Health Bill (Sixteenth sitting)

Helen Morgan Excerpts

Committee stage
Thursday 16th July 2026 Public Bill Committees

Brought up, and read the First time.

[Helen Morgan (North Shropshire) (LD)]

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

[The Chair]

With this it will be convenient to discuss new clause 37—Powers for coroners and medical examiners to report suspected health system failings—

“(1) The Secretary of State must, by regulations, establish a standard mechanism for coroners and medical examiners to refer cases where they suspect failings in the provision of health care.

(2) A coroner or a medical examiner has a duty to report (a ‘duty to whistleblow’) using the mechanism established under subsection (1) if, in the course of their duties, they have reasonable grounds to suspect that a death or incident involved systemic failings in a health care setting.

(3) A referral under this section must be directed to any or all of the following bodies, as the coroner or medical examiner considers appropriate, based on the nature of the suspected failing—

(a) the chief officer of police for the relevant police area,

(b) the Care Quality Commission,

(c) the Department of Health and Social Care, and

(d) the Health Services Safety Investigations Body.

(4) Regulations under subsection (1) must specify—

(a) the information to be included in a referral,

(b) the timeframe within which a referral must be made following the formation of a suspicion, and

(c) guidance on the criteria for determining to which of the bodies listed in subsection (3) the referral must be directed.

(5) A disclosure made in fulfilment of the duty under subsection (2) is a protected disclosure for the purposes of Part 4A of the Employment Rights Act 1996 (protection for whistleblowing).

(6) The duties imposed by this section are in addition to, and do not affect, a senior coroner’s duty to make a report under paragraph 7 of Schedule 5 to the Coroners and Justice Act 2009 (reports on action to prevent other deaths).”

This new clause requires the Secretary of State to create a standardised framework for them to formally refer suspected health system failings (including systemic issues) directly to the police, the CQC, the Department of Health and Social Care, and the HSSIB, with a duty on coroners to participate. It provides legal protection for those making such referrals.

[Helen Morgan]

New clause 36 would introduce a mandatory individual duty for members of NHS trust and NHS foundation trust boards to escalate evidence of systemic medical malpractice to the Care Quality Commission, the Department of Health and Social Care and the Health Services Safety Investigations Body. It would also impose a collective duty on the board to formally refer the trust to regulators if staff raise concerns about malpractice.

New clause 37 would require the Secretary of State to create a standardised framework for coroners and medical examiners to formally refer suspected health system failings, including systemic issues, directly to the police, the CQC, the Department of Health and Social Care and HSSIB, with a duty on coroners to participate. It would provide legal protection for those making such referrals.

The new clauses were tabled in the light of the Ockenden review into failings at Nottingham university hospitals NHS trust, which came out a couple of weeks ago, and other reviews, including the review of Mid Staffordshire some time ago, which showed that hospital management failed to spot, and more importantly deal with, systemic issues. Staff were dismissed, failures were hidden from regulators, and patients and their families were not listened to. In the case of Nottingham, the board commissioned a number of independent reports into maternity services, and when it did not see an answer it liked, it just commissioned another one. We feel strongly that those issues should have been referred onwards as soon as they were known about. The new clauses would introduce a mandatory duty and create a standardised framework within which such concerns could be raised.

Coroners and medical examiners often spot trends or worrying failures in care that they think might hint at something systemic, but their main power is a regulation 28 order. When an order goes back to the hospital board, it investigates and reports back: “Everything is fine. We’ve dealt with the problem. There’s nothing to see here.” Coroners are often overworked and trying to get through huge court backlogs, so they do not have sufficient capacity to push back, even when they question the diligence of the internal review. We want to give them more powers and standardised routes to escalate concerns to the police, the CHC, the DHSC or the HSSIB , where they see fit. We need as many eyes on this as possible, because we have seen a defensive cover-up culture too many times.

We tabled similar amendments to the Hillsborough Bill to achieve the same outcome. We all know that the NHS is under strain and overworked, but trust management need to be more transparent, open and receptive to staff concerns. Although I do not intend to push the new clause to a vote, I am interested to hear from the Minister what the Government plan to do to ensure that concerns are acted on more quickly.

[Karin Smyth]

I thank the hon. Member for North Shropshire, who raises issues of patient safety diligently on behalf of her constituents and the wider system. I will take the time to answer some of the points about where the Government are. Obviously, we support prioritising patient safety, which along with service quality and experience is of the utmost importance.

On new clause 36, trusts are already subject to regulatory and contractual requirements to report medical malpractice, which is why we do not think the new clause is necessary. For example, CQC regulations on safe care and treatment and on good governance are central to trust accountability for systemic malpractice. They require trusts to have effective systems to identify patterns of harm, manage risks and deliver system-wide improvements.

Trusts are required to identify and report incidents leading to significant harm through the Learn from Patient Safety Events service, ensuring that the CQC is informed and enabling NHS England to identify trends and support learning and improvement. This information can be shared with and accessed by HSSIB and could in the future be shared with and accessed by the investigations arm of the CQC.

The CQC regulation on duty of candour reinforces transparency through truthful accounts of what has happened when something goes wrong, including where harm reflects systemic issues. Under the patient safety incident response framework, trusts must undertake patient safety learning investigations into certain incidents to support learning and improvement.

In parallel, the NHS provider licence requires NHS trust boards to maintain clear accountability for quality of care and reporting of safety information through effective governance systems. Where failures of governance occur, NHS England has the powers to intervene. Those powers will transfer to the Secretary of State as part of the Bill.

The new clause would clearly duplicate current processes. Together, the existing mechanisms already help trusts to identify and address systemic issues locally, while enabling national aggregation to support system-wide learning.

New clause 37 seeks to require the creation of a standardised framework for coroners and medical examiners to report health system failings. I take the opportunity to reassure the hon. Member for North Shropshire that regulations already require medical examiners to report serious concerns identified in respect of clinical governance, patient safety or public health surveillance, in accordance with local reporting arrangements. Existing regulations also require coroners, in the context of an investigation, to issue a report to a person, organisation, local authority, or Government Department or agency where the coroner believes they may have power to take relevant action to prevent future deaths.

In September 2024, the Department of Health and Social Care introduced death certification reforms, putting in place regulations to provide greater safeguards for the public by ensuring independent scrutiny by medical examiners of all deaths not investigated by a coroner. These reforms, as set out in the Medical Certificate of Cause of Death Regulations 2024, which require an independent review to be carried out for all deaths in England, introduce a system whereby all deaths are subject to either a medical examiner’s independent scrutiny or a coroner’s investigation.

Should the medical examiner detect concerns about care, they will refer such cases to established clinical governance review processes and bodies and notify the coroner or, if necessary, the police. The Notification of Deaths Regulations 2019 require all doctors, including medical examiners, to refer a death to a coroner if they believe that deficiency of care while undergoing treatment contributed to the death, making the death unnatural. Under the Coroners and Justice Act 2009, a coroner has a statutory duty to report issues to the appropriate bodies where they believe that action can be taken to mitigate or prevent the risk of future deaths, and both the report and responses to it are published by the chief coroner.

When incidents and errors occur resulting in death or serious injury, it is important that we learn any lessons. The Government are committed to ensuring that the prevention of future deaths reports are taken seriously and lead to meaningful action. The Department is working across Government and with the chief coroner to identify ways to strengthen oversight and ensure that the right organisations are consistently notified of concerns, respond to them in a timely manner and drive appropriate action.

Under the Medical Act 1983, the General Medical Council ensures that all doctors, including medical examiners, report suspected health system failings by speaking up. That is a mandatory professional obligation linked to a doctor’s licence to practise, embedding this whistleblowing requirement into the GMC’s core regulatory and fitness to practise frameworks. The GMC also enforces a professional duty of candour requiring all doctors to be open and honest with patients and official bodies when things go wrong and actively report adverse incidents so that systematic lessons can be learned.

In summary, both new clauses duplicate requirements that already exist. Regulations, systems and processes are already in place to report suspected health system failings to the appropriate bodies. For that reason, I ask the hon. Member for North Shropshire to withdraw the new clause.

[Helen Morgan]

I thank the Minister for outlining the existing statutory framework. I agree that it ought to be sufficient, but there are high-profile instances where it has not been, so I look forward to hearing more from her on Report about how the cultural change will be implemented so that further legislation is not necessary. I beg to ask leave to withdraw the new clause.

Clause, by leave, withdrawn.

New Clause 38

Single sex facilities

“The Secretary of State is required to ensure that there are single sex—

(a) changing rooms for NHS staff

(b) toilets and washing facilities for NHS staff

(c) wards for NHS patients

(d) toilets and washing facilities for NHS patients.”—(Dr Caroline Johnson.)

This new clause creates a requirement for the Secretary of State to ensure certain single sex facilities are made available for NHS staff and patients.

Brought up, and read the First time.

[Dr Johnson]

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

This is a very straightforward new clause. The Secretary of State would be required to ensure that there are single-sex changing rooms, toilets and washing facilities for NHS staff and single-sex wards, toilets and washing facilities for NHS patients.

The UK Supreme Court unanimously ruled that a woman is defined by biological sex in 2025, and the Minister herself said:

“We are completely committed to single-sex spaces.”

However, it appears that the Minister for Women and Equalities did not get that memo. Despite having apparently been sat on her desk since September, the new draft code from the Equality and Human Rights Commission was not laid before Parliament until 21 May. One week before that guidance was published, a female NHS England employee in Leeds won her claims of indirect sex discrimination and harassment over a policy allowing transgender colleagues to use toilets and changing rooms that correspond to their gender identity rather than their biological sex. On 28 June, after the draft code was laid, it was reported that West London NHS trust had told patients that they could use single-sex facilities based on gender identity.

It has taken the current Health Secretary some time, but I understand that he has changed his mind on the issue and come to the same conclusion as others: that a woman is, in fact, a woman and that toilets and changing facilities must be protected. Will the Minister follow his lead and protect single-sex spaces in NHS trusts? The Supreme Court has ruled that a woman is defined by her biological sex. My party knows that. The Minister claims her party knows that too. It is time for her to show it by pulling the levers that only she can to ensure that patients and staff are protected right across our health service.

--- Later in debate ---

[Dr Johnson]

New clause 48 would require the Secretary of State to

“publish and maintain a national framework for improving access to radiotherapy services in England.”

One in four people can expect to need radiotherapy in their lives. That is a lot of people who will need consultation, assessment, pre-treatment planning and treatment delivery. Data published a few years ago showed that Scotland, Wales and Northern Ireland have more linear accelerator machines per million people than in England. Can the Minister confirm whether that is still the case? Last year, Radiotherapy UK had research indicating that more than 60,000 cancer patients are not getting the radiotherapy they need and I know particular areas of the country are struggling. Can the Minister provide an update on the roll-out of the new LINAC machines at 28 hospitals, which she spoke about in May 2025?

We were also told that by March 2027, up to 27,500 additional treatments will be delivered. Can the Minister share some information on how that will be achieved? The Labour Government have now been in power for two years. They have raised taxes by more than £60 billion and they do not have much to show for it. They have not produced a workforce plan. They have said that one will be imminent; can the Minister confirm whether it will be published today before we break for the recess? Is the intention to publish it during the recess or will we have to wait until the autumn?

There is a 31% shortfall in clinical radiologists. New clause 48 essentially requires the publication and maintenance of

“a national framework for improving access to radiotherapy services”.

This Government have essentially shown that if a requirement is not in legislation, plans just get delayed, diminished and disowned, but patients cannot afford to wait any longer.

[Helen Morgan]

I rise to speak to new clauses 53 and 54, tabled in the name of my hon. Friend the Member for Epsom and Ewell (Helen Maguire), and new clause 65, tabled by my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron).

New clause 53 would give patients a right to start cancer treatment within 62 days of referral and require the Secretary of State to establish a scheme to deliver that. It would also require the Secretary of State to update the House on progress against the target on or around the time of World Cancer Day. New clause 54 would require the Secretary of State to introduce regulations requiring the Government to co-ordinate research into cancers with the lowest survival rate.