of a fee or charge to reflect changes in the value of money,

(b) altering the amount of a fee or charge to be charged in connection with the exercise of a function which a public authority has by virtue of provision made under section 8C in connection with the EU medical devices Regulations, or

(c) altering the amount of a fee or charge to be charged under the Blood Safety and Quality Regulations 2005 (S.I. 2005/50).

(1B) In sub-paragraph (1A)(b) ‘the EU medical devices Regulations’ means—

(a) Regulation (EU) 2017/745 of the European Parliament and of the Council of 5 April 2017 on medical devices, amending Directive 2001/83/EC, Regulation (EC) No 178/2002 and Regulation (EC) No 1223/2009 and repealing Council Directives 90/385/EEC and 93/42/EEC, or

(b) Regulation (EU) 2017/746 of the European Parliament and of the Council of 5 April 2017 on in vitro diagnostic medical devices and repealing Directive 98/79/EC and Commission Decision 2010/227/EU,

as they have effect from time to time by virtue of Article 5(4) of the Windsor Framework.”’—(Karin Smyth.)

This allows regulations altering certain fees in relation to medical devices etc to be made subject to the negative resolution procedure. At the moment those regulations are subject to the affirmative resolution procedure.

Brought up, read the First and Second time, and added to the Bill.

New Clause 1

National Maternity Commissioner

“(1) The Secretary of State must, within six months of the passing of this Act, appoint a National Maternity Commissioner, situated within the Department of Health and Social Care.

(2) The functions of the National Maternity Commissioner are to—

(a) oversee NHS maternity services;

(b) act as an independent voice for women and families;

(c) ensure lessons are learned from identified failures and that the recommendations of maternity reviews are acted upon;

(d) promote consistency, safety and accountability across NHS maternity services; and

(e) advise the Secretary of State on matters relating to the safety, quality and provision of maternity services in England.

(3) The person appointed as Commissioner must—

(a) be a person with knowledge, expertise and experience relevant to the discharge of functions of the role;

(b) have first-hand experience of working in maternity services, so far as reasonably possible; and

(c) not be a sitting Member of Parliament.”—(Helen Morgan.)

This new clause would require the Secretary of State to appoint a maternity commissioner within the Department of Health and Social Care to oversee national maternity services. This person should be someone with experience and expertise of maternity services, and not a political appointment.

Brought up, and read the First time.

[Helen Morgan]

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

[The Chair]

With this it will be convenient to discuss new clause 13—Maternity Safety—

“(1) The Secretary of State must ensure that every NHS maternity unit is rated ‘good’ or ‘outstanding’ by the CQC.

(2) The Secretary of State must, within 6 months of the passage of this Act, establish a scheme to support NHS trusts to deliver the requirement under subsection (1), which includes—

(a) 24/7 consultant obstetrician cover on every labour ward,

(b) one-to-one midwifery care,

(c) a Director of Midwifery in every maternity service,

(d) ringfenced maternity service development funding, and

(e) a dedicated neonatal workforce plan.

(3) Within 12 months of the commencement of the scheme under subsection (2), and every 12 months thereafter, an annual report should be laid before both Houses of Parliament on the effectiveness of the scheme.”

This new clause would place a duty on the Secretary of State to create a scheme to ensure that every maternity unit in the country achieves a “good” or “outstanding” rating by the CQC.

[Helen Morgan]

New clause 1, which I tabled, would require the Secretary of State to appoint a maternity commissioner within the Department of Health and Social Care to oversee national maternity services. This person should be someone with experience and expertise in maternity services, and not a political appointment.

It is important to start by saying that I tabled the new clause before we had the report from Donna Ockenden on the Nottingham review, and last week’s report from Baroness Amos on her national review, both of which recommended the appointment of a maternity commissioner. Obviously, since then, the Secretary of State has announced that he will appoint a maternity commissioner. None the less, I will state the arguments for having one, and if the Minister can give us some assurances today, I will not press the new clause to a vote.

Just to set the scene, which I think we all know too well, maternity services in England have suffered a series of high-profile scandals. The cost of political neglect has been paid by families in terms of trauma, injury and lost lives. We have known for a long time that maternity services in this country have been failing. Numerous recommendations have been made over that period, but they have not been effectively acted on in a consistent way, and Baroness Amos’s inquiry finally confirms that.

It is important to say that the vast majority of births take place safely, successfully and happily. However, where things go wrong, having a baby safely has become a postcode lottery. Women are being routinely silenced, and staff who raise the alarm on unsafe care or systemic discrimination have been put off or crushed by a culture of fear. We therefore need to make England the safest country in the world to have a baby.

The Liberal Democrats have been campaigning on that for a long time, and following the Ockenden and Amos reviews it genuinely feels that there is now the will and focus to deal with the problem once and for all. This issue has been going on for far too long. We thank the Secretary of State for hearing our campaign and Baroness Amos’s calls for a national maternity commissioner to oversee national standards and drive change. We also pay tribute to campaigners such as Louise Thompson and the former MP for Stafford, Theo Clarke; without their advocacy, and without so many women sharing their stories, we would not be moving forward.

It is important to say that one individual—one maternity commissioner—will not solve all the issues in maternity by themselves, but they can help drive change and address recurrent issues, whether those are cultural or about safe staffing. They can hold Ministers to account, help restore public confidence in NHS maternity service and ensure that accountability exists. But I want to be clear that the buck should always stop with the Secretary of State; they hold the power and the purse strings, and this role cannot be used by Ministers as a way to shirk that responsibility.

I hope the Minister will clarify a few key points. First, can she reassure us that the commissioner will be independent and not a political appointee? It is essential that this individual feels confident to hold the Government to account and have those difficult conversations. That is far less likely if they are a political appointee.

Secondly, women have made it clear that for them to be reassured that this change will happen and happen meaningfully, they need a clear timetable for when the maternity commissioner will be in place and operating. Understandably, the Secretary of State has not been able to provide that yet, given the need for this Bill to pass through Parliament and for the statutory role to be on the books, and given the time it will take his maternity taskforce to define what it wants the role to look like and for the appropriate legislation to be written and put in place. However, we hope we can get a firm commitment to a timetable from the Minister today or, if not today, then on Report.

We think the commissioner should be involved in the establishment of the taskforce, because it is important that it does not develop a plan that they are required to implement, despite it being something they personally would not have approved. I therefore hope the commissioner will be in place very quickly, even if only on a temporary basis, so that they are working to get the taskforce plan into place.

We heard from the Secretary of State that the commissioner will co-chair the taskforce alongside him. That seems to be the right move, and I welcome it, but, as I said, it is important that they have some role in shaping its action plan, so that they can feel responsibility for it and be fully behind its implementation. Will the Minister commit to introducing a temporary maternity commissioner so that that can happen?

Finally, we have heard reports that the taskforce is not meeting very regularly. I hope the Minister can reassure me that it is now meeting much more regularly and getting that plan into place as quickly as possible, and that the Secretary of State is fully on board in driving forward the commissioner’s role as soon as possible.

New clause 13, which is also in my name, is about putting a duty on the Secretary of State to create a scheme to ensure that every maternity unit in the country achieves a good or outstanding rating from the CQC. I will not repeat some of the points I have just outlined about failing maternity services, but the first quarter of 2026 saw the worst ever recorded rate for maternity injuries. Four years ago, the Ockenden review into the Shrewsbury and Telford hospital NHS trust, which is in my area, found that over 200 babies had died unnecessarily in Shropshire. Yet, despite several immediate and essential actions being put in place, a subsequent CQC review found that the majority of maternity units in this country did not achieve a good rating for safety—they were inadequate in some way. That is just not acceptable.

Our package of measures includes the maternity commissioner, which the Government are obviously progressing with, and we are very pleased about that. However, we also need investment in the service to ensure that that maternity commissioner has the resources they need to make the changes required. We therefore call for one-to-one midwifery care for every woman in labour; a consultant on every labour ward 24 hours a day, seven days a week; a director of midwifery—a senior, experienced midwife—in every maternity service to ensure that more junior midwives on that ward are suitably supervised; the restoration of ringfenced service development funding; and a dedicated neonatal workforce plan.

New clause 13 also requires an annual report to be laid before the House on the “effectiveness of the scheme”. That would allow Parliament to track progress and hold the Government’s feet to the fire on it. Baroness Amos has also called for regular reporting to Parliament to maintain accountability, albeit through the maternity commissioner.

There seems to be consensus, here and across the NHS, on the need for meaningful and decisive action on maternity. There is a great deal of overlap between our plan and the recommendations Baroness Amos has made, and I hope the Minister will be able to take some of these points on board and incorporate them into the Bill.

[Dr Johnson]

As the hon. Lady said, new clause 1 seems somewhat redundant, because the Government appear to have decided to appoint a maternity commissioner.

New clause 13 asks for a report. Before I go any further, I should say that I am a member of the Royal College of Paediatrics and Child Health and have attended the delivery of many babies as a paediatrician at different levels of seniority. I should also say that I am a member of the British Medical Association, that I continue to work as an NHS consultant paediatrician and that I worked at Nottingham University hospitals NHS trust in late 2012 and 2013.

I have great sympathy with the reasoning behind what the hon. Member for North Shropshire is proposing. We have all been shocked by the many reports we have read, the circumstances we have heard about, the tragedies that have occurred over many years and the challenges that are faced by maternity care. I am not sure that writing more reports is going to help; I think we need more action rather than words.

The hon. Lady mentioned the taskforce. I was disappointed that it took the Government so many months to establish it, that it took so long for it to meet and that it has met only a few times. As we have talked about things such as Healthwatch and the HSSIB, the Minister has shown her enthusiasm to get on with things and ensure that the recommendations made in the varying reports are implemented. I would therefore be interested to understand how that will occur in maternity.

My understanding is that the Government are going to produce a plan on how to deliver the recommendations in the recent report, and that is going to be available by Christmas. However, that means that we will then be in a situation where the Government came into power in mid-2024 and then spent a year writing a plan—the 10-year “Fit for the Future” plan. Around the time that they published that, they decided that they needed an urgent maternity report; that was going to take a few months, but it ended up taking another year in of itself. Now we are going to take another six or seven months writing another plan on how to implement the plan we have written, based on the plan we wrote before, based on the plan we did not have at the general election.

I am interested to understand how the Government are going to convert the good intentions I am sure they have into action. In particular, their manifesto promised that thousands more additional midwives would be trained. I would be interested to know what progress they have made on that.

--- Later in debate ---

We will also shortly publish a 10-year workforce plan, which will put the NHS workforce on a sustainable footing so that it can deliver the service model set out in the 10-year health plan. The Government think that the focus should now be on developing the action plan. Now is not the time to legislate for a new approach, so I hope that the hon. Member for North Shropshire will withdraw the new clause.

[Helen Morgan]

I thank the Minister for her response. Given the commitments that she has made, I do not intend to press the new clauses, but I hope she will be able to come back to us on Report with some more concrete progress. I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

New Clause 3

Assessment of risks posed by contracts with non-UK based suppliers

“(1) Within six months of the passing of this Act, the Secretary of State must conduct and lay before Parliament a risk assessment of all contracts between NHS organisations and suppliers based outside of the UK.

(2) In conducting an assessment under this section the Secretary of State must—

(a) pay particular regard to contracts which provide technology companies with access to confidential patient data;

(b) consult national security experts on the risks posed to UK sovereignty by such contracts;

(c) consider risks associated with the sharing of confidential patient data with organisations based outside of the UK;

(d) assess public and NHS staff attitudes to relevant suppliers and any implications such attitudes may have on the use and effectiveness of products or services provided under the contract; and

(e) consider the background of relevant suppliers, known contracts with other states and organisations, and any relevant ethical considerations.

(3) Where any significant risk is identified, the Secretary of State must set out the Government’s intentions to manage and mitigate such risks, including its intention to use or develop domestic technologies, systems or products in place of those provided under the relevant contract.”—(Dr Chambers.)

This new clause would require the Government to publish a risk assessment of contracts between NHS organisations and suppliers based outside of the UK.

Brought up, and read the First time.

[Dr Chambers]

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