National Maternity and Neonatal Investigation

James Murray Excerpts

Tuesday 30th June 2026 Written Statements

[The Secretary of State for Health and Social Care (James Murray)]

I refer hon. Members to the oral statement I made in the House today, 30 June 2026, on the publication of the national maternity and neonatal investigation.

[HCWS166]

National Maternity and Neonatal Investigation

James Murray Excerpts

Tuesday 30th June 2026 Commons Chamber

[The Secretary of State for Health and Social Care (James Murray)]

With permission, Madam Deputy Speaker, I shall make a statement on the national maternity and neonatal investigation.

Less than a week ago, I stood at this Dispatch Box to respond to the report by Donna Ockenden that exposed devastating failings over more than a decade in Nottingham. As many right hon. and hon. Members rightly made clear following my statement, the shocking report into what had happened was far from the first: in 2015 we learnt of the failures at Morecambe Bay; in 2022 we were appalled to hear about what had happened at Shrewsbury and Telford; and that same year the Kirkup inquiry exposed failings in East Kent. There were also other reviews and reports over the years on specific issues related to maternity care, and it is deeply upsetting to recognise that Donna Ockenden is preparing to undertake further reviews into failings in Leeds and Sussex. Despite all the warnings, the NHS is still failing women, babies and their families on a scale that shames our society.

Bereaved and harmed families are hearing once again the unbearably painful and distressing consequences of the opportunities that have been missed to put things right. As I stand here, I think of how they must be feeling. I know from meeting some of the Nottingham families that their unwavering determination is accompanied by a sense of exhaustion—a sense that however many times they have told their stories, however hard they have campaigned for justice and accountability, and however strongly they have fought to stop what happened to them from happening to others, hardly anything has changed. That feeling will be shared by mothers and their families up and down the country who have suffered so appallingly too, and there will be deep sadness and distress as they are forced to relive their trauma. The burden they bear must sit with us all.

That is why my right hon. Friend the Member for Ilford North (Wes Streeting) decided last year to announce a national investigation into maternity and neonatal services. That investigation has been carried out by Baroness Amos, whose report is published today. I put on record my thanks to her and her team for the comprehensive and compassionate way they have carried out their work.

The Amos investigation gathered evidence from more than 10,500 people, with Baroness Amos and her team personally meeting more than 450 affected families. They visited 12 NHS trusts and heard from over 9,000 staff through surveys, site visits and one-to-one discussions. Although they found that many women experience good and safe care, the report paints a bleak picture of failings at every stage for too many: from pregnancy, labour and delivery to the first hours, days and weeks after birth. When I read about those systemic failures, I found them not only shocking and upsetting but devastatingly familiar, because they are explicitly repeated in review after review. Baroness Amos found a system that is fragmented, overly complex and far too slow to learn. It needs to be radically overhauled.

Last week I spoke about the need to avoid having review recommendations accepted but then sitting on a shelf gathering dust. Other hon. Members agreed with the need to break that cycle, so that is what we will do. As I told the House last week, the national maternity and neonatal taskforce, which I chair, will create a comprehensive action plan by the end of this year.

Today’s recommendations from Baroness Amos include a proposal for a modern service framework in line with the 10-year health plan to support system change and drive consistent, quality care. Those recommendations, along with the national-level recommendations from Donna Ockenden, will feed into our plan, which will make sure that women and babies receive safe, compassionate care no matter where they live. But I do not want people to have to wait for the plan to be completed for us to start making progress, so I am also taking immediate measures in response to Baroness Amos’s investigation, which I shall now set out for the House.

In considering Baroness Amos’s recommendations, the words of a Nottingham mother I met ring loudly in my ears. She said that “accountability drives action”, so today I can confirm that, in response to these recommendations, the Government will appoint the first ever maternity and neonatal commissioner. The holder of this new statutory role will have responsibility for driving change across all parts of the NHS, including those who provide, regulate and investigate care. They will co-chair the national taskforce, along with me. They will hold the system to account, and their role will be to champion the voices of women, babies and families; to ensure that those voices are heard within Government when decisions are made and implemented.

Last week I announced that the Government would roll out Martha’s rule, so that women and their families can demand a second opinion if they feel their concerns are being ignored. That meets a key and familiar concern that the Amos investigation pointed to: women not being listened to as a common factor in maternity failings. Because those concerns are too often batted away before women even arrive at hospital, I can today confirm that we will this week publish new national standards for maternity triage, so that care is consistent across the NHS and women’s concerns are recognised, valued and acted upon at every turn. I expect every trust to prioritise the implementation of these standards and I have asked NHS England to make sure that this is the case and to report progress directly to me.

Some of the starkest examples of racism, discrimination and inequality happen in maternity and neonatal settings, as the Amos report laid bare. The result is that the risks are notably higher for some women and babies and, as Baroness Amos points out, this is a critical safety issue. Black babies are still more than twice as likely to be stillborn as white babies, and black women are almost three times more likely to die during pregnancy or shortly after birth than white women. While tackling inequalities will be a core component of the national action plan, we will make a start straightaway by rapidly expanding the roll-out of the perinatal equity and antidiscrimination programme to every trust. All teams will be mandated to receive hands-on support, to hear first-hand experience, and to undertake face-to-face learning and development programmes. Every trust will have completed the programme by the end of next year.

Births that are safe for mothers and babies depend on health services having skilled, trained midwives. As Baroness Amos rightly identified, staff shortages can have a dangerous impact, with examples of some services being forced to delay admissions when they get too busy. Since coming to office, we have recruited 2,000 more midwives, and last year our graduate guarantee gave 850 more newly qualified midwives an immediate route into the profession. I can tell the House today that we have now created a further 1,000 temporary roles to help newly qualified midwives join the NHS. These new posts will be accompanied by investment, too, and I can confirm that we are investing an extra £41 million, on top of the £145 million already invested, to upgrade outdated and rundown maternity and neonatal facilities.

Alongside these practical measures comes a far more profound challenge that we must face. It is clear from my conversations with affected families, with Donna Ockenden and with Baroness Amos, and from the findings of all the reports, that culture is where so much of the responsibility lies. That culture is the most deep-rooted cause of the failures we have seen, and the most fundamental thing we must change. We know that when families have been in distress and looking for answers, they were too often ignored, sneered at, disbelieved, blamed and lied to. We know from review after review that wrongdoing is covered up and that bullying towards staff who try to sound the alarm is rife, so we will dismantle toxic dynamics, boost staff morale and support better teamwork between midwives, doctors and other clinicians.

We need not only the right policies, procedures and processes to be in place, but a fundamental reset in the culture of a service that too often puts the desire to protect itself above its duty to protect women and babies. That culture change must come from the top. It is time for trust leaders, executives and senior clinicians to pay attention to what is happening on their watch, to put professional tribalism aside, to lose the bunker mentality when things go wrong and to ensure that the safety of women and babies always comes first.

This has to be a watershed moment. We must break the cycle of recommendations sitting on a shelf gathering dust. We cannot go on having review after review while women and babies, as well as their fathers and other family members, continue needlessly to suffer injury, death and lasting trauma. We should all feel a responsibility to ensure that this opportunity is not squandered. We owe nothing less to every family the NHS has failed in the past, and to every family who will rely on it in the future. I commend this statement to the House.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Secretary of State.

[Stuart Andrew (Daventry) (Con)]

I thank the Secretary of State for advance sight of his statement, and I thank Baroness Amos and her team for their compassionate work. As I said last week, I pay tribute to the women and families who gave evidence and to the babies at the heart of the inquiry. Many revisited the most painful moments of their lives after years of fighting to be heard. Their courage places a responsibility on us all.

Last week, the House confronted Donna Ockenden’s devastating findings in Nottingham. Today we face the wider national picture. Successive investigations expose the same failures: women dismissed, deterioration missed, staff silenced, inequalities unchallenged and leaders failing to learn. The problem is no longer a lack of evidence; it is a failure to act. Donna Ockenden said this morning that, sadly, so much in this report is stuff that we already knew. She also raised concerns about waiting until December, and I welcome the fact that the Secretary of State has just announced some of the work. She also said that no commissioner alone can fix a system needing action from every level from the Secretary of State right down to every ward. Donna Ockenden commands enormous respect and we should all listen to her, because she is right.

When will the Leeds and Sussex reviews produce their reports, and how will Ministers act on concerns before they conclude, so that families in those areas can see the change that they need as soon as possible? Families should not have to keep proving the scale of harm. Their testimony must now lead to action. The Birth Trauma Association says that the report has overlooked serious injury to women and brain injury to babies, so will the action plan address those harms, and how will families shape and scrutinise it?

We welcome the work beginning immediately on triage, discrimination, staffing and urgent estate risks. This is so important, and we must get on with that work, but families cannot wait until the end of the year for the wider plan. Those expecting babies now need reassurance about what will change and when. So many must be anxious, and we need to do all that we can to reassure them. The new triage standards will be published this week. By when must every trust meet them? Will the Secretary of State commit to update the House, by oral or written statement, on trust-by-trust progress? Will the estates funding include accommodation for parents close to neonatal units so that families are not separated from their critically ill babies?

We do not oppose a statutory maternity and neonatal commissioner, but Ministers must be clear about the role’s purpose, powers and accountability, because just one person cannot bring the change that is needed; local leaders have a responsibility too. When will the commissioner be appointed, and what will they be able to compel trusts, regulators and national bodies to do? How will local leaders be held accountable when care remains unsafe?

The additional midwifery posts are welcome, but temporary roles are not a sustainable workforce plan. Donna Ockenden has warned of rota gaps and of staff leaving obstetrics and midwifery. The 10-year workforce plan has been promised, delayed and pushed back repeatedly. When will it finally be published, and will it provide the permanent workforce that these recommendations require? With women having babies later and pregnancies becoming more complex, how will those at higher risk receive early specialist care?

I agree with the Secretary of State that the culture has to change. Listening to women is a clinical duty, not a courtesy; as I said last week, it is at the core of our safety issues. When concerns are dismissed, warning signs are missed, and mothers and babies are put at risk. That duty must apply equally in respect of every woman. A woman’s safety must not depend on her ethnicity, first language, disability, income or ability to fight through the system. As I said last week, both to the House and to the Secretary of State privately, I want us to work together constructively. Where the Government act with the urgency that the report demands, they will have our full support. We all have a duty, and ours is to support these changes.

Women and families will not judge today by new structures, promises or another report. They will judge it by what happens when a woman says that something is wrong. Is she heard? Are warning signs acted on? Is senior help available when needed? Are maternity units safely staffed? Can staff speak without fear? Do families receive honesty and compassion when harm occurs? Are fewer mothers and babies coming to harm? When decisions are taken, will they be fully explained?

The evidence has been gathered. Families have told their stories. The system has been warned. Now it must change.

[James Murray]

I thank the shadow Secretary of State not only for his questions, but for his tone and approach. When I gave the statement about Donna Ockenden’s report last week, we all agreed that the responsibility to deliver real change is shared by everyone in this House, so I appreciate his approach.

The right hon. Gentleman asked about the investigations in Leeds and Sussex, to which Donna Ockenden will be turning her attention over the rest of this year. It might be helpful for the House to understand that in developing a comprehensive action plan through the national taskforce, a framework will be devised so that any recommendations from future reviews can be incorporated into that plan and its implementation. That will ensure that we do not have a situation in which the plan is developed and future reviews come to conclusions or recommendations without a clear way for those to be integrated into the action plan. I hope that that gives him some reassurance over the process.

The right hon. Gentleman spoke about recognising families who have been harmed, as well as babies who survived and have grown up into children and adults while living with the harm of failings in maternity care. I am very conscious of them, not least because of the people I have met who sometimes feel forgotten or feel that their children are forgotten when we have these conversations. They live with the impact of brain injuries or other issues that arise during birth. They must not be forgotten, and I will ensure that they are included in the process.

The right hon. Gentleman asked about the roll-out of the new national triage standards, which will be published this week. The NHS England chief executive is meeting with NHS system leaders today to begin the process of ensuring that the triage standards, along with some of the other urgent measures that I have spoken about today, are rolled out. Although it is right to take time to get the comprehensive action plan in place by the end of the year, we do not want to waste time before we get on with the measures that we have decided should progress more quickly. NHS England leadership is progressing with those today.

The right hon. Gentleman asked about the funding for critical safety works in the maternity estate. Those critical safety measures are important, but the action plan will set out a more comprehensive approach not just for the physical infrastructure, but for the culture, which we have spoken about many times. We cannot invest money in culture in the same way as we can do so in physical infrastructure, but it is something that we need to address. We all agree on that. I sense that I had agreement from the House when I raised the importance of addressing cultural problems in maternity services.

The right hon. Gentleman asked about the responsibility being placed on the commissioner as just one person. I reassure him that my vision is for the commissioner to play a crucial role, but not on their own: they will co-chair the national taskforce with me, help to ensure that the national action plan is implemented, hold the system to account and, crucially, be a voice for women in the system. One way of the Government starting to address the issue of women being ignored in maternity services—an issue I have heard about so many times—is by ensuring that the commissioner is a voice for them when decisions are taken.

The temporary roles are an immediate step this year to ensure that newly qualified midwives have a way into making a contribution to NHS maternity services. Funding for those will be baselined in future years, and trusts will decide, trust by trust, how the funding is distributed among different roles. That will vary depending on needs in local areas.

The right hon. Gentleman also spoke about the importance of identifying women who are at higher risk because of different circumstances or problems they may face in giving birth. That is exactly what I hope the new triage standards will begin to address. If the triage standards can identify issues before they escalate and ensure that women get the right support more quickly, we will have an opportunity to avoid the extra, avoidable harm caused to women by delays in getting the right support.

The shadow Secretary of State closed his remarks by talking again about the need for a change in culture. He talked about the support from the Opposition, who will of course robustly challenge us where appropriate but support the aims that we are seeking to achieve. I thank him for that.

[Several hon. Members rose—]

[Wes Streeting (Ilford North) (Lab)]

May I add my thanks to Baroness Amos? I join the Secretary of State in emphasising the importance of culture change, but culture change will not happen without accountability. In all the conversations I had with families who were suffering bereavement, harm to themselves or harm to their children, what shocked me most was the cover-up culture in the NHS, which persists to this day, and was exposed once again by Donna Ockenden in her report last week.

There is a legitimate debate to be had about whether we continue with place-based inquiries or have a national statutory public inquiry, and we must have that debate. But whatever the answer to that question, any report will be worth the paper it is written on only if all those involved in decision making and care are held to account through a duty of candour. Given that, where is the Hillsborough law? The law is important not just for justice for the 97, but for justice for these families and in preventing future harms. Will it at least go through this House before the summer recess? Until it is on the books, people will continue to duck the real questions.

[James Murray]

I thank my right hon. Friend for his comments, and again put on record my thanks and tribute to him for having initiated the investigation that Baroness Amos published today. He has been a committed champion of change in maternity services in this country.

I could not agree with my right hon. Friend more about the importance of accountability in culture change. Without accountability, we will not have culture change across maternity services, and the culture of cover-ups will continue. Senior clinicians will feel that they can continue to get away with any mistakes. They will feel that they can avoid scrutiny when investigations take place, and will continue, in too many cases, to be more concerned with protecting themselves than with protecting women and babies.

On what we can do to change that culture, culture is deep-rooted and requires us to take a number of different actions, but the duty of candour is the single most powerful change we can make clearly, loudly and publicly, because the message it will send to senior clinicians thinking about what to do in the future if they make a mistake, or if they are tempted to cover up things that go wrong, is that one day they will be held to account, and there is no avoiding that. With a duty of candour in place, there will no longer be an opportunity for clinicians, in particular senior clinicians, to refuse to engage in that process, to refuse to be held to account and be part of the justice process. People will face up to two years in prison if they refuse to co-operate, so it is a serious measure. I very much agree with him on the importance of ensuring that the Hillsborough law gets on the statute book so that this duty of candour can apply to future maternity investigations.

[Madam Deputy Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

May I also add my thanks to the Secretary of State, to Baroness Amos and her team, and to the families that have relived the pain of their experiences to bring about this report? But the Amos report tells us little that we did not already know—indeed, it confirms our worst fears. Maternity services in England are fundamentally broken with the cost of political neglect being paid in trauma, injury and lost lives. Figures revealed by the Liberal Democrats in the last week show that the first quarter of 2026 saw the worst rate ever recorded for maternity injuries. In fact, while the number of reviews into NHS maternity services has steadily ticked up, we have also seen rising maternal mortality rates.

Four years ago, I spoke in this Chamber in response to the findings of the Shrewsbury and Telford review, which were devastating for my community. Last week, I stood here really distressed, actually, as we heard further traumatic reports from the Nottingham review. But anger is not enough. The Government must meet this moment now and implement Baroness Amos’s recommendations in full and without delay, or the families simply will not forgive them. To do this, we need genuine accountability through the NHS and the Department of Health and Social Care, accompanied with the investment needed to make Britain the safest country in the world to have a baby.

I welcome the Government’s commitment to a national maternity commissioner—a long-standing Liberal Democrat campaign—and the other urgent and immediate actions that the Secretary of State has outlined in the last week. They are all urgent and are signs that this is being taken seriously. But we need to recognise that a commissioner alone cannot fix the broken system. I urge the Secretary of State to work with us and look at our maternity rescue package for inspiration for his action plan—it has a great degree of overlap with Baroness Amos’s recommendations. Our package would ensure one-to-one midwifery care for every woman in labour, additional senior midwives, an obstetrician on every ward, and mandatory updated annual training. Will the Government commit here and now to implementing all those recommendations and working with us to deliver the change we need?

[James Murray]

I thank the hon. Lady for her comments, and she puts it well when she talks about Baroness Amos’s investigation confirming our worst fears. I was shocked but not surprised, sadly, to read the investigation report. It was devastatingly familiar to read what it set out as being the failings across the country. The report’s recommendations will now become part of the work of the taskforce, which I chair, to produce the comprehensive action plan by the end of this year. My intention is that the taskforce will take all the national recommendations from Baroness Amos’s report, as well as the national-level recommendations from Donna Ockenden’s report last week and recommendations from any other investigations and reports, and ensure that the action plan it produces comprehensively addresses all the issues raised. I think that we would all agree that there is not—one, two, three—a small number of actions that we need to take; this has to be a comprehensive plan to truly transform the service.

[Madam Deputy Speaker]

I call the Mother of the House.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Ind)]

The Secretary of State will know that many women are never more vulnerable than in childbirth. It is about not just the vulnerability, but the horror of what women and their babies are exposed to in childbirth. We see inquiry after inquiry, and nothing seems to improve. Very many of those who suffer during childbirth are black women and their babies. The Secretary of State said himself that

“Black babies are still more than twice as likely to be stillborn than white babies, and black women are almost three times more likely to die during pregnancy or shortly after birth than white women.”

The whole House wants to see progress, but it is not enough to have another inquiry or another report; what black women want is equity of treatment and fewer black women and their babies dying.

[James Murray]

I thank my right hon. Friend for her comments and agree about how shocking the failures in maternity services are, particularly because these failings and the failure to listen to women happens at a point when they are at their most vulnerable. It is at that moment when they are let down. When they need the NHS the most is when the NHS fails them, and that is one aspect of this that makes it truly devastating.

My right hon. Friend also rightly highlights the impact on black women and their babies, who are at more risk than white women and their babies, and the inequalities that exposes. As I mentioned during my earlier statement, we will begin by ensuring that the perinatal equity and anti-discrimination programme is extended to all trusts by the end of next year, but that is an immediate measure we are taking rather than the sum of all measures that we will take on this front. Inequality, racism and discrimination will be a central part of the action plan that the taskforce develops.

[Sir Jeremy Hunt (Godalming and Ash) (Con)]

I strongly agree with the comments of the former Secretary of State, the right hon. Member for Ilford North (Wes Streeting), about the need for getting the culture right with accountability. When I was Secretary of State, we passed the duty of candour regulations. They were supposed to make it—well, they do make it—a criminal offence for trusts not to tell the truth to families when a tragedy has happened. Yet to this day, trust lawyers advise doctors, nurses and midwives not to be open about what has happened when there is the prospect of legal action further down the line. Does the Secretary of State—I know he is very committed to this—agree that we will clear up this anomaly in the Hillsborough law so that it is just not possible for trusts not to tell the truth and so that trust lawyers always advise their own doctors, nurses and midwives that they must tell families exactly what happened?

[James Murray]

I thank the right hon. Gentleman for his comments. Again, I agree with him and my right hon. Friend the Member for Ilford North (Wes Streeting) on the importance of accountability for changing culture. During the statement on Donna Ockenden’s report last week, he commented that this is about having accountability structures embedded throughout the system, because this is not something that the top of the NHS, the NHS chief executive, the Secretary of State or the ministerial team can control throughout the NHS. The structure has to be embedded to ensure that accountability happens at every level—something I very much took to heart and agree with when it comes to what we need to do next.

On the right hon. Gentleman’s specific point about the Hillsborough law and how that will address the issue that he refers to about legal departments effectively advising a cover-up, that sounds concerning, so I will look into that as part of our work to ensure that the system works properly. The expectation with the duty of candour, which will come in under the Hillsborough law, is to ensure that we never again have a situation as happened in Nottingham—I could not quite believe it, if I am honest—where many senior clinicians simply refused to take part. It is outrageous. It is unacceptable that so many senior clinicians were able to, and felt able to, just say no. That is not accountability if it is optional, and that is what we need to change.

[Andy MacNae (Rossendale and Darwen) (Lab)]

I hugely welcome the report and join in the thanks to all those who made it possible, but most fundamentally the families who shared their experiences and showed extraordinary courage through the whole process. Many of those stories were shared with us in the all-party parliamentary group on baby loss, and I assure those families that we will carry on listening to and being a voice for them through this process.

The reports makes many powerful recommendations—I welcome the action plan and the maternity commissioner—but the Government must retain responsibility for the ultimate outcomes. Following the expiration of the national maternity safety ambitions in 2025, will the Secretary of State recommit to meaningful targets to reduce stillbirths and neonatal deaths and introduce a target to finally fully eliminate inequalities in baby loss?

[James Murray]

My hon. Friend draws out an important point: a key part of developing the national action plan is to ensure we have the right metrics and mechanisms for monitoring its implementation and the right structures in place to make sure it is implemented across all trusts. In working with members of the taskforce, I will ensure that those accountability mechanisms for the delivery of the plan are in place, because I have spoken many times today about the importance of recommendations not sitting on shelves. We need to ensure we have the structures in place such that the actions in the national action plan are implemented, we can see they are being implemented, and we can give people confidence that that is the case.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

I, too, thank Baroness Amos, her team and, most especially, the families who so bravely gave the evidence that has formed this report. Further to the conversation about accountability, the Secretary of State will have noticed that some families are concerned that the commissioner is just one person, and that there is too much for them to do. Can he make clear that the buck stops with him and, indeed, the PM, and that he will not let go of this? The commissioner will report every six months to the Health and Social Care Committee—we welcome that—and once a year to Parliament. Further to that, will he personally commit that the Secretary of State will seek permission from Mr Speaker to make a statement to the House once a year, so that they can be held personally accountable for the progress made too?

[James Murray]

In describing the role of the commissioner, the hon. Lady is right to emphasise that it cannot all be on one person. The commissioner is a vital role, and it being on a statutory basis will give the position real weight within the system to hold the system to account and help the Government to ensure the implementation of the comprehensive national action plan. But she is right to say that accountability has to include the Secretary of State and the Prime Minister, because it is a duty that we all hold as MPs, that the Government hold and that I hold as Secretary of State, and the Prime Minister ultimately holds that responsibility too.

It is not in any sense intended to be a passing of responsibility to a commissioner. The commissioner role is being established to support the effectiveness of the work we are seeking to do as a Government to implement the national action plan, but crucially, when accountable politicians are taking decisions, the commissioner will be a voice for women in the system. I have heard so many times that women’s voices are not being heard in the healthcare system, particularly when things go wrong and women have concerns in maternity services. This commissioner will be a way of making sure those voices are right at the heart of decision making.

[Florence Eshalomi (Vauxhall and Camberwell Green) (Lab/Co-op)]

I thank the Secretary of State for making this statement. I pay tribute to the noble Baroness Amos for her work and the care and dedication with which she has produced this report, and to the many women who came forward with their testimonies. I think back to the concerns that I raised just over nine years ago, when I was giving birth to my second son. Nine years on, women are still being dismissed, still not being listened to and still being silenced when they raise those valid concerns.

I pay tribute to the hard-working midwifery team at St Thomas’ hospital across the river, who continue to care for many women. I also want to highlight the Southwark Maternity Commission, led by Councillor Evelyn Akoto, and the work of organisations like Five X More, which continue to expose the issues faced by black and minority ethnic women. We also have to highlight the concerns of black and minority ethnic staff, who are told by some patients that they do not want to be served and helped by them. When will the real action plan be published? How will it create accountability to ensure that doctors and clinicians actually listen to these women?

[James Murray]

The action plan, which will be developed through the taskforce that I chair—the commissioner will co-chair it when that position is established—will publish its national action plan by the end of this year. That will consider all the recommendations from Baroness Amos’s report, as well as Donna Ockenden’s reports.

My hon. Friend makes a point that is worth drawing attention to, which is that many midwives and others working in maternity services do a really important job and work really hard to provide excellent care to women. That is not to diminish the scale of the failings, but it is to give the right perspective on all those midwives who do a really important job and work hard to care for women and their babies. That is evidenced by the fact that 9,000 members of staff came forward to give evidence in Baroness Amos’s investigation—they are concerned, and they want to see change as well. While this is, of course, primarily about women and their babies and families, staff also have a really important voice in this, and we need to improve the system so that they can make their contribution as well.

[Alicia Kearns (Rutland and Stamford) (Con)]

This week last year, I had multiple pulmonary emboli only a few weeks after giving birth. I am very grateful to Dr Laura Stephens, who saved my life and then was punished for ordering the test which found the emboli. Blood clots are the No. 1 cause of death in pregnant and post-partum women, and yet there is not a word about their risk in any pregnancy pack given out in this country. The national action plan will fail if it does not tackle blood clots as the No. 1 cause of maternal deaths. Will the Health Secretary kindly meet me and work with me, so that together we can save lives?

[James Murray]

I thank the hon. Lady for sharing her experience and raising the importance of this issue for the benefit of maternity services more widely. I am very happy for myself or one of the ministerial team to meet her to discuss this in detail, because it is very important that that is part of the national action plan and our wider response.

[Jen Craft (Thurrock) (Lab)]

I very much welcome the report and Baroness Amos’s work to highlight the failings across our maternity system. It is pure and utter medical misogyny that has led us here. The value that we place on the lives and experiences of women has been brought to the fore, and it is very, very low. The throughline of this report and the ones before it is that women’s voices were not heard, their pain was not believed, and their experiences were completely and utterly disregarded. That must change.

I would like to add my voice to the calls for measures to address the disparity in treatment for black and ethnic minority women. There must be proper training and continuing professional development to ensure that black women do not have the experiences that we have seen to date. I also plead with the Secretary of State to ensure that any proposals contain real accountability measures. I have a maternity unit in my constituency that is inadequate and has always been rated inadequate or “requires improvement”, but I have never seen a senior member of staff ever hauled over the coals. That cannot be right and it has to change.

[James Murray]

My hon. Friend is absolutely right to call this what it is in many cases, which is misogyny in maternity services, and to draw attention to the different impact on different mothers and the racial and ethnic inequality within the system. The anti-discrimination programme that I mentioned, which is being rolled out over the next year and a half, will be an important first step, but it cannot be the sum total of what we do to address discrimination and inequality. That will be a focus of the national taskforce, as will—to repeat a point many Members have rightly made—accountability, because it is only by embedding accountability throughout the system that we can be truly confident of change.

[Andrew George (St Ives) (LD)]

Like others, I welcome this report. The Secretary of State referred to Dr Bill Kirkup, who resigned from the Amos review as an adviser because he felt that it was skirting around certain birthing ideologies and caesarean targets. The Secretary of State said that “staff shortages can have a dangerous impact”, and indeed they can. Although he and Baroness Amos refer to culture, a lot of that culture is to do with budgetary and other pressures that result in members of staff on the frontline being belittled and discouraged from blowing the whistle about unsafe staffing levels. Will the Secretary of State look again at the report, and consider for the first time introducing mandatory safe frontline staffing levels for these services?

[James Murray]

The hon. Gentleman raises an important point about ensuring the right levels of staff and training, and about ensuring that the right structures are in place. I know from seeing Baroness Amos’s report, and from the recommendations in Donna Ockenden’s report last week, that those questions will be central to the work of the taskforce in developing the national action plan. As I have said a few times today, it is not the case that there are simply one or two levers that we need to pull, or actions that we need to take, to bring about change; however, the issues that the hon. Gentleman mentions are clearly central to what we need to do.

[Josh Fenton-Glynn (Calder Valley) (Lab)]

I echo what was said by my colleague from the Health and Social Care Committee, the hon. Member for Oxford West and Abingdon (Layla Moran). Baroness Amos pointed to workforce challenges and their impact on care and safety, and she noted that 67% of midwives reported burnout. Meanwhile, a General Medical Council survey found that 63% of obstetrics and gynaecology trainees had a high or very high workload. That is higher than the 42% average. The workforce plan has to address those problems—but will it?

[James Murray]

My hon. Friend asks a question about staffing, and ensuring not only that we have the right levels of staffing, but that people in the service have the right responsibilities, so that we do not have members of staff suffering from burnout or having a workload that they cannot cope with. Those are critical issues that the taskforce will consider in its development of the national action plan.

[Sir Julian Lewis (New Forest East) (Con)]

Last Wednesday, and again today, the Secretary of State expressed his shock at the number of senior clinicians who refused to take part in the Nottingham review. May I repeat a suggestion that I made last Wednesday? Those clinicians should be named publicly. That is a step that he could take straight away. If a parliamentary question for written answer is tabled, asking him to name those clinicians, will he answer it? I cannot think of a better or more justifiable use of parliamentary privilege.

[James Murray]

I will take away the right hon. Gentleman’s suggestion and think on it, because it is critical that we have accountability. As I said in response to earlier questions, I find the decision of senior clinicians not to take part in the Nottingham inquiry utterly unacceptable, and incomprehensible on a personal level. We must ensure that that never happens again.

[Madam Deputy Speaker (Caroline Nokes)]

I call Dr Ben Coleman.

[Ben Coleman (Chelsea and Fulham) (Lab)]

I am not a doctor, but thank you so much, Madam Deputy Speaker. Perhaps I am a doctor from the university of life—who knows?

I pay tribute to Baroness Amos for this excellent report, and to my right hon. Friend the Member for Ilford North (Wes Streeting) for commissioning it. It is a remarkable piece of work. It follows on from Ockenden, and the report on black maternal health done by my Health and Social Care Committee—its Chair, the hon. Member for Oxford West and Abingdon (Layla Moran), sits on the Opposition Benches. We see the same problems again and again: misogyny, racism and a lack of accountability. I am therefore delighted that this plan will be developed in six months, through the taskforce, and that we will have a maternity commissioner. I know that my constituent Louise Thompson, who has been campaigning hard for this position to be created, will be delighted. However, like me, I think she will have a question about timing. Will it be possible for the commissioner, who will be introduced on a statutory basis, to be brought in quickly enough for them to have a full role in shaping and creating the plan that will be before us in six months? If not, why not?

[James Murray]

My hon. Friend asks about the timing, and the process for establishing a commissioner. As a first step, in the next two weeks, I will meet members of the taskforce to agree the scope, and a detailed role for the commissioner, because I want that scope and role to be agreed with them, given that they will be developing the national action plan. We then need to get the commissioner on a statutory basis, and I want to do that as quickly as possible. I am keen to look for options to do that through the Health Bill, but that will obviously be subject to discussions with the usual channels. Once that is in place, we can appoint the commissioner as quickly as possible.

It is worth emphasising that the role of the commissioner will be to implement the national action plan, so work on developing the plan and on establishing the commissioner will begin immediately. When the commissioner is appointed, they will have a role in implementing the national action plan. The issue is not simply about developing a national plan; it is about ensuring that it gets implemented, and that we hold trusts and other organisations across the system to account.

[Rosie Duffield (Canterbury) (Ind)]

Our APPG on birth trauma report in 2024 was the first in Parliament on that subject. We heard from more than 1,300 women and families. The report was titled, “Listen to Mums”. I am glad that an independent maternity commissioner will finally be implemented, after our years of calls for one. Bill Kirkup’s headline finding in his 2023 review of east Kent was also that we should listen to women. The Health Secretary has repeated the importance of listening to women—the mothers, midwives, and experts, and even the MPs who have worked for years on this issue. Why does he think that we have not been listened to, and are often not even invited into the room? How will he work to demonstrably change that in his time in the Department?

[James Murray]

The hon. Lady is absolutely right to draw further attention to the issue of women being ignored in health services generally, but specifically when it comes to maternity services. That goes back to the culture in maternity services. It is a devastating conclusion to come to, but we see a culture there of misogyny, of women being ignored, and of their concerns not being listened to and acted on. We need to change that culture, and one of the first actions that we can take to do so is to have accountability. We must ensure accountability, through the duty of candour that we have discussed, and through other actions that we can take to enhance accountability throughout the system. That is a critical first step in ensuring that we change the culture.

[Michelle Welsh (Sherwood Forest) (Lab)]

I welcome Baroness Valerie Amos’s review, and I thank her and her team for their commitment to this vital work. Once again, this review confronts us with a very uncomfortable but real truth. The reality is that this inquiry and the Donna Ockenden inquiry did not come about because of a system, NHS England or a regulatory authority; it came about because families have to keep on speaking up, over and over again, about one of the most horrific and traumatic things ever to happen. All the while, there is a culture within of mutual protection, and a code of silence, which has enabled some staff to shield each other from consequences.

I welcome the recommendation on the national maternity and neonatal commissioner—a strong, independent voice with the power to challenge—but we know that one appointment alone will not solve the problems. We need fundamental reform of the wider system of oversight and accountability. Regulators, NHS bodies and inspection regimes must change. Reviews do not save lives, but action does. We need strong leadership; big, bold decision making; and a determination to implement change, rather than simply to recommend it.

[James Murray]

My hon. Friend is absolutely right. I again put on record my thanks to her for supporting families in their fight for justice and accountability. She is absolutely right to say that families have driven this work. It is families who have had the determination, persistence and stamina. It is quite hard to imagine people having those qualities when they are dealing with such unimaginable pain that lasts their whole life, but that is what families have done. That is why I feel that it is our responsibility to ensure that they do not have to drive these changes alone. We as MPs, Government Ministers and Secretaries of State support families in the drive for accountability, justice and change. My hon. Friend is absolutely right; this must be about fundamental reform to all parts of the system, including the regulators, which have let women down far too often.

[Sir Bernard Jenkin (Harwich and North Essex) (Con)]

Will the Secretary of State keep an open mind as to whether it is right to abolish the Health Services Safety Investigations Body, which was specifically designed to provide for a duty of candour? Clinicians would be obliged to give evidence to HSSIP; they could not refuse, and there would be criminal penalties if they did. As we have already established, the duty of candour, as conceived in the Hillsborough law, does not work, and I suspect there will be no improvement unless HSSIP is allowed to carry out completely independent investigations that have proven that they can carry the confidence of the public, patients and clinicians. Will the Secretary of State keep an open mind about keeping HSSIP?

--- Later in debate ---

[James Murray]

I thank the hon. Gentleman for his question. I know that this is an issue that he feels strongly about, and he has raised it with me before. The Minister of State for Health, my hon. Friend the Member for Bristol South (Karin Smyth), who is taking the NHS modernisation Bill through Parliament, is leading on the changes that we are seeking to make around HSSIP and the Care Quality Commission. I hear what the hon. Gentleman is saying, but my hon. Friend has clearly set out the Government’s rationale for the changes we are seeking to making and what they will accomplish.

[Marsha De Cordova (Battersea) (Lab)]

I pay tribute to Baroness Amos for the report she has published, which lays bare the scale of racism and discrimination in maternity and neonatal care. This is not a surprise to anyone; it is an issue that I and many other hon. Members in this place have been raising for years. I welcome the recommendation to root out racism and discrimination in these services, but more broadly, we all know that structural inequalities exist across the NHS, whether we like it or not, and we need to hold those responsible accountable. Can the Secretary of State say a little bit more about how he intends to be held accountable in this place, and about how senior clinicians will be held accountable for their actions? We need to root out racism and discrimination.

[James Murray]

My hon. Friend is right to again draw attention to the importance of accountability in making maternity services operate as they should. That applies to the racism, discrimination and inequality that it is important that we tackle, as she says. Ultimately, it is right that I as Secretary of State and all Government Ministers are held to account by Parliament for our actions in this space, but we also need to make sure that accountability is spread throughout the system. Our decision to extend the anti-discrimination programme across all trusts by the end of 2027 is an important first step in making sure that all trusts are held accountable for tackling discrimination and racism where it exists. More broadly, the national action plan, which we will publish by the end of the year, will explain exactly how we will embed accountability for racism and discrimination throughout the system.

[Liz Jarvis (Eastleigh) (LD)]

Recommendation 3 of the report calls for improvements to how the system responds when something goes wrong, including providing a sincere apology. Will the Secretary of State apologise now to my constituents Charlotte and James, who lost their baby Norah at Winchester hospital, and to the thousands of families who have suffered the loss of a baby due to systemic failures in NHS maternity care?

[James Murray]

I thank the hon. Lady for her comments, and I am incredibly sorry to hear about her constituents Charlotte and James and their baby Norah. I met some of the families in Nottingham two weeks ago, and the depth of pain was numbing—that is a word that someone in the room said to me—because what was said was so heavy to hear and to understand. What made me feel even more numb was recognition that this deep pain is replicated so many times; there is also the breadth of the pain—the sheer scale of it. The hon. Lady’s constituents Charlotte and James and their baby Norah are just one more example of families being let down by NHS maternity services. The responsibility to do something about it weighs heavily on all of us, and on me as Secretary of State.

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

I welcome the Secretary of State’s statement and the work of Baroness Amos on this vital report. Disabled women are 44% more likely to suffer a stillbirth than non-disabled women. Drawing on the evidence session I chaired with our MaternAble campaign of disabled mothers, Baroness Amos’s report highlights the devastating discrimination and structural barriers that are causing such inequalities for disabled women, from devastating assumptions that we are not sexually active or capable of parenting to the lack of accessible maternity spaces and medical equipment, as well as insufficient access to British Sign Language interpreters. It sets out the appalling lack of co-ordination and continuity of care across maternity pathways and services for disabled mothers. Will the Secretary of State meet me to ensure that disabled women’s voices are central to the Government’s taskforce and in implementing the report’s recommendations to overcome the inequalities we face in our maternity care?

[James Murray]

My hon. Friend is an incredibly powerful advocate on the issue of the discrimination that disabled mothers face in the health service, but particularly in maternity services. She has spoken about both the discrimination and the barriers to accessing care; she is right to say that those barriers are wide and systemic, and that needs to be addressed as part of the comprehensive action plan. I would be very happy for myself or a member of my ministerial team to meet my hon. Friend to discuss this issue in more detail.

[Dr Ellie Chowns (North Herefordshire) (Green)]

I welcome Baroness Amos’s investigation, which has shone a light on the fact that these failings in maternity services are not isolated to one hospital or another, but exist across the piece. The Secretary of State rightly identifies that culture is at the centre of this issue, and that we must listen to the voices of women and of whistleblowers. That applies not just to maternity services, but across the NHS and, indeed, in public life more widely.

The Secretary of State has spoken about accountability starting from the top, but I noticed that he swerved the question about whether he would come back to the House to report on progress against the goals he has set himself. It is shocking and shameful that black women are three times more likely than white women to die in maternity. Will he commit to coming back to the Chamber, reporting and holding himself to account on changing those racial disparities and ensuring true equity in healthcare?

[James Murray]

I absolutely agree with the hon. Lady that I, as Secretary of State, must be held to account, and that is the role of this House. I will take that away and work out the best way of making sure that that happens, on a basis and to a timetable that people can understand, because I would like to make sure that I am held to account for delivering the whole action plan in the right way. I will take that point away and come back to the hon. Lady with an update.

[Bell Ribeiro-Addy (Clapham and Brixton Hill) (Lab)]

I, too, put on the record my thanks to Baroness Amos and her team, and to the families who relived their pain so that this report could exist—they are the real heroes here. I welcome the report, as well as the announcement of the new maternity and neonatal commissioner. It is vital that the report recognised structural racism, but that will mean nothing unless it leads to national standards that tackle inequality and deliver high-quality care for every mother and their baby.

I note that the report stops short of recommending a target to bring racial disparities in maternity care to an end. Perhaps that is because the commitment was ours to keep from our manifesto. In April, the Minister for Secondary Care told the House that the target to end racial disparities in maternity outcomes would be informed by this report’s recommendations. They have been published now, so will the Secretary of State finally give us a timetable for delivering on that target? I remind him that black women are three times more likely to die in pregnancy and childbirth, and their babies are twice as likely to be stillborn. These are not statistics; they are mothers and children who are still dying. We promised a target at the last election. Without one, we cannot measure progress, and we cannot end that disparity.

[James Murray]

My hon. Friend is right to draw attention to the disparity in what black women and their babies experience in the health service and the extra risks they face, particularly in maternity services. The taskforce will produce a comprehensive action plan by the end of the year, and I anticipate that it will include metrics for delivery and ways of monitoring progress. I will make sure that my hon. Friend’s comments are fed into the work of the taskforce.

[Bobby Dean (Carshalton and Wallington) (LD)]

To deliver on this review’s recommendations in full will require serious capital investment. Just last week, we heard that St Helier, the hospital in my constituency, was considering closing its maternity unit altogether due to potentially unsafe pipework. Will the Government commit to reviewing the phasing of the new hospital programme, or at the very least providing the funds required to keep those buildings safe and open until the delivery of a new building?

[James Murray]

On capital investment, I set out in my statement that we have announced an extra £41 million specifically to address critical safety issues in maternity and neonatal services. That funding is on top of the funding already in place, and it will help address those critical safety issues. The wider action plan will set out our overall approach. While funding will be a consideration in what the Government do, I again draw attention to the importance of deep-rooted issues such as culture, which must be addressed as part of the plan.

[Dr Zubir Ahmed (Glasgow South West) (Lab)]

I start by commending my right hon. Friend on his thoughtful and considerate approach to this investigation and other matters during his time in office. He rightly spoke about culture, and others have spoken about ideology. Does he agree that the only ideology that matters as we try to change this culture should be rooted in science and evidence?

Will my right hon. Friend therefore consider ensuring that women in maternity are the first in line to be the beneficiaries of that science and evidence, whether through the single patient record or having access to their maternity care records? That data can make sure that poor care has nowhere to hide. We need to finally get AI-enabled scanners and replace the 19th-century equipment that is currently being used to listen to babies’ heartbeats.

Finally, will my right hon. Friend share the findings of this report formally with the Scottish Government, because many of the findings on training, culture and clinical pathways will resonate there? Unfortunately, the Scottish Government have been less than forthcoming with their own investigations into this matter.

[James Murray]

I thank my hon. Friend for his emphasis on the need for us to tackle the deep-rooted cultural problems in maternity services. He talks about how the only ideology that we should follow should be based on science and evidence. I agree with him on the importance of science and evidence, and of making sure that women are aware of the risks and benefits of the different options available to them, so that they can make informed choices. I add that the only ideology I would be comfortable signing up to is one that says that women must be listened to. That is a principle that I think we can all agree on, and we should make sure that it is embedded in our maternity services.

My hon. Friend mentions investment in technology, including the single patient record. The single patient record can be of real benefit and make a difference, particularly in maternity services, and it will be enabled by the NHS modernisation Bill that is going through Parliament. I want to make sure that the single patient record is available to maternity services as quickly as possible. I am happy to share a copy of the report with the Scottish Government.

[Alison Bennett (Mid Sussex) (LD)]

The Secretary of State’s announcement of 1,000 extra midwives is welcome, even if the funding is temporary. However, this is a review of maternity and neonatal services. In Baroness Amos’s review of Sussex, she noted that in the 12 months ending in October 2025, only 50.1% of shifts at the Royal Sussex county hospital in Brighton were staffed according to British Association of Perinatal Medicine guidelines. What provision is the Secretary of State making to ensure that neonatal staffing is safe?

[James Murray]

I thank the hon. Lady for welcoming the additional 1,000 positions to make sure that newly qualified midwives can find a way to contribute to the NHS. She raises staffing and training, as other Members have rightly done. The taskforce will consider questions about ensuring that we have the right staffing in place, with the right training to support it, ahead of the publication of the national action plan at the end of the year.

[Catherine McKinnell (Newcastle upon Tyne North) (Lab)]

This report is welcome, but that does not make its existence any less tragic. Far too many mothers and babies have been failed, including mothers like my constituent Amie, who late last year was turned away repeatedly, despite reporting reduced movements. Her baby Seren was born stillborn. The NHS spends almost as much on clinical negligence payouts as it does on maternity care itself. Can the Secretary of State update us on progress made following the Lock review into clinical negligence? It is about time we started investing in better care, rather than paying out for failure.

[James Murray]

I was incredibly sorry to hear about my hon. Friend’s constituent Amie, who was turned away repeatedly from services despite asking for their help. We have heard that story far too many times as part of the work that Baroness Amos and Donna Ockenden have done and from our constituents. My hon. Friend is right to point out the amount of money that goes on clinical negligence, rather than making sure that services are better in the first place, which would avoid the need for clinical negligence payouts. I have met David Lock KC to discuss his ongoing work on that issue, and I will be working with him closely on it in the months ahead.

[Adam Dance (Yeovil) (LD)]

Yeovil hospital was included as part of the review after the temporary closure of its unit last year. Since then, families, frontline staff and I have repeatedly raised concerns with Government and NHS leaders about working culture, bullying, staffing levels and support. Today’s review backs that up, after months of feeling that our concerns have not been properly acted on. Can the Secretary of State detail what the Government are doing to improve staffing levels in rural maternity units and to address working culture, leadership, accountability and whistleblowing?

[James Murray]

The hon. Gentleman is right to draw attention to the impact that bullying and a poor working culture can have on maternity services. That focus on culture and on what we can do to change it will be a key part of the national action plan that the taskforce will develop. We want to make sure not only that staffing levels are correct and that staff have the right training, but that different members of staff work together across different disciplines and roles, because that is one way to make sure that the service improves.

[Ian Byrne (Liverpool West Derby) (Lab)]

The Secretary of State, like countless other Ministers over the years, has stood at the Dispatch Box to outline and apologise for yet another state cover-up. Can we agree that enough is enough? Will he personally intervene and beg the Prime Minister to pass the Hillsborough law in full—it has been promised to us on numerous occasions—before summer recess and end this culture of cover-ups?

[James Murray]

My hon. Friend is right to point to the importance of the Hillsborough law, because it will enable greater accountability and justice across society, as well as being crucial for future maternity investigations. That is why one of the commitments I made last week following Donna Ockenden’s report was to apply the duty of candour, which the Hillsborough law will enable, to all future maternity investigations, so that never again can we have a situation where senior clinical leaders choose not to participate and choose to avoid accountability.

[Sarah Dyke (Glastonbury and Somerton) (LD)]

A retired paediatrician and constituent told me recently that after giving 50 years’ service to the children of the NHS, she was devastated by the treatment of mothers and babies and loyal staff, whose concerns are routinely ignored, as when Yeovil’s specialist baby unit was recently closed without notice. While I welcome the Government’s commitment to a new maternity commissioner, will the Secretary of State set out how the commissioner will intervene in a trust like Somerset, rather than simply reporting on failures after harm has been caused?

[James Murray]

In the coming two weeks, I will be meeting the national taskforce, which I chair, to establish the scope and role of the new national maternity commissioner. I want to make sure that that is agreed with the taskforce. The taskforce will produce the action plan, which the commissioner will help to implement. I want to ensure that this is all done with the same principles in mind.

The hon. Lady also raised an important point about not only mothers being ignored, which they are far too often, but staff being ignored. A few Members have made that point today, and it bears repeating. We know that 9,000 staff contributed to Baroness Amos’s report, which underlines the fact that they want a better maternity service, too.

[Anneliese Dodds (Oxford East) (Lab/Co-op)]

The lack of national maternity triage standards has been of huge concern to a number of my constituents, in some cases through bitter and heartbreaking experience. The Secretary of State said that NHS England would be responsible for rolling out and monitoring triage standards. Will that responsibility pass into his Department by April next year, and how will he ensure that those standards are genuinely implemented in every trust?

[James Murray]

My right hon. Friend is right to point to the impact that national triage standards can make by ensuring that when there are problems, the women concerned are seen earlier and those who need support can receive it at the right time, in order to prevent greater harm from occurring whenever possible. The national triage standards are currently being set out by NHS England, because that organisation still exists. The chief executive is meeting representatives of the trust today to begin the work of rolling out triage standards across all the different trusts. When NHS England becomes part of the Department for Health and Social Care, we will of course continue to monitor that, and the taskforce will also consider it as part of its national action plan.

Resident Doctors: End of Industrial Action

James Murray Excerpts

Monday 29th June 2026 Written Statements

[The Secretary of State for Health and Social Care (James Murray)]

I am pleased to inform the House that the Government and the British Medical Association’s resident doctors committee have agreed a deal to resolve their dispute on pay and training places, bringing an end to a period of industrial action that has seen 21 days of strike action in the past year. This follows a referendum of all resident doctor members of the BMA, in which a majority voted to accept the deal.

The deal is fair to doctors, affordable for the taxpayer and in the best interests of patients. Resident doctors will benefit from improved pay scales, better working conditions, enhanced career progression, and up to 4,500 new training places over the next three years.

I am incredibly grateful to staff across the NHS who have kept the NHS going during the recent rounds of industrial action. The absence of strikes by resident doctors will allow the NHS to focus on supporting patients and improving working conditions for all staff, rather than managing disruptive industrial action. When unions and the Government work together, patients, staff, and services benefit.

The deal means resident doctors will be on average 35.2% better off than they were four years ago. It also means resident doctors will benefit from pay structure reform, leading to more frequent pay progression as they develop and gain additional skills which benefits the health service.

Up to 4,500 additional training places will also be created, giving more resident doctors the opportunity to progress in their careers to more senior roles. This builds on the Medical Training (Prioritisation) Act 2026, which now means UK medical graduates, and doctors with significant NHS experience, are prioritised for foundation and specialty training posts, which has halved competition ratios from 4:1 to just 2:1.

The offer will also put money back in doctors’ pockets, tackling the unique costs resident doctors experience through the reimbursement of mandatory royal college portfolio and examinations fees, and will improve working conditions for locally employed doctors and those who work less than full time.

Taken together, these measures recognise the vital contribution resident doctors make every day, while supporting the long-term sustainability of the NHS workforce. These changes are not simply investments in doctors. They are investments in patient care.

I want this agreement to mark the beginning of a new chapter of co-operation with resident doctors.

We must now begin to implement this deal and embed a new working relationship so that the NHS remains a place where doctors can thrive and develop.

This Government are getting the NHS back on its feet and making it fit for the future. Waiting lists have fallen by 400,000 since we took office, satisfaction with general practice has increased from 60% to 76% and ambulances are arriving faster. The acceptance of this deal by resident doctors today is a significant milestone on that road to recovery.

[HCWS157]

Nottingham Maternity and Neonatal Services

James Murray Excerpts

Wednesday 24th June 2026 Commons Chamber

[The Secretary of State for Health and Social Care (James Murray)]

With permission, Madam Deputy Speaker, I will make a statement on the independent review of maternity services at Nottingham University hospitals NHS trust.

Donna Ockenden’s review is the largest into a maternity service in the history of the NHS. The nature and sheer scale of the failings it exposes are horrific. It uncovers dangerously and tragically deficient care at almost every turn. Its findings and conclusions are chilling.

The report covers 13 years, including accounts from 838 members of staff and, crucially, the experiences of 2,536 affected families. I met a small number of those affected families last week, and I felt numb after hearing the depth of their pain. I felt even more numb when I considered how many families not in the room went through such trauma too, and the forgotten children who survived but live every day with the consequences of maternity care failings.

I felt devastated that so many women and babies, as well as their fathers and other family members, had suffered injury, death and lasting trauma while under the care of the NHS. Now having met the families, and having seen the report, I feel appalled by the neglect, incompetence, racism, discrimination, contempt and harassment that so many suffered. I feel heartbroken to know that, so many times, when they tried to raise the alarm about their care, they were ignored, sneered at, disbelieved, blamed and lied to. How on earth could this have happened? There is no single answer, but Donna Ockenden shines a light on what was going on.

First and foremost, women were not listened to. Donna Ockenden says that the staff shortages and lack of training in Nottingham were among the worst she has ever come across. Bullying by doctors and senior midwives was rife, which meant that staff who tried to speak up were intimidated and ridiculed. There was a culture of cover-up at the highest levels of the trust, and there were ineffective and inadequate responses from regulators.

Perhaps most damning of all, for years the trust ignored evidence of clinical and cultural flaws in both internal and external reviews that it had itself ordered. When I met Donna Ockenden last week, she told me that those inquiries were “diligent” and of “good quality” but that they were effectively swept under the carpet by the board. That refusal to act is unforgivable.

Donna Ockenden and her team deserve huge credit for their forensic and compassionate approach, as does my hon. Friend the Member for Sherwood Forest (Michelle Welsh), herself a harmed mother, as well as Members for neighbouring constituencies who have walked side by side with their constituents through years of anguish and struggle.

However, the driving force behind the review has been the affected families themselves. They have demonstrated more patience, more courage and more tenacity than one might imagine is possible from those dealing with broken hearts that will never mend. Though each of their experiences is unique, one feature is common: at the very moment when they were at their most vulnerable, they placed themselves and the lives of their unborn babies in the hands of the NHS—and the NHS failed them catastrophically.

To all those who have suffered so appallingly, I say today, on behalf of the NHS: I am sorry. I am sorry not just for the failures, or the heartless and undignified treatment, but because your cries of concern went unheard for too long—and so the Government will act. We will act by taking immediate steps, including to expand Martha’s rule to all maternity and neonatal settings so that parents can demand a second opinion if they feel their concerns are being ignored.

I know that some people may want me to accept all the review’s recommendations today, but in the past too many recommendations have been accepted and then have sat on a shelf gathering dust, and we have seen more deaths and more suffering. I do not want to let down the families I met in Nottingham, or bereaved parents anywhere else in the country. I want to use the national maternity and neonatal taskforce, which I chair, to create a comprehensive action plan to be published by the end of this year that will address all the national-level recommendations from this review and others. I am confident that work will be welcomed by all those midwives, obstetricians, paediatricians and other healthcare workers who strive every day to make sure that babies are born safely and that women receive outstanding levels of care.

It is clear that, in case after case, families felt that regulators, including the General Medical Council, the Nursing and Midwifery Council and the Care Quality Commission, were more concerned with protecting clinicians than with providing accountability. That is damning and that is wrong. As one grieving mother told me:

“They put the fox in charge of the hen house.”

Clinicians and trust leaders must know that their behaviour will be properly scrutinised and that their actions will have consequences. We must meet the test of the Nottingham victim who told me last week that “accountability drives action”.

We are making changes to the CQC, one of which is to extend the cut-off period to initiate proceedings from three to five years so there is more time for families to bring cases. I will also call in the chair and chief executive of the GMC to hear directly their account of the failures at NUH. Let me be clear: if their response falls short, things will change at the GMC.

From speaking to families in Nottingham, I know that there is real and understandable anger that some leaders and clinicians at the centre of this review were able to avoid giving evidence. Today, I make a commitment that, when passed, we will use the Hillsborough law’s duty of candour to ensure that witnesses in upcoming reviews of maternity service failures, including those in Leeds and Sussex, can be forced to provide evidence. That change will make sure no one is able to refuse to co-operate in the search for accountability and justice ever again.

There is so much in the stories of the families in Nottingham that is shocking and heartbreaking, but the way the bodies of their loved ones were handled by hospital mortuary services revealed a level of disrespect and a lack of humanity that—I will be honest—left me utterly aghast. The details are disturbing, but they need to be heard to understand the gravity of what families were confronted with: deceased babies referred to as a “specimen” or “sample”; a baby placed into a mortuary space already occupied by an unknown and unrelated adult; a baby disposed of as clinical waste against the express wishes of their parents; and a baby kept in a domestic fridge in a bereavement room. The emotional and psychological effect of those dehumanising failures was to layer the most profound disrespect on the most unbearable distress. There is also evidence that the trust actively decided not to report failings in mortuary care to families.

As hon. Members will know, there is an active police investigation and arrests have been made, which limits what I can say. As a start, however, I have asked NHS England to write to trusts to make sure these appalling experiences are not happening elsewhere in the NHS. I confirm today that the Human Tissue Authority will require all mortuaries to review internal records going back 10 years to ensure all incidents have been logged and reported. I have instructed them to report the findings directly to me by 16 October.

When I met the Nottingham families last week, they also raised with me the issue around what are known as secondary victims. In maternity settings, fathers, partners and others are actively encouraged to be present to support mothers through labour and delivery. However, the law does not allow them to bring their own claims for the psychiatric illness suffered as a direct result of witnessing their partner or baby suffer injury or die. I have therefore asked David Lock KC to work with my officials to consider that important issue as part of his wider work on clinical negligence.

Donna Ockenden acknowledges that NUH has not waited for her findings to be published to start making improvements. I will speak to the chief executive next week to interrogate the trust’s response and make sure there is a proper plan in place for implementing the recommendations speedily and effectively. But there is a long road ahead before NUH fully addresses all the issues and before it can possibly regain the full trust and confidence of the communities it serves.

I close where I began: with the families. Nothing can make up for what they have gone through, but this report is a tribute to their resilience and tenacity. I say to them directly: you had to drive this for so long, but you are no longer driving this alone. We are with you and we will not stop until you have the accountability and the justice you deserve. I commend this statement to the House.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Secretary of State.

[Stuart Andrew (Daventry) (Con)]

I thank the Secretary of State for advance sight of his statement and Donna Ockenden and her team for the care and compassion with which they conducted the review. We had a meeting with her yesterday, and I have to say that it was probably one of the most difficult meetings that I have ever had. I pay tribute to the hon. Member for Sherwood Forest (Michelle Welsh). I can see how deeply personal and painful this is, and I admire her and all her colleagues from the region at what must be a very difficult moment.

Let me say from the outset that I want to be constructive in opposition when it comes to this issue. We need to work together; we have to see improvements. I begin with the women, babies, fathers, partners and families whose lives sit behind the review’s findings. To them, we owe a profound apology for failing them when a family should feel safest, most supported and most able to trust the care around them. For too many, that trust was broken; women were not listened to, families were not believed and warning signs were missed. Some suffered the deepest lost, others were left physically unsafe and others psychologically scarred. No statement can repair that pain, but it can mark the point at which testimony becomes responsibility, and responsibility becomes action.

The painful truth is not only that the failings occurred but that the themes are familiar: women not heard, families dismissed, poor communication, missed deterioration, weak governance and people unable to speak up. Maternity and neonatal safety has challenged Governments of both parties, but it would be wrong to let that history soften the urgency. Women and families are tired of telling their story, hearing promises and seeing the same themes return. The question is whether the system will move because of this review, and so I put three tests to the Secretary of State.

The first is the listening test. Women and families were not consistently listened to. Their concerns were too often dismissed or not acted upon. That is not a soft issue; it is a safety issue. How will the Government embed listening as a clinical discipline? How will trusts measure whether women feel heard? Will complaints and near misses be treated as information for improvement?

The second is the culture test. The review describes bullying, hierarchy and poor psychological safety affecting staff’s decisions and willingness to escalate. I pay tribute to those who were brave enough to do so. In maternity and neonatal care, minutes matter. If staff cannot challenge, safety is weakened. Staff cannot provide the care they want to if they are exhausted or unsupported, or if hierarchy matters more than candour. So I ask: how will boards be held accountable for that ward culture?

The third test is the delivery test. Harm rarely followed one error; it usually followed a chain of poor communication, weak risk assessment, delayed escalation, staff pressure, inadequate governance and missed learning. The response cannot be a single announcement. It must be accompanied by a delivery plan, so will the Secretary of State publish a national implementation plan with named accountability, delivery dates and regular updates to this House? That plan must address the workforce so that staff have the support and information they need to fulfil their roles to the ability they wish.

That plan must design services for today and the future, not rely on assumptions from the past. Women are having children older, pregnancies are more complex and more women are entering pregnancy with pre-existing conditions, previous loss, fertility treatment, mental health needs or circumstances shaping care. That means a need for practical, personalised care, informed choice and each woman being treated as a whole. The review also requires us to confront inequalities. The safety of a patient must not depend on confidence, class, ethnicity, language or an ability to fight through the system. The issue with our mortuaries is also really shocking. The horror stories that we have heard must never happen again. Is the Secretary of State working with colleagues in the Department of Justice to see what more needs to be done to overhaul this area?

Finally, we must recognise the psychological harm caused through silence, poor communication, lack of bereavement support and the battle for honesty. We know that our mortuaries need to have the highest standards. Compassion after harm is not a courtesy; it is a duty. Trust is rebuilt when women feel the difference in the room, when words change decisions, when staff speak without fear, when risk is escalated in time and when boards are judged by results. Where the Government act to improve safety, accountability, staffing and family voice, they will have our support so that we can see this through together. Where they do not, they will face our scrutiny. This review began with families who had to fight to be heard. The task now is to ensure that no family has to fight so hard again.

[James Murray]

I thank the shadow Secretary of State for not only the content but the tone of his response, and for the approach that he has taken. I firmly welcome this collaborative approach, because he rightly points out that this is an area that we should work across parties and across this whole House to address. His summary of the key issues that we must address through the work that we are doing—first and foremost, ensuring that women are listened to; the cultural changes we need to see; and the delivery test, recognising that this is a chain of failure—was very well made and in line with where I and the Department are coming at this issue from.

As I mentioned earlier, all the recommendations from today’s report, as well as the recommendations from the national report that Baroness Amos has been working on and from other inquiries and reviews of maternity service failures, will come to the national taskforce that I chair, precisely to deliver that delivery plan—that comprehensive plan of action. We will ensure that it is published by the end of this year, and the Government, working with the Opposition, will ensure that it is delivered across this country.

[Michelle Welsh (Sherwood Forest) (Lab)]

I thank the Secretary of State for his statement. For openness and transparency, I note that I have been campaigning on this for six years and I am a harmed mother at Nottingham University hospitals NHS trust. I start by thanking the brave families—my friends—and Donna Ockenden and her team. What has happened is horrific: bullying, cover-ups, racism, discrimination and appalling practice. The way babies have been treated at birth and then at the end of their life is a national disgrace.

One of the most uncomfortable truths in this report is that it was not a regulator, a policy, a protocol, a law or a Government Department that brought us this inquiry; it was families—bereaved families, harmed families—having to speak again and again about their most horrendous and traumatic experience for more than a decade. That does not signify a system that is working. The report identified avoidable deaths, harm and profound failings. The publication of this report is simply not enough. What is required now is action, accountability and change. Can the Secretary of State therefore assure the House that there will be a plan with robust oversight and questioning of regulators and senior staff? Will he work with Nottinghamshire families and Nottinghamshire MPs to ensure that justice is truly and fully delivered?

[James Murray]

I thank my hon. Friend for her questions. Let me put on record again how much I have appreciated her advocacy, her support, her sharing of her own experience and her standing up for the many hundreds of families in the area she represents. Her contribution is invaluable to this most important work that we are doing as a Government. She talked about families driving this report and making sure that it happened, and she is absolutely right. I met some of those families last week in Nottingham, and as well as feeling numb at the depth and breadth of their pain, the feeling I left with was a sense of their exhaustion at having fought for so long to be listened to and to get this into the open. Our responsibility as a Government and as MPs is to say that, now it is out in the open for us all to see, we all bear a responsibility to help them carry this forward. I take that responsibility with the utmost seriousness.

My hon. Friend asked about a plan to change maternity services in Nottingham and across the country. There will be specific local recommendations in Nottingham, and I am meeting the chief executive of the trust next week to pick that up directly with him, but there are more recommendations in the report that will have national implications, along with the recommendations from the national review that is under way. It is crucial that all those recommendations are formed into a plan of action, and the taskforce that I chair will be crucial in making sure that these recommendations do not just get accepted and then sit on a shelf gathering dust, but form a plan of action that we can stand behind as a Government.

Finally, my hon. Friend mentioned the importance of action, accountability and change. I repeat what I said in my statement: one of the phrases that stuck with me powerfully from my meeting with Nottingham families last week was from the person who said that “accountability drives action”. Without that accountability, we cannot have a guarantee of action. That is why the accountability that the families seek is the change that we as a Government must seek to deliver.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

May I start by acknowledging the hon. Member for Sherwood Forest (Michelle Welsh), Donna Ockenden and the Secretary of State for the statement and for their hard work? I thank the Secretary of State for the actions that he has proposed so far, which I think are the first tangible actions we have heard in this place. I must also acknowledge the incredible courage and resilience of the Nottingham families who have been instrumental in bringing about this review. No one can imagine the pain that they have gone through.

I am distressed and angry to be stood here once again speaking about babies who should not have lost their lives, mothers who should not have lost their lives and trauma that families should not have experienced. Review after review has led to 748 recommendations since 2015, but birth injury and mortality rates have continued to rise. These reviews all reveal similar issues: unsafe staffing levels, lessons not learned, issues not escalated, insufficient training, and women’s concerns ignored.

Four years ago, after the Shrewsbury review, we found that over 200 babies had died unnecessarily in Shropshire, yet things have got worse. Donna Ockenden’s Nottingham report reveals new and extremely distressing revelations about serious failures to protect the dignity of the deceased in after-death care, something that must be addressed through proper regulation.

Liberal Democrats have put forward a maternity rescue package that would guarantee one-to-one midwifery care and introduce a national maternity commissioner to oversee vital improvements. It would be nonsensical for the Government not to take a strategy forward. Will the Secretary of State pledge to implement every single one of the Nottingham report’s essential actions, and to work with us to deliver the essential investment we need to make Britain a safe place to have a baby, and end this shocking cycle of failure? Anger is not enough. Mothers, doctors and midwives are sick of seeing review after review and being met with stasis, with the same failures repeated over and over again. This must be the moment we say, “Enough.”

[James Murray]

I thank the hon. Lady for her words. When she spoke about ending this cycle, she sums up a feeling that I think many of us have: the cycle of inquiries and investigations revealing what has been happening in maternity services and leading to recommendations, which are accepted, but then things do not change enough, and action is not taken to address all the issues raised. That is the cycle we need to break. The national taskforce, which is established and which I chair, will take all the recommendations from Donna Ockenden’s report, as well as those from Baroness Amos’s national review, which will be published shortly, as well as some of the other hundreds of recommendations that the hon. Lady mentioned, and ensure that it produces a comprehensive action plan by the end of the year. The challenge for us is not simply to accept recommendations, but to produce and deliver that action plan.

[Michael Payne (Gedling) (Lab)]

Today’s publication of Donna Ockenden’s report into maternity services in Nottinghamshire is a difficult and deeply emotional moment for families across our county and city. I want to place on the record my thanks to Donna Ockenden and her outstanding team for the care, compassion and thoroughness with which they have exposed the devastating cases of these families. Let me also place on the record my thanks to my hon. Friend the Member for Sherwood Forest (Michelle Welsh). She is a fearless and formidable campaigner for justice and has walked this journey with the families every step of the way, and I know just how proud her son Billy will be watching her from home today.

My thoughts are first and foremost with the families whose lives have been changed forever by the loss of their babies, and the mothers who should have received safe care but were harmed. Behind every page of this report are families who have endured unimaginable grief and who have spent years fighting simply to have their voices heard. I pay tribute to their courage, dignity and determination. In the face of heartbreak, they refused to be silenced. They fought not only for answers about their loved ones, but to ensure that other families would not suffer the same pain.

Can my right hon. Friend confirm that he will consider all options available to deliver justice and accountability for those families who have waited far too long for answers? Will he assure me and the whole House that the lessons identified in the report will be fully implemented and embedded throughout maternity services in Nottinghamshire and around the United Kingdom, so that no family has to endure what far too many families have already endured?

[James Murray]

I thank my hon. Friend for his comments and questions, and I echo his words about paying tribute to the courage, dignity and determination of the families who have driven the report and driven these shocking failures out into the open, so that we can all see the scale and depth of what has happened. He asks me about embedding the lessons from the review. I assure him that my priority is to ensure that the local lessons around the situation in Nottingham are embedded, and I will meet the chief executive of the trust next week, but also that those recommendations that have implications about national maternity services are taken directly into the taskforce that I chair, along with recommendations from other reports, and that we produce that plan of action by the end of the year. Let me also reassure him that, in that search for change, justice and accountability, I will take nothing off the table.

[Madam Deputy Speaker]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

I, too, pay tribute to those families who came forward with their stories, but also to the thousands, if not tens of thousands, of families across the country who are hearing these stories today and are triggered because it reminds them of their own, including in my area in Oxfordshire.

What struck me most about the report was the section on leadership and culture, and how when midwives and members of staff raised the alarm, they did not have access to the board, and board members were not curious enough to ask the right questions. I am also struck that in the Secretary of State’s answers—he is right to point to the national recommendations that are yet to come; our understanding is they are coming next week—he failed to mention whether there will be any pot of money to ensure that any recommendations that need double-running in order to happen quickly will have the necessary resources. Can he assure the House not only that will his taskforce seek to implement these recommendations, but that he will ensure that the money exists for staffing, training and buildings so that they are implemented as quickly as possible, so that we do not have to sit here crying on these Benches on behalf of our constituents any more?

[James Murray]

I thank the hon. Lady for her comments. She speaks about funding, which is of course a very important part of the response that we need to have to the failings in maternity care. We are investing £25 million, as I am sure she is aware, in tackling the causes of maternal death, to enhance bereavement facilities and to improve triage facilities, as well as £145 million through the estates safety fund to address safety risks in the maternity and neonatal estate. For me, this is not just about funding; this is also about culture, exactly as she says. When there is a culture of mothers and midwives not being listened to, and of the board, in this case, commissioning reviews and then ignoring them, that is where the problem lies. That is what we need to change. There is no single lever we can pull, no single change we need to make; we need to ensure that, from top to bottom, maternity services are overhauled in order to be fit for the future.

[Nadia Whittome (Nottingham East) (Lab)]

First, I want to thank the families who were bereaved and harmed by Nottingham University hospitals NHS trust—some of the most courageous and selfless people I have had the privilege of knowing, including my hon. Friend the Member for Sherwood Forest (Michelle Welsh). They have for years relentlessly pursued the truth, justice, accountability and real change, often at great personal cost, and not only for their own families but to prevent future families having to endure similar trauma and cruelty. I also want to express my sincere gratitude to Donna Ockenden for her service to Nottinghamshire. I am so thankful that it was her who led this review.

The scale and magnitude of the systemic failures uncovered by the review are truly harrowing. Mothers and babies were harmed and even died through the most shocking negligence and indifference. Families were lied to, disbelieved, blamed and gaslit. Mistakes were covered up and regulators failed to do their jobs. One of my constituents included in the review summed up well where we go from here when she told the Secretary of State that

“we need immediate action and we need long-term accountability”.

On immediate actions, will the Secretary of State set out a timeline of when he expects to be able to implement the recommendations in full? On accountability, is he open to a statutory inquiry, provided that it does not delay criminal proceedings?

[James Murray]

I thank my hon. Friend for her comments and questions. As well as thanking the families for what they have done to drive the report forward, she also thanked Donna Ockenden for her critical work in producing this report, and to those thanks I add my own. My hon. Friend asks about the timetable for action. The national taskforce, which I chair, will draw together all the national recommendations, all the recommendations from Donna Ockenden’s report, the recommendations from Baroness Amos’s report, and any other report on failures in maternity services, and the taskforce will report by the end of the year. That will be the timetable for us ensuring that there is a comprehensive plan of action. I know from my conversations with families that some have wanted a public inquiry and others have had different views. Let me be clear that, for me, no options are off the table.

[Sir Jeremy Hunt (Godalming and Ash) (Con)]

It is a matter of profound shame for all of us in the House that in a society that we call compassionate, a baby’s body could be disposed of as clinical waste. I add my thanks to the families and salute their courage, including the hon. Member for Sherwood Forest (Michelle Welsh), and particularly Jack and Sarah Hawkins, and all those families who have shown such courage in coming forward with these utterly appalling stories.

I commissioned a number of maternity reviews, and I am afraid that today I feel a terrible sense of déjà-vu. I worry that a lot of the recommendations, and the things that I suspect the Government will end up doing, amount to central direction and central control, which we know usually does not work in the NHS. I was encouraged that the Secretary of State, in his thoughtful comments, used the word “accountability”, because the core problem is a lack of clinical accountability. For his solutions, will he consider a complete overhaul, so that every mother, the moment she knows she is pregnant, is given a small team, including a doctor and midwives, and is told, “This is the team, this is the person who is responsible for the safe birth of your child”, so that she always knows who to go to? That is where things are currently falling between the seams. Ensuring that people always know who is responsible and who to go to is the only way that we will stop these things happening time after time.

[James Murray]

I sincerely thank the right hon. Gentleman for his comments. I have a great deal of respect for him, as he knows, so I very much appreciate him making his suggestions in that manner. Let me add to what he said about Jack and Sarah Hawkins, who I met last week in Nottingham. Their sheer determination to push for accountability and justice is incredibly humbling. The right hon. Gentleman mentions the importance of clinical accountability, which gets to the core of how to drive change in the NHS—as he knows, and as I now know, that is not always possible through central control, or by instructions being sent out from the Department of Health and Social Care or NHS England. We must ensure that the entire system is structured in the right way to provide that accountability and to drive change and action, and I will put under careful consideration his suggestion about how that might be achieved.

[Steve Yemm (Mansfield) (Lab)]

Today’s publication of Donna Ockenden’s report has laid bare absolutely appalling and systemic failures in maternity services in Nottinghamshire, with thousands of families suffering avoidable harm, and in many cases feeling ignored, dismissed or let down by the very institutions that were put in place to protect them. The report identifies profound failures of leadership, governance and accountability, and an inability to learn from mistakes. Given the scale of the failings and the repeated concerns raised in previous maternity reviews, is it now time for the Government to establish a full, judge-led, statutory public inquiry, with the power to compel witnesses, and examine whether wider NHS and regulatory failures have allowed these tragedies to occur over such a prolonged period?

[James Murray]

My hon. Friend raises the important issue of compelling witnesses to give evidence. Although many members of staff contributed towards Donna Ockenden’s review, I found the fact that so many senior leaders did not shocking, and I think it is unacceptable. We will change that by ensuring that the duty of candour, which is due to come in under the Hillsborough law once that is in place, will apply to future maternity reviews, including those taking place in Leeds and Sussex. As I said a few moments ago, there are different views among different families about whether they do or do not want a public inquiry, but I am not taking any options off the table.

[Robert Jenrick (Newark) (Reform)]

May I put on record my admiration for the 2,500 families across our county of Nottinghamshire who gave evidence to Donna Ockenden and shared what were undoubtedly the most personal stories that one could ever imagine sharing as a parent? I will never forget a family coming to see me at my surgery, who said they had been told that their time was up when they were sitting together with their baby, and they were asked to leave. They went to the café, and then they sat on the floor, on the kerb in the car park, and cried together. They said that it was like being shooed out of a restaurant by a rude waiter, not literally the most heartbreaking moment in someone’s life. I was very disturbed to read for the first time revelations about the mortuary service at Nottingham, which is frankly astonishing. It seems as if the right steps are being taken, but we all hope that those responsible for that feel the full force of the law.

Nationally, I hope that every hospital trust reading the report now treats the situation as the emergency it truly is. It is astonishing that the NHS is spending almost as much on negligence claims as on maternity services themselves, although of course the money is nothing compared with the misery and pain that has been inflicted on families. For our hospitals in Nottingham, improvements seem to have been driven by ensuring that there is now regular and high-quality training, which was sadly very absent for a long time. Can the Secretary of State assure me that mandatory and regular training is now ensured in all maternity hospitals across the country?

[James Murray]

I thank the right hon. Gentleman for his remarks. The story he told was of yet another horrific and harrowing experience that a family has gone through in this scandal. He asked whether we want to prioritise a focus on regular and high-quality training across the country, and I think it is essential to ensure that such training is in place. Although I do not want to prejudge the action plan that the taskforce I am chairing will produce, I cannot imagine a world where training is not a key part of that. Having seen the report, and spoken to families and to Donna Ockenden, my strong feeling is that no single action will transform the system on its own, and that we need a comprehensive plan from every angle to truly transform maternity services across the country.

[Jo White (Bassetlaw) (Lab)]

My mum was a midwife, and as a child I lived vicariously the life on a maternity ward. She worked to the very highest standards possible, and used to come home and talk to me about sloppy standards, falling standards and insensitivity. What happened at NUH is the lowest of the low, and I send my thoughts and condolences, and pay tribute to the families, and to the staff who tried to whistleblow. The memories of the babies must never be forgotten; it is our responsibility to ensure that those memories live forever.

I also pay tribute to my hon. Friend the Member for Sherwood Forest (Michelle Welsh). She came here with the dedication, commitment and desire to ensure that this report was done. So often she spoke to me about it, and so often she has had conversations with her Nottinghamshire colleagues about what she is doing. We have tried to support her all the way through, and I am so proud to be with her today. I believe this House should congratulate her on her commitment and dedication, to what happened to her child, and to the lost babies and the support she has given to those families. [Hon. Members: “Hear, hear.”]

My ask of the Secretary of State is to follow this through, so that the recommendations are implemented, reported on and monitored. I welcome his announcement that he will use the Hillsborough law to ensure that those who have failed to give evidence or to come forward are forced to do so.

[James Murray]

I thank my hon. Friend for her comments and I welcome her support for our decision to ensure the duty of candour introduced by the Hillsborough law will apply to future maternity reviews, such as those due to happen in relation to Leeds and Sussex. In terms of the process of what happens next and the implementation of the changes that we know need to happen, I reassure her that the national taskforce that I chair will produce, by the end of this year, a comprehensive plan of action that will be based on a consideration of all the recommendations that apply nationally in Donna Ockenden’s review, as well as the recommendations from Baroness Amos’s review and any other reviews that have issued recommendations on the subject too.

[Sir Gavin Williamson (Stone, Great Wyrley and Penkridge) (Con)]

I was not that familiar with the issue of neonatal and maternity services until my constituent, Mr Thomas Hender, contacted me about the tragic loss of his son, Aubrey. He highlighted the battle that he and his family had gone through, and that so many others had been going through. Sadly, these issues have happened not just at the NHS trust in Nottingham, but at those in Morecambe Bay, East Kent, Shrewsbury and Telford, Leeds and Sussex. Some six further reviews and investigations have been carried out. I value the fact that the Secretary of State said that he had an open mind about a public inquiry; I think we need to move in that direction. It was not until the review of care at the Mid Staffordshire NHS trust became a public inquiry that we were able to address some of the issues. The issues facing neonatal and maternity services are present not only in the areas that I mentioned, but they touch on many other corners of the country, and only a public inquiry can address that.

[James Murray]

I thank the right hon. Gentleman for his comments and for telling us some of the story of Thomas and his son, Aubrey. On the need for action, I intend the taskforce that I chair, which will consider all the recommendations from Donna Ockenden’s report and other investigations into failures in maternity services, to produce a comprehensive action plan by the end of this year. That will ensure, as I said earlier, that these recommendations do not sit on shelves gathering dust and that they are put into action. I take on board his points about a public inquiry. I know that his views are shared by some of the families, but I am conscious that other families have different views on this matter. What unites them all is a desire for action, accountability and justice. We need to find the best route to deliver that for them, because that is, above all, the most important thing. However, I reassure him, as I have reassured other hon. Members, that for me no options should be off the table.

[Juliet Campbell (Broxtowe) (Lab)]

I pay tribute and give my admiration to the families who have fought so hard and who have been so strong at this time in their lives, when they have had to repeat what they have been through over and over again. Their fight for justice and accountability is truly fought. I also pay tribute to my hon. Friend the Member for Sherwood Forest (Michelle Welsh), who has not stopped this fight and has continued the story, and I commend her for everything that she has done.

The findings of the Donna Ockenden review are harrowing. It is indefensible that babies, mothers, fathers and families in my constituency have suffered injury, death and lasting trauma under the care of the NHS. The Ockenden review has made it clear that mothers’ voices were not listened to and that families were not treated with the dignity, respect and compassion that they not only deserve but is expected from our NHS. The indifference that people have shown to families is indefensible. The public listening to the debate at home will understandably be wondering how we are here again and asking when things will change. I say to the Secretary of State: let us not treat these recommendations as just another set of recommendations to put on the shelf, but let us look at them as a catalyst for change and improvement, making sure that inequalities are addressed. Will the Secretary of State outline what immediate steps the Government will be taking on the most urgent recommendations in the review, and set out how they will be monitored and reviewed?

[James Murray]

I thank my hon. Friend for her comments about the role of the families in fighting for justice. She is absolutely right that the recommendations of the Ockenden report, Baroness Amos’s report, which is due shortly, and other reviews and inquiries into maternity services must not simply end up on the shelf gathering dust. That is why the process that I have spoken about today, whereby the national taskforce that I chair will produce a comprehensive action plan by the end of the year, is so important. That will give us the right forum to develop a plan across all aspects and from all angles on this horrific scandal, including the inequalities faced by different families from different backgrounds that my hon. Friend alluded to. I agree with her wholeheartedly that this moment and this process that we are now going into must be a catalyst for change.

[Freddie van Mierlo (Henley and Thame) (LD)]

I thank the Secretary of State for the way in which he delivered the statement and the apology that he issued, which I think will be received as sincere and heartfelt. Hearing the details in the report, I am not angry but ashamed—ashamed that women and babies have suffered so grievously in this country at their most vulnerable moment. It is a moment of shame for all of us. The report and the Secretary of State speak of failed regulation. I was shocked to learn that a “good” rating can be issued by the Care Quality Commission even when there are still ongoing safety failures at a trust. Does he agree with me that no trust should be labelled “good” if it still has the “requires improvement” rating for safety?

[James Murray]

The hon. Gentleman makes an important point about regulators and our regulatory system. The report exposes how completely unacceptable it is that regulators have protected their own and what a serious matter that is. We need to ensure that the regulators are doing their job properly, that they have the right mandate to do so and that they have the right instructions about driving up performance in trusts across the country, because otherwise we run the risk of being in a situation in the future where we are again confronted with what he accurately described as shame.

[James Naish (Rushcliffe) (Lab)]

I put on record my thanks and respect for the resolute campaigning of the Nottingham survivors, especially my constituents, Jack and Sarah Hawkins, who have worked so hard to bring these issues to regional and then national attention. They have made sure that baby Harriet’s death was not in vain. I also pay tribute to my hon. Friend the Member for Nottingham South (Lilian Greenwood) who was their MP for many years. As she is a Minister, she will not be speaking in this statement, but she deserves recognition for the steadfast support she gave to them as a family, as well as other families from Nottingham South.

I thank Donna Ockenden who, in addition to supporting thousands of families, invested so much time in Nottingham and Nottinghamshire MPs to ensure that we understood the systemic failings that she was working so hard to identify. This is undoubtedly a shameful day for the NHS.

Another fearless campaigner from Rushcliffe is Ashley Harper, who has been in touch with me about the maternity and neonatal taskforce and its perceived failure to recognise and support families who have been harmed. She would like to see a family expert for harmed children and a family expert for harmed mothers on the taskforce. I know that these asks have been raised by my brave and hon. Friend the Member for Sherwood Forest (Michelle Welsh), who has done so much for the Nottingham families, but will the Secretary of State say whether that is something he is actively considering?

[James Murray]

Let me repeat what I said earlier about my humble admiration for Jack and Sarah Hawkins and their campaign for justice over baby Harriet. My hon. Friend is absolutely right to refer to the failings as systemic. This is not a handful of cases or problems; this truly is a problem that affects the entire system. The culture and the systems that are in place have let people down, and that is why our response must be so comprehensive.

My hon. Friend mentions the input of families into the taskforce and his constituent Ashley Harper, who raised that matter. I am very happy to discuss with him after this statement how we can ensure that the taskforce represents the views of all families.

[Sir Julian Lewis (New Forest East) (Con)]

When whistleblowers tried to alert society to what was happening, was any action taken against them, and if it was, does that indicate that there needs to be strengthened protection for whistleblowers? At the other end of the spectrum, are those clinicians who refused point blank to take part in the review process going to be named?

[James Murray]

The right hon. Gentleman raises an important part of the dynamic that has been exposed through Donna Ockenden’s review: people not feeling able to challenge what is happening—feeling that they are being intimidated or forced to stay silent—even when they want to raise issues of great importance. We must ensure that the right structures and culture are in place not only so that women and their families can raise their concerns, but so that staff, midwives and others working in maternity and neonatal services have the confidence to raise their concerns through whatever mechanism is most appropriate in the circumstances. They must have confidence in the mechanism to raise their concerns.

The right hon. Gentleman spoke about clinicians who refused to take part in Donna Ockenden’s review in Nottingham. As I said earlier, although more than 800 members of staff contributed towards the review, I was appalled at the number of senior clinicians who did not agree to take part. That is why it is so important that we change the law—applying the duty of candour through the Hillsborough law to ensure that this can never happen again.

[Amanda Hack (North West Leicestershire) (Lab)]

I thank the Secretary of State for his statement and the confirmation that he will expand the Hillsborough law to apply to those clinicians who did not speak but should have spoken. I also want to put on record my thanks to my hon. Friend the Member for Sherwood Forest (Michelle Welsh) for her leadership and courage, as well as my heartfelt sadness that so many families endured so much harm.

This report has been so thoroughly and expertly delivered by Donna Ockenden, and it has to be the watershed moment. A key feature of this report and every meeting with Donna and the families has been an overwhelming sense of failure at every single level: failure to listen, failure to react and failure to prevent harm. The experiences of the harmed families will stay with me forever. Will the Secretary of State outline how the immediate and essential actions, including the first one—listening to women and families—will be the catalyst for the change that we need? What steps will he take in his first day of taking forward this report to ensure that we do not have Nottingham repeated elsewhere?

[James Murray]

My hon. Friend asks about the immediate actions that the Government are taking in response to Donna Ockenden’s review. For me, above all else—above all the shocking, harrowing detail—the review highlights the fact that women simply were not listened to. That comes up time and again. I know that it comes up in other aspects of healthcare as well, but it came up so strongly in this report and underlined so many of the shocking failures that have occurred.

As a first step, extending Martha’s rule to all maternity services across the country means that when women or their family members are concerned that they are not getting the treatment or care they need, they can get a second opinion—an urgent, independent review. That is an important first step, but this must be a watershed moment that does not rely simply on one action or a small handful of actions. There must be a comprehensive plan to tackle this issue from every angle and to ensure that we have the systemic change that so many Members today have said is crucial.

[Rosie Duffield (Canterbury) (Ind)]

In the 25 months since Theo Clarke and I produced the first ever parliamentary report on birth trauma, and nearly four years since we discussed the East Kent Kirkup report in this place, we have seen more and more reports, more and more scandals, more and more heartbreaking stories, and several Health Secretaries. Campaigners are grateful to the brilliant Donna Ockenden but, frankly, expectations are pretty low about ending this crisis in maternity care all these years later. Does the Secretary of State agree that as well as training, we have to end this patchwork postcode lottery of care, and introduce basic, nationwide standards and accountability across all NHS trusts?

[James Murray]

The hon. Lady makes an important point about the fatigue, weariness and exhaustion of families at so many recommendations being made and accepted but not put into action. To pick up on the point made earlier by the Liberal Democrat spokesperson, the hon. Member for North Shropshire (Helen Morgan), we must now break that cycle to ensure that the recommendations do not simply get accepted and sit on a shelf gathering dust, but that they feed into the plan of action, which will then produce the change that we need to see.

As the hon. Member for Canterbury (Rosie Duffield) said, the change must be nationwide. Although we are today rightly talking about what happened in Nottingham, we know that it is far from the only place where such failures in maternity and neonatal services have been seen. We know this is a national problem that needs a national solution.

[Paulette Hamilton (Birmingham Erdington) (Lab)]

May I start by saying that my thoughts are with the families and with the babies who have died?

I would also like to say to my hon. Friend the Member for Sherwood Forest (Michelle Welsh): I am sorry you had to go through this. It should not have happened, and I am angry. I am a member of the Health and Social Care Committee, and the reason I am angry is that last year we did a follow-up review on black maternal health, and the same things kept coming up over and over again: racism, equality issues, women being silenced, a lack of governance, women not being heard, unavoidable deaths, and a lack of accountability. Where does it stop? There is a lack of training, and the system is failing our women; we have had over 70 recommendations, but that is what we found last year. Every time we say, “Enough is enough”, what happens? We have yet another review.

My daughter had a baby a few years ago. If I had not been with her, she would have lost that baby, because it was as if she was invisible. It was not until somebody else went into the room with her and said, “Enough”, that the people there were really willing to listen. These failures are systemic.

What worries me is that funding is not ringfenced for maternity services—it can go anywhere in the system. Once this review—or whatever it might be—has been done, what will be done to ensure that the funding follows the recommendations? It is no good having the funding there if it is being run by local organisations that are using it to plug holes. That has got to stop.

[James Murray]

I thank my hon. Friend for her comments, and for talking about the shocking situation with her daughter’s baby that she managed to avert. She spoke about the inequalities, the racism and the fact of women being silenced, all of which come through very strongly in Donna Ockenden’s report. As I have explained, the taskforce I chair will now consider the full set of recommendations from that report, as well as the recommendations from Baroness Amos’s national review and other reviews and inquiries into what has happened in maternity services. That taskforce will produce a comprehensive plan of action that will cover the whole range of actions that need to be taken, because we know it will take more than one action, or even a small handful of actions, to transform maternity services and make them as they should be. This is a problem that goes very deep; it is systemic, cultural and deeply embedded, and a comprehensive plan will be required to change that.

[Simon Hoare (North Dorset) (Con)]

The Secretary of State and the shadow Secretary of State, my right hon. Friend the Member for Daventry (Stuart Andrew), are both to be congratulated on the tone and tenor with which they have approached this most sensitive of issues—it is in the very best tradition of this place. It also indicates, I hope, a preparedness to work across the two parties to bring forward speedy solutions to the horrors we are hearing about and have read about in the report.

May I ask the Secretary of State two direct questions? First, the management of bodies post mortem seems to fall between his Department and the Ministry of Justice. We have talked far too often about how to regulate that space.

[Simon Hoare]

The hon. Member for Leeds South West and Morley (Mark Sewards) is in agreement. Can the Secretary of State’s Department now grip that issue and drive it forward in order to give certainty to all our people that there is dignity and decency for all in death?

Secondly, this issue clearly affects Nottinghamshire most acutely, but there are expectant parents across England today who will be worried about the level of service they can expect and about the outcomes for themselves and their child. What is the Secretary of State proposing to do to communicate with those people, to say that the Government are aware of this issue and are gripping it—that a shake-up is taking place and better services will be provided—as well as to give them some indication of what they can expect, and to give them comfort and confidence in what should be the most exciting period of their lives?

[James Murray]

I thank the hon. Gentleman for his remarks, and for his tone and approach in encouraging cross-party working—he is absolutely right that that will be essential for making progress on this most important issue. I will consider the important point he has made about the Ministry of Justice and its remit in relation to what we have seen in mortuary services. As I said earlier, in a report full of shocking revelations, that inhumanity and lack of dignity left me truly aghast; it is almost unbelievable that it could have happened.

The hon. Gentleman also raises an important point about women and their families across the country using maternity services. While the conversation we are having today is of course about the failures in Nottingham, we know that most women will receive high-quality care, and the majority of the NHS workforce do an important job supporting them. We should make sure that is acknowledged in this difficult conversation. However, one of the changes we want to make immediately is extending Martha’s rule to maternity services right across the country, because we know it is something we can do now. Martha’s rule is a mechanism that has worked well in other parts of the NHS, and it will mean that when women and their families feel they are not being listened to, they will have a way to get an urgent, independent review of the care they are receiving.

[Adam Thompson (Erewash) (Lab)]

I thank the Secretary of State for his statement, and extend my thoughts to everyone who has been a part of the Ockenden review. I also hugely thank my hon. Friend the Member for Sherwood Forest (Michelle Welsh) for her unending efforts in campaigning for the families we represent in our constituencies, who have been through so much. Of course, I also thank Donna Ockenden for her work, her amazing support, and her constant engagement with us as the local affected Members of Parliament and with our constituents.

In the past two years, I have met so many families who have been harmed in ways I cannot understand or comprehend, and have heard of and seen horrors that I can barely believe. In addition to those babies and mothers who lost their lives, it is important that we highlight children like our mate Ryan, who recently turned 18 but who will never be independent because of his acquired brain injury. Can the Secretary of State please reassure the House that he will do everything in his power to support children with acquired brain injuries, such as by recognising their conditions in education, health and care plans?

[James Murray]

I thank my hon. Friend for his question. I was personally inspired by meeting Ryan’s mum Sarah when I visited Nottingham last week—she told me about Ryan, and showed such incredible strength and courage in advocating for the forgotten children in Nottingham. I can reassure my hon. Friend and the whole House that I will do everything in my power to support children with acquired brain injuries. We are working on an acquired brain injury plan at the moment, and I am also working with the Department for Education and NHS England on ambitious reforms to the special educational needs and disabilities system, including on the future direction of EHCPs.

[Mike Martin (Tunbridge Wells) (LD)]

Could I draw the Secretary of State’s attention to the Sir Jonathan Michael inquiry and report, which followed on from the David Fuller case at Pembury hospital in my constituency? It dealt with sexual impropriety with cadavers, so there is crossover here. Phase 2 of that report came out in July 2025, and it spoke to the lack of regulation of after-death care of bodies in mortuaries, hospitals that look after cadavers and other organisations. I do not know whether the Secretary of State is aware of that report, but are the Government planning on implementing its ready set of recommendations? Sir Jonathan Michael’s report seems to speak to a lot of the issues that happened in this case as well.

--- Later in debate ---

[James Murray]

I thank the hon. Gentleman for drawing my attention to that report. We will certainly ensure that any reports containing relevant recommendations are considered as part of the taskforce’s work, because one of the changes that I want to make sure we achieve is to not have so many different reports with hundreds of recommendations that then do not become a plan of action. That is a cycle we are seeking to break through the taskforce’s work by producing a plan of action by the end of the year.

[Josh Fenton-Glynn (Calder Valley) (Lab)]

In her remarks this morning, Donna Ockenden noted that maternal deaths are at a 20-year high, and total clinical negligence costs are greater than the money spent on maternity services. That should give us pause for thought. It is a national emergency, one that is causing unimaginable pain. The failure of the regulation is stark, so will my right hon. Friend confirm that we will tackle the culture of defensiveness across medical regulators that has caused such harm?

[James Murray]

My hon. Friend is absolutely right to point to regulatory failure, which has been drawn out very strongly by Donna Ockenden’s report. For me, what is completely unacceptable is that in their response to what has happened in Nottingham, they have sought to protect their own. That is something we must change, because it is only through effective regulation that we can have true accountability, and it is only through true accountability that we can get action and change.

[Alison Bennett (Mid Sussex) (LD)]

I thank Donna Ockenden, the hon. Member for Sherwood Forest (Michelle Welsh), and the Nottingham families for all the work they have done to bring us today’s report about what went on across Nottinghamshire. It is truly shocking. At the same time, they were also supporting Sussex families to get their own justice when those families were repeatedly begging the right hon. Member for Ilford North (Wes Streeting) to appoint Donna Ockenden to review what happened in Sussex. I thank them for their support for other families right across the country.

When the Secretary of State was appointed to his role, I shared with him a letter I had written along with Sussex and Leeds MPs, asking for the duty of candour to be written into the terms of reference of the Leeds and Sussex reports. I am so grateful that he has announced today that the Hillsborough law will apply once it is enacted. That is very welcome, but that law has not yet been enacted, and it was delayed in the last Session. Does the Secretary of State know when the Hillsborough law will be enacted, and if he is not clear on that, will he commit to pushing at Cabinet to make sure it becomes law as soon as possible?

[James Murray]

I thank the hon. Lady for welcoming our decision about applying the duty of candour to future maternity reviews and inquiries, including those in Sussex and Leeds. We have always been clear that the Public Office (Accountability) Bill—the Hillsborough law—is an important priority for this Government. As soon as it is in law, we will ensure that the duty of candour is applied. Our commitment today is to ensure that NHS staff, current or past, cannot refuse to take part in what the lead investigator wants in future inquiries.

[Ben Coleman (Chelsea and Fulham) (Lab)]

The Ockenden report is shocking and its findings are repellent. As my hon. Friend the Member for Birmingham Erdington (Paulette Hamilton) said, it is shocking how many of its findings also featured in a report on black maternal health that the Health and Social Care Committee, on which I sit, published last September. As she set out, women were not listened to. There was no accountability, weak leadership, a toxic culture, racial inequality, understaffing and poor data gathering. All those things are referenced in both reports, and my hon. Friend the Member for Calder Valley (Josh Fenton-Glynn) pointed out that things have been getting worse over the past 20 years. It used to be the case that women who were black were 4.7 times as likely to die in childbirth or around childbirth as white women. The figure is now only 2.3 times. While we can welcome that, the sad fact is that it is not because things have got better for black women; it is because things have got worse for everybody else across the country. The Ockenden report and its findings on what happened are the culmination of problems that have been building for years.

I want to recognise my constituent, Louise Thompson. She suffered terribly giving birth, when the NHS would not listen to her about the care she needed. She is now running a powerful campaign for a maternity commissioner and improved maternal care. I hope she will meet my hon. Friend the Member for Sherwood Forest (Michelle Welsh) soon. The Secretary of State promises a comprehensive action plan to be formed by a national maternity and neonatal taskforce. That is welcome, but we have had action plans in the past and they have not delivered the change promised. Given that record, will the Government commit to publishing measurable targets and firm deadlines within the action plan and to report progress to Parliament at fixed intervals? We need to know, and women across the country need to know, what will really be different this time.

[James Murray]

I commend my hon. Friend on mentioning his constituent, Louise Thompson, who is campaigning on this important issue. He mentioned the impact of racism, discrimination and inequality in maternity services and their failures—all raised powerfully by Donna Ockenden’s report today. As I said earlier, the action plan, which the taskforce will be producing, will be published by the end of this year. We are determined to break that cycle where recommendations get accepted and then get left on the shelf to gather dust. We want an action plan that can be implemented. We want to make sure that delivery is set out and is progressed by the Secretary of State and the Department. That is a key part of the accountability in making sure that the delivery plan is put into action.

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

I thank Donna Ockenden and her team, the hon. Member for Sherwood Forest (Michelle Welsh) and all the Nottingham families who are involved in the development of this report. Today, I am angry and upset for all the families concerned, because this report reinforces what we already know: the maternity crisis must end and it must end now. Babies should have lived and mothers deserved better. The same systemic issues have come up again and again: unsafe staffing, lack of training, unchanging culture and a failure to listen to women. At the same time, we have increasing maternity negligence payouts of £2.5 billion. Following the report today, and bearing in mind the £2.5 billion of negligence payments, will the Minister commit to restoring the service development funding to support complex births and bereavement, after it was cut from £95 million to £2 million?

[James Murray]

I thank the hon. Lady for expressing how she feels angry and upset. I think that that feeling is shared by all of us in the House today. The publication of Donna Ockenden’s report today has exposed the lifelong suffering of those families. The details of the action plan will be published by the end of the year, because we want to make sure that recommendations are not simply accepted and then not implemented. The recommendations must go into the taskforce, and the taskforce must produce that clear action plan, which we can then implement, and people can see us doing so. That is the way to break the cycle of recommendations that do not get implemented and to make progress towards the justice, accountability and change that I understand from families is so important to them.

[Rebecca Long Bailey (Salford) (Lab)]

The whole House is appalled by the neglect, contempt, and sheer trauma that these families have faced. I commend their strength and the strength of my hon. Friend the Member for Sherwood Forest (Michelle Welsh), but these themes are chillingly all too familiar. The Secretary of State will be aware that NHS England has taken enforcement action against the Northern Care Alliance in recent weeks over multiple safety concerns. Indeed, staff and I raised serious safety concerns relating to the gynaecology department directly with the trust as far back as last year, demanding urgent action, but little happened. Will the Secretary of State meet me to discuss these issues, and will he outline what action he will now take to ensure that patient safety, adequate resourcing and safe staffing levels are urgently addressed at the trust?

[James Murray]

I thank my hon. Friend for raising the important issues that she referred to in her remarks. I am happy to make sure that either me or a member of my ministerial team will meet her to discuss them in further detail.

[Mark Sewards (Leeds South West and Morley) (Lab)]

I welcome the Secretary of State’s statement today. It is a difficult and painful, but that is as nothing compared with what those families have been through. On the shocking details he shared with us about babies’ bodies being mistreated in mortuaries, I am sorry to say that that story will be directly relevant to two constituents I am representing. I would appreciate a meeting with him, however brief, to discuss their cases ahead of his Department’s publication of its decisions on the final recommendations from the phase 2 report of the Fuller inquiry. He will also know that Leeds families at the start of their maternity journey—Donna Ockenden is conducting an inquiry into Leeds maternity services—will welcome, as do I, his commitment to ensuring that the duty of candour will apply in that inquiry. Can he confirm for them and for me that all the lessons that Donna Ockenden and he have learned from this inquiry will be applied to the Leeds inquiry, so that those families get the answers they deserve?

--- Later in debate ---

[James Murray]

My hon. Friend speaks about his constituents whose experience might be relevant to some of the findings around mortuary services and their failings. I would be happy to ensure a meeting with either me or a member of my ministerial team. As I said earlier, the details of what happened in mortuaries leave me struggling for words, because of how dehumanising, disrespectful and abhorrent that was. I would be happy to make sure that his constituents’ points are picked up as part of that.

On learning the lessons from the review in Nottingham and applying that to Leeds and Sussex, we are fortunate that Donna Ockenden will be leading those reviews, having just completed the review in Nottingham. She will be in a strong position to ensure that she goes into that with the learnings she has made from the current review. One of those learnings that I am conscious of is how unacceptable it is that senior leaders refused to take part, for which I can see no justification whatever. I am pleased that, through the duty of candour that have we spoken about today, that will no longer be possible.

[Jonathan Davies (Mid Derbyshire) (Lab)]

Nottingham University hospitals NHS trust is one of the trusts that serves my constituents. For those who have been patients there, or who have had babies who have come to harm—I have met some of them—Donna Ockenden’s report is difficult reading indeed. In respect of the staff at that trust, many of them, often junior and low-paid, are on the frontline providing kind, compassionate, person-centred care, and they will be feeling raw today. We value what they do.

We have heard a great deal about the appalling practices in the mortuary. They are subject to a criminal investigation, but I want to reflect on the experience of one of the several constituents I have met who have been affected by what we are discussing today. She came to see me as part of Donna Ockenden’s inquiry, and sadly she had engaged with the trust on a number of occasions because she felt that she was experiencing complications with her pregnancy. She was told to lie down and have a fizzy drink and then have an early night, and, despite repeated calls, she was repeatedly fobbed off. Sadly, her baby died.

Behind that is a culture of a failure to engage. There was a very poor culture at the trust—so poor that “FOH” was written in patients’ medical notes and on whiteboards, standing for “F*** Off Home”. How could leaders not be more curious about the practices that were taking place on their watch, and where were the regulators? It is absolutely staggering.

We are making some very positive changes in the NHS, but I want to push the Secretary of State briefly on changes we are making to the mechanisms that allow people to feed back on their care. We are winding down the National Guardian’s Office and Healthwatch; we are also removing NHS England, which has a regulatory function—and we know that regulators have failed in the case of this trust. What steps can my right hon. Friend take to ensure that those feedback mechanisms will enable people to be heard and action to be taken, so that we can prevent this kind of scandal from happening again?

[James Murray]

I thank my hon. Friend for his comments, and for telling us what happened to his constituent. He asked about some of the wider changes that we are making in the NHS modernisation Bill. The aim is to bring the patient experience across the NHS into the heart of the new organisation that will arise from the merging of NHS England into the Department of Health and Social Care to ensure that the patient experience drives the decisions being taken about how NHS care is delivered, and is at the heart of what we do as a Department and a national health service.

However, as the report makes clear, the level of failure in maternity and neonatal services is truly devastating. It demands a specific response, which is why the work of the taskforce will begin and it will report by the end of the year. As my hon. Friend has said, this is not just a case of individual cases going wrong or individual members of staff making the wrong decision. It is endemic, and shows the incuriosity of leaders in maternity services about what is going on and what is going wrong in their services. It is a failure of regulators, it is systemic, and the response to it must step up accordingly.

[Amanda Martin (Portsmouth North) (Lab)]

I pay tribute to those families, whistleblowers and campaigners who simply kept going, and to Donna Ockenden for her report and her approach. The report is damning, and my heart goes out to all the families who are having to relive their awful experiences as they see, in black and white, that their suffering and that of their loved ones was not only horrific and harrowing, but entirely avoidable, if only the leaders had been responsible and accountable, and had just listened. As we heard from my brave hon. Friend the Member for Sherwood Forest (Michelle Welsh), this is a national disgrace that must not be repeated.

I welcome Martha’s rule, which gives patients the right to an independent second opinion. I also welcome the Secretary of State’s commitment to using the Hillsborough law to ensure that those who avoid scrutiny are compelled to give evidence and are held accountable in the future, but may I ask him two questions? First, can he confirm that he is working across Government to ensure swift implementation of this law, with clear and transparent timelines, so that these families, who have already waited far too long, can finally see justice? Secondly, what will happen to those who shockingly avoided giving evidence and avoided accountability in respect of this review?

[James Murray]

My hon. Friend is right to emphasise quite how shocking it is that people in senior leadership positions refused to take part in Donna Ockenden’s review. I cannot understand how they could make that decision and think it acceptable. That is exactly why the law needs to change. It shows why the Hillsborough law is so important and why it was important to put it on the statute book, and also why it was important for us to decide now to apply that duty of candour to future reviews of the failures of maternity services so that never again can NHS staff, current or past, decide not to take part in the search for justice and accountability that it is so crucial for us to deliver.

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

I pay tribute to my hon. Friend the Member for Sherwood Forest (Michelle Welsh) for all her work. My heart goes out to those families in Nottinghamshire, and I pay tribute to their work as well. I cannot imagine what it is like to lose a child in those circumstances, but I do know what it is like to see your own child suffer a brain injury at birth. I work very closely with other families with children who have cerebral palsy or hemiplegia, because of what they have been through and what my own family have been through.

The reasons why such things happen are often connected with negligence, but they are often a result of other circumstances. In our circumstance, our children were born at 31 weeks, as twins. In other families, it is the fact that this woman is black or that woman is disabled that has caused those issues and that negligence. Will my right hon. Friend act on the recommendations of the Ockenden review and the review that is being undertaken by Baroness Amos, and work to ensure that those disparities are overcome when mothers have a greater risk of these things happening to them?

[James Murray]

I thank my hon. Friend for sharing with us his experience of brain injury in his own family, and for reminding us how some of the issues that we are discussing today touch the lives of many people in the House and across the country. We all have a responsibility to act on the basis of the recommendations of today’s report, and I assure my hon. Friend that those recommendations, along with those in Baroness Amos’s report, will enable the taskforce to produce a comprehensive action plan. A key element of that work—this concerns his direct point—will be ensuring that when people are at greater risk of harm, greater risk of being ignored, greater risk of being discriminated against, lied to or not being given the care that they need, that inequality will be addressed.

[Laurence Turner (Birmingham Northfield) (Lab)]

I was born in Nottingham City hospital, and while the Ockenden report was necessarily bounded by the last 13 years, I think it is important to record that women and children were avoidably harmed and avoidably died in those settings many years before, and the pain is not diminished by the passing of time. As I have listened to these exchanges, I have had at the forefront of my mind those friends and people I grew up with who, many years later, found themselves close to death in circumstances that could have been avoided.

As my right hon. Friend said in his compassionate and thoughtful statement, the description of what happened in Nottingham will be all too familiar to families well beyond that city. He will know that Sandwell and West Birmingham hospitals NHS trust is one of the trusts that are subject to particular attention as part of the national investigation. What assurance can he give people in cities such as Birmingham that this time, after these reports and their recommendations, things will change and NHS senior management will be held to account?

[James Murray]

Although the report that we are discussing today deals with what has happened in Nottingham over the past 13 years, my hon. Friend is right to point out that it has not just happened in Nottingham and it has not just happened over the past 13 years. When I have spoken to people about this report, even today, so many have shared their own stories from many years ago in all different parts of the country. That reminds us that although the focus of the report is what has happened to the families in Nottingham, this issue affects families throughout the country, which is why, as my hon. Friend says, it is “all too familiar” to so many people when they hear what has happened. That is why it is so important that we develop our plan, which will have a nationwide impact, in order to finally tackle this challenge head-on and ensure that we deliver the maternity and neonatal services that women across the country need and deserve.

Nottingham Maternity and Neonatal Services

James Murray Excerpts

Wednesday 24th June 2026 Written Statements

[The Secretary of State for Health and Social Care (James Murray)]

I refer hon. Members to the oral statement I made in the House today, 24 June 2026, on the publication of the report from the independent maternity and neonatal review of Nottingham University hospitals NHS trust.

[HCWS145]

Puberty Blockers

James Murray Excerpts

Tuesday 23rd June 2026 Commons Chamber

[The Secretary of State for Health and Social Care (James Murray)]

I know what a sensitive, emotive and difficult issue this is. As I said in the House yesterday, I have myself struggled with the profound challenges this subject raises. We all, as adults, owe a duty of care to every child and young person in this country. That is a responsibility I bear, both as a citizen and as Health Secretary, with the utmost seriousness and sincerity. It is why, in all my deliberations on this matter, my consideration is to protect the safety and wellbeing of children and young people. Children’s healthcare must always be evidence-led, safe and effective. The way to ensure that is to follow expert clinical advice, which is what the Government are doing.

Dr Hilary Cass, the clinician who I think has more respect in this space than any other, has spoken about the importance of this trial in recent days. I remind the shadow Minister that it was her party that commissioned the Cass review and accepted its findings, which included the Pathways trial. I have been clear to the House that this is a challenging area. I accept and welcome the scrutiny of Members, but I encourage us to keep in mind Dr Cass’s request to consider the issues sensitively and cautiously. She says:

“Polarisation and stifling of debate do nothing to help the young people caught in the middle of a stormy social discourse, and in the long run will also hamper the research that is essential to finding the best way of supporting them to thrive.”

I do not think that there is any question that a few years ago, children’s safety and wellbeing was not being protected when it came to gender incongruence. From around 2009, the number of children and young people being referred for NHS support around their gender identity increased rapidly. Stories subsequently emerged of young people struggling after undergoing radical and permanent transition surgery at an early age, of children rushed into taking medication without adequate therapy beforehand, and of clinicians disregarding conditions such as neurodiversity and mental health issues. As such, there was rightly deep concern about the vulnerability of these children and young people, the care and treatments they were receiving, and the surge in referrals. And so, in 2020, NHS England commissioned the leading paediatrician, Dr Hilary Cass, to carry out a review into NHS gender identity services for under-18s.

What Dr Cass uncovered was shocking and scandalous, and she made a series of recommendations for how children can be better protected and supported. It was, in my mind, unquestionably wrong for children and young people to be routinely prescribed puberty blockers for gender dysphoria without any clear evidence on their benefits or risks. The situation then was out of control and so I fully supported the indefinite ban introduced by my predecessor, my right hon. Friend the Member for Ilford North (Wes Streeting), which followed the temporary ban brought in by the previous Government.

In considering what to do next, Dr Cass identified that treatment for gender incongruence was

“an area of remarkably weak evidence”.

She found that even clinicians working in the field were divided on the best way to support, treat and care for young people suffering from gender dysphoria. Where there is strong divergence of medical opinion on treatment, the two possible responses are either to continue with uncertainty—and with that, conflicting opinions and advice—or to undertake a trial. It is only by doing that that we can ensure that children with gender-related distress get the same access to and standards of care as everyone in the NHS.

[Gregory Stafford]

There is a third option, which is to get NHS England to motor ahead with the data-linkage study, so that we can use the data that has already been collected to find out the answers to the questions that the Secretary of State is posing. Only then, if the information is not there, should the trial go ahead. Why is he not pushing that third way?

[James Murray]

The hon. Gentleman’s question allows me to address that matter directly. The data-linkage study will not provide clear evidence of the risks and benefits of puberty-suppressing hormones, which is needed to guide future clinical practice for this cohort. The type of information that would be available in a linkage study is much more limited than the detailed information that the research team will collect about the relative benefits and harms of puberty-suppressing hormones when accessed alongside a holistic model of care.

[Harriet Cross (Gordon and Buchan) (Con)]

For clarity, are Scottish children going to be included in the trial, either by being able to travel south of the border or via NHS Scotland directly?

[James Murray]

I have responsibility for NHS England as Secretary of State for Health and Social Care, and I am setting out the protocol agreed in relation to this trial, as it is a subject that is arousing a lot of questions in the Chamber, which is fair. [Interruption.] I will come back to that point, if the hon. Member for Gordon and Buchan (Harriet Cross) allows me to make a little progress.

[Iqbal Mohamed]

Will the Secretary of State give way?

[James Murray]

I will make a little progress, and then I will be open to more interventions. We need to be clear about who we are talking about. As Dr Cass said, the vast majority of children and young people who question their gender will resolve it without needing any support other than their friends and family. For many young people, questioning their identity, on many different fronts, is a normal part of growing up, and we should simply let them be. A small number of those young people, however, need greater support because of the level and longevity of discomfort that they feel, and that can often involve counselling or therapy.

For a very small number of young people, it is possible—and I emphasise the word possible—that medical treatment would help improve their quality of life and mental health and reduce their gender-related distress. That is why Dr Cass recommended a trial to study the effects of puberty-suppressing hormones on young people’s physical, social and emotional wellbeing, and to establish how best to support children and young people suffering gender incongruence.

[Iqbal Mohamed]

On that point, in normal clinical trials, the active substance and a placebo would be used, and the impact, changes or benefits that each cohort experienced would be checked. If children have a psychological leaning and are emotionally feeling that they are in the wrong body, is there not value in having a cohort that takes a placebo and seeing if that improves their mental health?

[James Murray]

The hon. Gentleman raises an important question around how the clinical trial is designed. In this case, the young people involved in the trial, of whom there will be around 226, will be split into two groups; one half will have the puberty blockers from the start, the other half will receive them after a year.

My understanding of this matter, having interrogated the detail carefully, is that a placebo would not be appropriate for this trial because the subject will be able to know the impacts of having the puberty blockers; they will be aware of whether they are having the medication. What is important, however, and what I hope will set this Pathways trial in a wider context, is all the other work that is being done to study the incidence of gender incongruence and the responses to that among young people, which will go beyond the trial we are talking about to look at children and young people questioning their gender through talking to them, understanding their mental health and their approach to that. All that will happen alongside this trial, which is one part of a much wider study to understand how best to support young people who are facing these gender-related issues.

[John Glen (Salisbury) (Con)]

I acknowledge the serious way that the Secretary of State is approaching this. I think many people will be concerned that, as the shadow Minister has said, there is no objective blood marker for these individuals; I think they will be concerned that a group of people will be taken forward in this trial when a whole range of influences could have governed how they have got to that point, given that the implications of taking these drugs are quite profound for their life and further development. How does one reconcile the fact that there is no way of verifying the suitability and the way that these individuals have been selected for the trial? Perhaps he could help me to understand it better.

[James Murray]

I thank the right hon. Gentleman for the tone he took in asking an important question, which I am pleased to be able to respond to. The bar for getting on to this trial is set extremely high, with strict eligibility criteria: parental consent, alongside the young person themselves consenting or assenting; a diagnosis of gender incongruence for at least two years; and consent from both the NHS care team and a national multidisciplinary team, including a wide range of disciplines, to understand all aspects of a young person’s health, context and situation. The level of approvals and scrutiny that young people will have to go through to participate in the trial will, therefore, set the bar extremely high.

[Dame Harriett Baldwin (West Worcestershire) (Con)]

rose—

[James Murray]

I will give way one more time, and then I will make some progress.

[Dame Harriett Baldwin]

I am grateful to the Secretary of State for giving way. He mentioned parental consent—what would happen in a situation where the child was in the care of the state? Would they be included or excluded from this trial?

[James Murray]

If a child is looked after under a care order, the local authority has parental responsibility, so it would need to be part of the consent process as the corporate parent.

I turn to the points raised by the right hon. Member for Salisbury (John Glen) about young people becoming involved in the trial and the checks that are in place to enable that to happen. As I set out earlier, as the trial involves children, it comes with a responsibility to interrogate and understand its design. As Health Secretary, I have sought the most detailed assurances possible from my clinical advisers as to how children taking part in the trial will be protected.

There are a number of important safeguards. As I have said, children can participate only with the consent of a parent or guardian, and the child themselves must consent or assent. They can participate only if they have had a diagnosis of gender incongruence for at least two years, have received psychosocial support through the NHS and are of stable physical and mental health. They can participate only if they are not subject to any safeguarding concerns and if they and their parents demonstrate sufficient understanding of the nature of the treatment, including its possible advantages and disadvantages. They can participate only if the treatment has been deemed clinically appropriate by both the NHS care team and the national multidisciplinary team and if they are already accessing NHS gender services. On eligibility, the bar is extremely high.

The number of young people who would expect to qualify for the trial will be low and the safeguards to ensure their safety and wellbeing will be rigorous. I have sought and had an assurance that, once they are involved in the trial, participants may be withdrawn at any point. We are not proceeding with the previous, now decommissioned, model of care overseen by the Conservatives when they were in government. We are proceeding cautiously, with rigorous safeguards in pursuit of the evidence, as Dr Cass recommended.

Last Thursday, the independent MHRA approved an updated protocol that significantly strengthened the objective criteria for withdrawing children from the trial, which is a change that I welcome. Signs of greater risk to participants will now trigger increased monitoring, clinical review or their automatic withdrawal from the trial. All participants will be monitored before, at the start of, every three months during, and after the trial. Before and during the trial, information will be collected about mental health, quality of life, self-harm and suicidality, body image, cognition, puberty stage, physical health and side effects.

I have been determined to ensure that the oversight of this trial is as rigorous and robust as it possibly can be, so I have requested monthly updates on its progress. That will include my being notified of any emerging risks.

This trial is rightly one of the most scrutinised UK clinical trials of recent times. We should expect nothing less when we are talking about the health and wellbeing of some of the most vulnerable children in our country. Yet, as Dr Cass has made clear, we have to build the evidence base to show whether the treatments are safe and whether they produce the positive outcomes that young people and clinicians want from them.

The Opposition’s motion would prevent us from following expert clinical advice, when proceeding with the trial is the most appropriate way forward. I say that not because I am suggesting that we should feel instinctively comfortable in doing so but because I have arrived at that conclusion after considering the clinical evidence and receiving robust assurances on the safeguards that are in place.

[Sir John Hayes (South Holland and The Deepings) (Con)]

I know that the Secretary of State has agonised over this matter—he made that clear in his statement to the House last night and again today—but what is not in doubt is the harm that these drugs do. It is an established medical fact. He is determined to be driven by the evidence. That is evidential. We know that the drugs have harmful effects, so in essence what he is saying is that we are prepared to wear those harmful effects on the off-chance that the drugs may have a beneficial set of effects, when there is no evidence to suggest up until now that they do.

[James Murray]

The MHRA has introduced additional safeguards. As a result of its dialogue with the trial sponsors, the amended protocol published last week increases the level of safeguards. That means that if the regular monitoring, which will happen at least every three months—it can be more regular during the trial—shows any sign of increased risk of harm, that will lead to increased monitoring, clinical review and, when considered against objective criteria, automatic withdrawal from the trial.

It is a question of monitoring this trial, possibly more closely than any trial before—the level of scrutiny is very great indeed—to ensure that at the first sign of any increased risk of harm, action will be taken. That is the assurance that I have sought in interrogating this matter carefully in recent days, and that is the basis on which I am talking to the right hon. Gentleman and others in the House today.

We must come to a fair and settled conclusion on this matter to move forward as a country, and I believe that we should follow clinical advice and establish the clinical evidence gathered in a highly scrutinised trial with all the safeguards in place that I have described. Only that approach will give us the confidence about where we settle on this matter in the future. On that basis, the Government oppose this motion.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

Pathways Clinical Trial

James Murray Excerpts

Monday 22nd June 2026 Written Statements

[The Secretary of State for Health and Social Care (James Murray)]

I refer hon. Members to the oral statement I made in the House today, 22 June 2026, on the Pathways clinical trial.

[HCWS135]

Pathways Study: Puberty Suppression

James Murray Excerpts

Monday 22nd June 2026 Commons Chamber

[The Secretary of State for Health and Social Care (James Murray)]

With your permission, Madam Deputy Speaker, I shall make a statement on the Pathways trial.

I know what a sensitive, emotive and difficult issue this is. I myself have wrestled with, and at times struggled with, the profound challenges that this subject raises. In all of my consideration and deliberation over this matter, my bottom line has been to protect the safety and wellbeing of children and young people. The way to do that is to follow expert clinical advice and take an evidence-led approach, which is what this Government are doing. As adults, we all owe a duty of care to every child and young person in the country. It is a responsibility that I—both as a citizen and as Health Secretary—bear with the utmost seriousness and sincerity.

I do not believe that children’s safety and wellbeing was being adequately protected just a few years ago. I think it would be helpful to remind Members how we arrived at that point. For several years before the turn of the decade, the number of children and young people being referred for NHS support around their gender identity increased rapidly. Stories subsequently emerged of young people struggling after undergoing radical and permanent transition surgery at a young age, children being rushed into taking medication without adequate therapy beforehand, and clinicians disregarding conditions such as neurodiversity and mental health conditions. As such, there was rightly deep concern about the vulnerability of these children and young people, the care and treatment they were receiving and the surge in referrals.

In 2020, NHS England commissioned leading paediatrician Dr Hilary Cass to carry out a review of NHS gender identity services for under-18s. What Dr Cass uncovered was shocking and scandalous, and she made a series of recommendations for how children could be better protected and supported. I remind the House that those recommendations were accepted in full by both the Conservative Government of the time and my party in opposition.

It was, in my mind, clearly wrong for children and young people to be routinely prescribed puberty blockers for gender dysphoria without any clear evidence on their benefits or risks. The situation was out of control, and I fully supported the indefinite ban introduced by my predecessor, my right hon. Friend the Member for Ilford North (Wes Streeting), which followed the temporary ban brought in by the previous Government.

I do not think there is anyone with more respect as a clinician in this space than Dr Cass, and my predecessors in this role recognised that too. Dr Cass identified treatment for gender incongruence as

“an area of remarkably weak evidence”.

She found that even clinicians working in the field were divided on the best way to support, treat and care for young people suffering gender dysphoria. Where there is strong divergence of medical opinion on treatment, the two possible responses are to continue with the uncertainty—and, with that, conflicting opinions and advice—or to undertake a trial, not just to resolve a dispute but to make sure that children with gender-related distress get the same standards of care as everyone else in the NHS.

As Dr Cass has said, the vast majority of children and young people who question their gender will resolve it without needing any support other than that of their friends and family. For many young people, questioning their identity on many different fronts is a normal part of growing up, and we should simply let them be. For a small number of young people, though, greater support is needed because of the level and longevity of the discomfort that they feel. That can often involve counselling or therapy. For a very, very small number of young people, it is possible—I emphasise the word “possible”—that medical treatment would help to improve their quality of life and mental health, and reduce their gender-related distress.

That is why Dr Cass, whose approach until recently commanded cross-party consensus, recommended a trial to establish how best to support children and young people suffering gender incongruence. That is the Pathways study. It has four main parts, one of which is the clinical trial to study the effects of puberty-suppressing hormones on young people’s physical, social and emotional wellbeing. The Pathways trial, which is being led by King’s College London and the South London and Maudsley NHS foundation trust, was initially approved last November. The trial seeks to gain evidence on whether those potential benefits are real, alongside evidence on whether such treatment comes with the risk of harm.

It is right that this Government are guided by expert clinical advice and a clinical, evidence-led approach, but as this study involves children, and therefore comes with a particular responsibility, as Health Secretary I have sought the most detailed assurances possible from my clinical advisers about how children taking part in the trial will be protected. There are a number of important safeguards. Children can participate only with the consent of a parent or guardian, and the children themselves must consent or assent. They can participate only if they have had a diagnosis of gender incongruence for at least two years. They can participate only if they have received psychosocial support through the NHS. They can participate only if they are of stable physical and mental health. They can participate only if they are not subject to any safeguarding concerns. They can participate only if they and their parents demonstrate sufficient understanding of the nature of the treatment, including its potential advantages and disadvantages. They can participate only if they have been deemed clinically appropriate by both the NHS care team and the national multidisciplinary team, and they can participate only if they are already accessing NHS gender services. So, when it comes to eligibility, we are talking about a very small subset of a very small group. The number of young people who would expect to quality for the trial will be low, and the safeguards to ensure their safety and wellbeing are rigorous. I have sought and had reassurance that once participants are on the trial, they may be withdrawn at any point.

As hon. Members will know, the Medicines and Healthcare products Regulatory Agency raised new concerns at the beginning of this year, and the start of the trial was delayed so that they could be fully scrutinised. On Thursday last week, the regulators approved an updated protocol that significantly strengthened the objective criteria for withdrawing children from the trial. I welcome that change. Signs of greater risk to participants will now trigger increased monitoring, clinical review or automatic withdrawal from the trial. All participants will be monitored before, at the start of, every three months during and after the trial. Before and during the trial, information will be collected about mental health, quality of life, self-harm and suicidality, body image, cognition, puberty stage, physical health and side effects.

On bone health, puberty is normally a time of rapid bone gain, so if changes in bone density are identified, that will lead to a reassessment of whether the participant should continue in the trial, with set criteria for automatic withdrawal. On fertility, there is no published scientific evidence of irreversible changes, but that will be proactively addressed, with every participant offered repeated counselling and a range of options to preserve their fertility. On cognition, while there are no established scientific reports proving a cognitive effect, the new protocol sets out strict definitions for investigation and automatic withdrawal of young people from the trial.

The new criteria for increased monitoring or withdrawing children from the trial will mean that, at the first sign of negative impacts, action will be taken. These criteria will stop short-term harm, and the view of the National Institute for Health and Care Research is that that means any long-term harm should not occur or go unnoticed. Those reassurances about preventing harm to the children who take part in the trial, and taking clear action if any risks appear to increase, are critical. After considering the matter closely over the past few days, I have requested monthly updates on the progress of the trial, including on any emerging risks.

Pathways is rightly one of the most scrutinised UK clinical trials of recent times—we should expect nothing less when we are talking about the health and wellbeing of some of the most vulnerable children in our country. Yet, as Dr Cass has made clear, we have to build the evidence base to show whether the treatments are safe and whether they produce the positive outcomes that young people and their clinicians want from them. My view is that proceeding with the trial is, on balance, the most appropriate way forward.

This has not been easy—I am sure many hon. Members are also wrestling with this dilemma—and, as we debate this issue today, I hope that we will keep in mind Dr Cass’s ask to consider the issues sensitively and cautiously. As she said:

“Polarisation and stifling of debate do nothing to help the young people caught in the middle of a stormy social discourse, and in the long run will also hamper the research that is essential to finding the best way of supporting them to thrive.”

I will not pretend that I do not continue to feel discomfort and unease, but I believe that the only way for us all to come to a fair and settled conclusion on this matter—to move forward as a country on this difficult and sensitive issue—is on the basis of clinical evidence in which we trust. Thanks to the strengthened criteria now in place for monitoring children’s wellbeing and withdrawing them from the trial, there is now intense scrutiny, and there are robust mechanisms to prevent harm from coming to the young people who take part. It is on that basis that I believe we should follow the advice of clinical experts and seek the clinical evidence that will give us the confidence to know that where we settle on this matter in the future is right. I commend this statement to the House.

--- Later in debate ---

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

I declare an interest as an NHS consultant paediatrician and a member of the Royal College of Paediatrics and Child Health. What does this trial do? Put simply, it takes physically healthy children with normal pubertal development and subjects them to powerful drugs that may weaken their bones, affect their ability to think, damage sexual function and make them unable to have children of their own. Serious stuff—and for what? To treat a diagnosis of gender incongruence that will probably resolve without treatment.

Let us look at this carefully. Gender incongruence is a subjective condition; it is how someone says they feel. There are no lab markers and no scans. That, of course, is not necessarily unusual. In fact, it is common in mental health conditions. Gender incongruence is often self-resolving; it gets better on its own. Again, this is not unusual in paediatrics. It is really common for children to be admitted to hospital for supported care for things like gastroenteritis and respiratory viruses. Puberty blockers are powerful drugs. This is a powerful treatment with significant long-term consequences. Again, this is not new to paediatrics. Some chemotherapy, for example, has substantial short and long-term consequences. But what is unusual and, I think, toxic is the combination of all three. Medicine is about balancing risk. Where else would we give powerful drugs with potentially serious long-term consequences for a subjective condition that is likely to get better on its own?

I understand that this trial has been approved, but time and again we have seen and heard how fear and hostility can distort priorities. We have seen tragedy occur when fears of accusations of racism limited mental health treatment. We have seen profound suffering when fear of accusations of Islamophobia limited inquiries into the grooming gangs. The healthcare of children distressed about their gender is another topic where there have been attempts to shut down debate with threats and accusations of transphobia.

Such attempts were reported in relation to the Tavistock.

When considering treatments for life, with lifelong implications, we have a duty to be careful and sensible, so I ask the Secretary of State: why are this Government funding a trial that will cause harm to physically healthy children? These children may be 11 years old, at Tanner stage 2. Some of them are primary school children with only minimal signs of puberty. This is far too young. The MHRA warned in February that the youngest patients are at greatest risk; they may end up on puberty blockers for a much longer period, and face a higher risk to fertility, because sperm and eggs have not yet fully developed at Tanner stage 2.

I am reminded of this point in the judgment in Bell v. Tavistock:

“There is no age appropriate way to explain to many of these children what losing their fertility or full sexual function may mean to them in later years.”

Yet as the Secretary of State confirmed, the children must consent or assent to being in the trial. Why did the Government not heed the MHRA’s recommendation of a minimum age of 14 years? This Labour Government think that 14 is too young to watch social media. Why do they think 11 is old enough for this trial?

What is the goal of the treatment? In the trial, the outcome is a short to medium-term effect on quality of life and body satisfaction. Does the Secretary of State believe this is proportionate to the risks of these medications? Is there any evidence suggesting that puberty blockers are safer than they were thought to be in 2024, when the Government banned them, following the expert advice from the Commission on Human Medicines? Some have suggested that the drugs help adults to pass as the opposite sex. Is the long-term damage really worth it for the cosmetic benefit of a few? And it is just a few, because we know that the vast majority will be better without any treatment.

The Secretary of State said that “when it comes to eligibility, we are talking about a very small subset of a very small group.” Even if we were to accept the premise that a very small number might benefit from treatment, how could the clinicians identify which those children might be? A study of clinical outcomes from kids treated at the Tavistock is due to be completed next year. That could help, so why is the Secretary of State not waiting until that report is completed before conducting an experiment on an unnecessarily broad group of children? Has evidence come to light since the Cass review that helps clinicians confidently work out which 11-year-olds will become adults with gender dysphoria and which will not?

The Secretary of State has said that the criteria will stop short-term harm, and that should mean that long-term harm will not occur or go unnoticed, but history is littered with examples of things that do not cause short-term harm but do cause long-term damage. He also suggested that the trial will resolve the dispute, but sadly, I do not think that will be the case, because, first, a single trial rarely resolves a dispute; and, secondly, the comparison group, who are not getting the puberty blockers, are not randomised and are an intrinsically different population. This is bound to be highlighted once the result is published. In medicine, we have a founding principle: primum non nocere—first, do no harm. I ask the Health Secretary to please cancel this trial before vulnerable children suffer unnecessary, irreversible harm on his watch.

[James Murray]

I agree with the shadow Minister that most children and young people who are questioning their identity and gender are likely to resolve those questions on their own, and I think Dr Cass would agree with that. As I said in my opening remarks, for the majority of children who question their gender, we should let them be; they will resolve the matter through their friends and family and their own development. We are talking here about a small subset within a small group of children who need further support. I also agree with the shadow Minister that the situation before Dr Cass did her review—the situation that had developed in the last few years before the turn of the decade—was totally unacceptable, and we should be clear that that was wrong.

The shadow Minister asked about protecting the young people involved in the trial from harm. As I set out, there is intense scrutiny, and there are robust mechanisms to prevent the children involved from being harmed. She mentioned the MHRA recommendation for the lower age limit. Initially, there was no lower age limit, but a scientific dialogue between the MHRA and the trial sponsor led to publication last week of the updated protocol, which recommended the minimum ages of 11 and 12.

The gateways to younger people and children becoming involved in the trial are significant. There must be not just consent or assent from the children, and consent from their parents or guardians, but approval from the NHS care team, the national multidisciplinary team and others before anyone can be involved. As I set out, I feel uncomfortable and uneasy when considering this matter, but I think that the right way for us to move forward is to have the clinical evidence on which to base decisions. I have received reassurances about there being the highest possible level of scrutiny and protection from harm for young people involved in the trial, and that is the basis on which, on balance, I think it is right for it to proceed.

[Danny Beales (Uxbridge and South Ruislip) (Lab)]

I thank the Secretary of State for his statement. The Conservative party committed to and commissioned the Cass review, and today’s statement takes forward Dr Cass’s recommendations in full—guided not by ideology, but by evidence. Some Members who are critical of that approach have said in this place that these young people just need love. I agree that we should show trans people and trans young people more care and compassion—far too often, those things have not been demonstrated in public discourse in recent months and years—but trans people and trans young people also need and deserve high-quality, evidence-based and timely healthcare. I therefore welcome today’s statement and the Secretary of State’s commitment. Will he say that this Government are still committed to rolling out gender clinics in every region?

[James Murray]

As my hon. Friend will know, the recommendations in Dr Hilary Cass’s review set out how to establish better services for young people in the future. The focus of today’s statement, the clinical trial, is just one part of the wider work on how best to support young people who need extra support in this situation. It was welcome that there had been, at least until recently, a cross-party consensus that Dr Cass was finding the right way through this difficult matter.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

I thank the Secretary of State for advance sight of his statement. The Liberal Democrats have long highlighted the need for better access to specialist healthcare for children and young people struggling with gender identity. The closure of the Tavistock clinic and its inadequate rating by the Care Quality Commission demonstrated that urgent change was needed. Young people struggling with gender identity face serious challenges. They have been badly let down for years by low care standards and extremely long waiting lists. On top of that, they have to contend with a toxic public debate, which comes at a huge cost to their wellbeing at a particularly vulnerable stage in their life. The average three-year wait for a young person to see a specialist can be extremely harmful at such a vulnerable age.

We agree that treatment should first be based on talking therapies, so that patients are given the space and support that they need, but it is crucial that young people can start those therapies as a matter of urgency, not after years of delay. Decisions about these young patients’ futures should be made in an informed way, with expert clinicians and based on the best possible evidence, which the NHS must build up safely and effectively. We support prioritising clinical evidence, so that patients’ interests are put at the heart of decision making in all areas of healthcare. Guidance and decisions around puberty blockers must be led by experts and clinical evidence, and not influenced by ideological opinion. That is why we supported the decision of the former Secretary of State, the right hon. Member for Ilford North (Wes Streeting), to pause the Pathways clinical trial while concerns raised by the MHRA were thoroughly addressed. Will the Secretary of State confirm whether the MHRA has confirmed that the concerns that led to the withdrawal of the trial have been substantially addressed, and how many children are expected to take part in the trial now that its parameters have been altered?

[James Murray]

I welcome the fact that the hon. Lady agrees with the Government that we should base our decisions about whether and how to provide support for children, particularly in the case of the treatment that is at the centre of this clinical trial, on clinical evidence and the expert advice of clinicians. There can be no one in this field more widely respected than Dr Hilary Cass, whose recommendations form the basis of the decision that we have taken as a Government.

The hon. Lady asked about the work of the MHRA since early this year to strengthen the safeguards for young people involved in the trial. As I said earlier, I welcome the changes that it has brought forward to strengthen the criteria, which will lead to greater monitoring and clinical reassessment, and to setting objective criteria for withdrawing children and young people from the trial entirely. The MHRA has been engaged in a scientific dialogue with the trial sponsors, and it was the outcome of that process that led the MHRA, as an independent body, to publish the updated protocol towards the end of last week. Now that that is in place, we have greater reassurance about the safeguards.

The trial is expected to involve around 226 children and young people over five and a half years, with each participant potentially being offered puberty blockers for up to 24 months. As I said, a decision to withdraw is triggered by the participant meeting set objective criteria related to the risk of harm.

[Steve Race (Exeter) (Lab)]

I welcome the statement and the Health Secretary’s calm approach, which contrasts sharply with some of the language that is used around this very important issue. When it comes to the Pathways trial, does he agree that we must follow the science and avoid vilification, polarising language and politicisation for the good of young people and our communities?

[James Murray]

I absolutely agree with my hon. Friend about the importance of following clinical evidence and taking a clinically led and evidence-based approach to this decision. As I said, I have felt uncomfortable and uneasy about some of the challenges raised by this matter, but for me, the right way to move forward is to follow the clinical advice, and to base future decisions on clinical evidence, given that I have received the most robust assurances about the safeguards that are in place to protect young people involved in this trial from harm.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

I welcome the statement and this approach. I thank the MHRA for engaging with the Committee when we asked it specific questions about this. It told us that the role of the regulator is to ensure that participants in any clinical trial are kept safe and are exposed to medicine only if there is a reasonable expectation of a positive effect, and that is what was foremost in its mind. It also reassured us that if it had not felt 100% assured, it would have not allowed the trial to go forward.

There was a lot of disquiet about the iterative process that the trial has gone through—that it was stopped, paused and then started again. Could the Secretary of State outline for the House how usual or unusual that is? What support can the NHS offer those families who might have hoped to be part of the trail but now find themselves excluded from it?

[James Murray]

I am sure that the hon. Lady will agree that this is now one of the most heavily scrutinised clinical trials in this country in recent history, and rightly so—it is right that it is so heavily scrutinised and that we all seek assurances about the safeguards in place. It is right that, as Health Secretary, I made sure that I got those detailed safeguards before coming to the House to set out the Government’s position today.

The hon. Lady asked how usual it is for the MHRA to work with the sponsors of trials. My understanding is that the MHRA routinely works with trial sponsors to iterate the protocols in relation to those trials. Because this trial involves children and young people, for me, the bar should be exceptionally high, to ensure that those safeguards are in place. That is why, although my starting principle is that clinical evidence is the right way to approach such a matter, I wanted that extra reassurance. That is why I asked for the most detailed possible assurances from my clinical advisers, to ensure that those robust safeguards are in place in the way the trial is now designed.

[Adam Thompson (Erewash) (Lab)]

Before my election, I was a scientist—albeit not in the health sciences. Using that background, however, can I agree with the Secretary of State that healthcare practices and medical trials, like all scientific trials, must be led by expertise and evidence, not politics? Therefore, what precedent is there for politicians, including Members of this House, intervening in a medical trial?

[James Murray]

My hon. Friend raises an important point about the relationship between politics and clinical evidence and clinically led decisions. Being led by clinical advice and clinical evidence is a decision that I and this Government stand behind. In this case, it is a matter where in considering some of the issues raised, I have felt uncomfortable and uneasy, but that commitment to clinical evidence, particularly recommended by someone as widely respected as Dr Cass, is the basis on which we can move forward. As I mentioned in response to the Chair of the Health and Social Care Committee, because this involves children and young people, I wanted to receive extra assurances that the clinical advice was robust and that the safeguards would be as robust as possible. That is the assurance I have received, it is what I very much wanted to receive before coming here today.

[Rebecca Paul (Reigate) (Con)]

I thank the Secretary of State for his statement. No child put on puberty blockers at the earliest stage of puberty and whose natural puberty is permanently blocked will ever have an orgasm or be fertile. No child can consent to that. Around 2,000 children have already been given puberty blockers for gender distress, so there is ample information available on impact and outcomes held by gender clinics. It makes no sense to experiment on even more children while this exercise remains incomplete. Why is the Health Secretary not prioritising the completion of this important data linkage study before experimenting on more children?

[James Murray]

The hon. Lady refers, apparently with some certainty, to what she considers to be the clinical outcomes of these puberty blockers on young people. I have to say, with all due respect, that I would trust Dr Cass’s conclusion more than the hon. Lady’s, which is that there is not evidence about the risks or benefits of these medications. That is exactly why Dr Cass was so clear in recommending a trial to find that clinical evidence, because that is the basis on which we can take those decisions.

[David Smith (North Northumberland) (Lab)]

I thank my right hon. Friend for his detailed and nuanced statement. Notwithstanding the risks of using puberty blockers on children, which he has outlined, and the inability to guarantee that they will not be harmed by participation in the trial, how can the trial determine long-term impacts of the use of puberty blockers when it lasts for only two years? Does that not show the inefficacy of the trial itself? If we really are committed to evidence, which I agree we should be, why are we not—as we just heard from the hon. Member for Reigate (Rebecca Paul)—using the long-term data that already exists, which came from clinics such as the Tavistock and was gathered over many years?

[James Murray]

As a result of the work that the MHRA has been doing with these trial sponsors in recent months, there are now objective set criteria against which children and young people involved in the trial would be automatically withdrawn. Those criteria, as I set out earlier, will stop the short-term harm, and the view of the National Institute for Health and Care Research is that this means any long-term harm should not occur or go unnoticed. It is important that we ensure that the appropriate safeguards are in place for this trial. That is why I welcome what the MHRA has done in recent months, because it strengthens those safeguards, which are important in any clinical trial but, in this trial, could not be more important.

[Sarah Pochin (Runcorn and Helsby) (Reform)]

The Secretary of State has said that no child subject to safeguarding concerns will be considered for participation in the trial. Can he confirm, therefore, that no already vulnerable children currently in the care system will be accepted on to the trial?

--- Later in debate ---

[James Murray]

The hon. Lady is right to draw attention to some of the gateways that children and young people will have to go through before being accepted on to the trial. That will involve not just the child assenting and the parents giving consent, but the NHS care team and a national multidisciplinary team, which will take into consideration all the different aspects of a child’s life that I set out in my earlier remarks about their health, but also the wider context that the children are coming from. The importance here is to ensure that there is an exceptionally high bar for children and young people taking part in this trial, and that is the process that has now been established.

[Jonathan Davies (Mid Derbyshire) (Lab)]

I thank the Secretary of State for the considered way in which he has delivered his statement. In December 2025, The BMJ reported that

“the Pathways trial should wait for findings from former patients treated by GIDS between 2009 and 2020”

and that

“A data linkage study of 9000 patients, now adults, has full HRA approval, and NHS England has encouraged gender clinicians to cooperate, describing it as an opportunity to gather ‘high quality evidence.’”

But The BMJ reported that the clinicians

“refused to share their data”.

Hilary Cass said that was “extraordinary”. Can he tell us whether all the data that is out there is available and whether it is being shared appropriately?

[James Murray]

My hon. Friend asks about the data linkage study, and I apologise to my hon. Friend the Member for North Northumberland (David Smith), who a few seconds ago also asked about that—I did not respond then but can now address both questions together.

It is important to understand that the information in the linkage study is much more limited than the detailed information that the research team will be able to collect about the relative benefits and risks of puberty blockers. NHS England is, however, committed to delivering the data linkage study. NHS England, since assuming responsibility for that study, has taken time to ensure that the data is shared by relevant organisations. Let me be absolutely clear, for the avoidance of all doubt, that the Government’s clear expectation is that all relevant organisations will provide the data required to complete the study.

[Sir John Hayes (South Holland and The Deepings) (Con)]

I first raised the horrors of the Tavistock clinic in this House in 2019, having been provoked to do so by staff who said that they were often under pressure to refer for life-altering treatment children and young people who had experienced mental health difficulties, abuse and family trauma. Indeed, the Secretary of State will know that the Cass review found that childhood trauma, neglect and abuse featured heavily in the cohort of patients seeking gender changes. As many as two thirds of those referred had suffered neglect or abuse, with high levels of parental mental illness, substance abuse and exposure to domestic violence. So will the Secretary of State, even at this late juncture, abandon this trial? I have no reason to believe that he is anything other than a good man who wants to do the right thing. He has made it clear that he knows that this matter often sorts itself out through puberty and adulthood. I implore him to do so, for I fear that because he is a good man, he will regret this cruel experiment on harmless children.

[James Murray]

I thank the right hon. Gentleman for his comments, and although he and I come to a different conclusion on this, I do not doubt for a second the sincerity of his motivation in wanting to protect children and young people. I actually agree with him, as I said in my earlier comments, that most young children who are questioning their gender will resolve it on their own—let them be to resolve it. But there is a small subset of children who will need extra support, and within that there is a question about whether for a very small subset of them there might be a benefit to having treatment, and that is what this trial seeks to conclude.

I would add that the right hon. Gentleman refers to what happened in the Tavistock clinic and the stories that led to Dr Hilary Cass being commissioned. I think the right hon. Gentleman and I agree on how unacceptable that situation was, and I put on record my thanks to Sir Sajid Javid for commissioning the work by Dr Cass, because it has been such an important piece of work not only to expose what was happening before, but to provide a way forward.

[Lizzi Collinge (Morecambe and Lunesdale) (Lab)]

Puberty suppressors have been used for many years for precocious puberty, but the evidence base for their use in gender dysphoria lacked rigour, so I welcome the news that the trial will go ahead, as recommended by the Cass review. Will the Secretary of State confirm that the medications are only one part of the research, and can he outline some of the other measures being looked at? Given the small numbers expected to take part in this trial, will research also be undertaken into the impact on young people who are showing gender distress but are unable to access a trial or, of course, be prescribed puberty blockers, in order to get a full clinical picture? Will he furthermore ensure that all young children showing gender distress will have some care and support?

[James Murray]

My hon. Friend rightly points out that the clinical trial—the Pathways study, which is the subject of this statement—is just one part of the wider work being done to make sure that the support is there for children and young people who are questioning their gender and who might, or might not, need support in order to feel well about themselves. The Pathways horizon is an observational study of all children and young people attending NHS children and young people’s specialist gender services. Pathways connect is a brain-imaging study. Pathways voices will interview young people. Horizon intensive is about making sure that there is a comparison group of 300 participants who are expressing gender incongruence but not receiving puberty-suppressing hormones, as my hon. Friend suggested.

[Christine Jardine (Edinburgh West) (LD)]

I welcome the statement and the Secretary of State’s tone, because it is important that we all acknowledge that we are dealing with young children and their safety is paramount. While many children will resolve the issues themselves, there is an important group of children for whom that will not be the case; they face enormous challenges and we must do everything we can. I also welcome the Secretary of State’s stress on the importance of talking therapies, but given the long waiting lists and the difficulty in getting access to those talking therapies, how will he ensure that children get the support they need and that there are adequate staff who are properly qualified to support them?

[James Murray]

I thank the hon. Lady for her remarks, and for her tone and approach to this sensitive matter. Sadly, we have waiting lists across many different parts of the NHS. This Government are determined to deal with that so that everyone can receive the appropriate treatment. There are wider questions, which we could debate at another time, about the support that children who are questioning their identity might need. The focus of today’s statement is specifically on the clinical trial, and it is right that we let that happen. The trial will last five and a half years and it is right that we do that thoroughly, because I do not want this country to be taking decisions in future that are not based on the most solid evidence.

[James Naish (Rushcliffe) (Lab)]

I welcome confirmation that the Pathways clinical trial will continue with the modified protocols in place; it was an important manifesto commitment for the trans community. Does the Secretary of State agree that it might help to reduce the risk in the long term of vulnerable young people seeking to access drugs online, which is currently happening in my constituency?

[James Murray]

Dr Cass has raised that point a number of times, particularly when she has spoken in public and been interviewed on her concerns about young people accessing equivalent drugs through an unregulated source—through online sources that are not carefully controlled and where there is no monitoring of the effects on young people. That is part of her motivation for recommending the approach that she proposes. As I said earlier, I and the Government want the decisions about what role, if any, such treatments play in the future to be based on the clinical evidence, with the highest possible safeguards in place for children involved in the trials.

[Rebecca Smith (South West Devon) (Con)]

I want to press the Secretary of State a little further on looked-after children in particular. At the beginning of his statement, he said that his bottom line is to protect the safety and wellbeing of children and young people. Given that parental or guardian permission has to be granted for the trial to take place, I am wondering who will give that permission for a child in care. Will it be himself, the Secretary of State? Will it be the foster parent? Will it be a social worker from a local council? We already know that looked-after children are overrepresented within the cohort of children with gender dysphoria. Ultimately, if we are going to protect them and make sure that their safety and wellbeing are at the forefront, we need some clear direction on what that is going to look like.

[James Murray]

I thank the hon. Lady for her question, which highlights the importance we all place on making sure that vulnerable children are protected in the way that the trial proceeds. Perhaps I can offer her some detail which might reassure her by explaining who is on the national multidisciplinary team. As I mentioned earlier, the national multidisciplinary team will have to give permission for young people to be involved in the trial, as will the NHS care team. That national multidisciplinary team has an independent chair and its membership comprises senior clinicians from a range of clinical backgrounds: paediatric endocrinology, general paediatrics, child and adolescent mental health, clinical nursing, safeguarding, adolescent medicine, allied health and service leadership. Those are the specialisms represented in the national multidisciplinary team, which means that those aspects of the child’s wellbeing are all being considered in that process.

[Peter Swallow (Bracknell) (Lab)]

On a quiet day in Westminster, I have had a chance to dive into the Conservative party’s 2024 manifesto, which promised:

“We will complete the implementation of the Cass Review”.

A similar commitment appeared in our own manifesto, which we are now cracking on with and delivering. Does my right hon. Friend share my concerns that the Conservatives seem to have abandoned their commitment?

[James Murray]

I share my hon. Friend’s disappointment that the cross-party consensus that was in place about the way to approach the issue does not currently seem to be holding. I urge Opposition Members who are not aligned with that cross-party consensus to reconsider their position, because that is the best way forward for our country.

[Rosie Duffield (Canterbury) (Ind)]

The Secretary of State mentioned following the advice of clinical experts, but has he sought any meetings with whistleblowers, former clinicians at the now closed Tavistock clinic, detransitioners and psychologists such as James Esses and Marcus and Sue Evans, who are all campaigning to stop this trial and the testing of children as young as 11 years old, who are too young to access social media and certainly too young to give meaningful consent to taking banned drugs?

[James Murray]

I reassure the hon. Lady, as I set out in my responses to earlier questions, that while my starting point is that clinical evidence should be the basis for our way forward, I have taken the responsibility to interrogate that with the highest level of scrutiny in order to ensure that the conclusions are as robust as possible. That has involved my ensuring that my clinical advisers at the Department for Health and Social Care and the other bodies associated with the Department have provided me with the highest level of detail and reassurance about the safeguards in place. Although I stand behind the principle of following clinical advice and basing conclusions on clinical evidence, I feel that it is important for me, as Health Secretary, to have an extremely high bar for a decision of this magnitude.

[Jonathan Hinder (Pendle and Clitheroe) (Lab)]

The Secretary of State has repeatedly told us that he feels uncomfortable and uneasy. If I am totally honest, I do not think that he believes that this is right at all. I think that in his heart, he knows that this is wrong. Of course it is wrong: stopping an 11-year-old—a primary school child—from going through the natural process that we must all go through to become adults by injecting them with drugs is wrong. We must think about the title of the statement: puberty suppression. People do not need a medical or a science degree to know that the suppression of puberty is wrong. This is a moral question and I am afraid that as it stands the Secretary of State is on the wrong side of it. He says “let them be”—if only they had let Keira Bell be. When she had the treatment, Keira Bell was much older than these children will be when they are given it. She regrets it all and now campaigns to stop this. There is huge public opposition to this—

--- Later in debate ---

[Madam Deputy Speaker]

Order. The hon. Gentleman’s question is far too long. I call the Secretary of State.

[James Murray]

Despite our different conclusions on this matter, I respect my hon. Friend. Part of taking decisions as Health Secretary involves sometimes approaching issues where one might feel uncomfortable on a personal level, but none the less being guided by the right principles in order to take decisions for other groups of people in the country and for the country as a whole. I am not in any way disputing how difficult a matter this is; it is one where I, as Health Secretary—and my predecessors—have had to carefully consider how we ensure that the clinical basis for any future decisions is robust and that we can point to it as a foundation for where this matter settles.

Before Dr Cass did her review, the situation at the Tavistock clinic was totally unacceptable, as the right hon. Member for South Holland and The Deepings (Sir John Hayes) recognised, and we must never go back to a position where the situation is out of control in the way that it was then. In working out how to move forward, I believe that, as uncomfortable as it may make myself and others on an individual basis, focusing on the principle of following clinical evidence, demanding the highest possible safeguards and protections for the children involved, and setting objective criteria for them to be withdrawn or for action to be taken if the risk of harm increases, is the balanced and correct way to proceed.

[Jerome Mayhew (Broadland and Fakenham) (Con)]

Despite all the safeguards and precautions that the Secretary of State has listed, we must be clear about what this trial actually does: it proposes to give puberty blockers to children as young as 11 that may well make them sterile for life, all to treat something that the Secretary of State also says is likely to get better by itself. I accept that this trial may well create clinical evidence, but at what price? How can this damage to children ever be justified?

[James Murray]

Although the hon. Gentleman comes to a different conclusion from the one that I and the Government have come to, he poses the right question when he asks what harm do we need to protect against while getting clinical evidence. If we are to be led by clinical evidence, it is important to have that evidence in a way that we can rely on, but particularly because it involves children and young people, it is incumbent on us to ensure that the level of protection against the risk of harm is exceptionally high. That is why the strengthening of the protocol announced by the MHRA last week provides that higher level of assurance that I have sought to interrogate and to ensure is there in as robust a way as possible. That gives us the confidence that those safeguards are in place as the trial proceeds.

[Mr Gregory Campbell (East Londonderry) (DUP)]

I agree with the Secretary of State that we should come to this subject matter with care and compassion given the age profile of the children affected. He majored on the small number of people who would take part in the trial. In fact, he said that

“we are talking about a very small subset of a very small pool.”

If that amounts to a couple of hundred people as he said, it is unlikely that there would be universality of outcome, either positive or negative, because in that size of pool there are obviously going to be mixed views. If it is a small number of people who benefit, as he believes, but a much larger number who do not, what then?

[James Murray]

The number of expected participants in the trial is 226. That is not a firm target—it does not have to be exactly that number—but that is the number at which statistically significant conclusions can be drawn. The 226 will fall into two camps: one will access the medical treatment immediately and the other will access it after one year. In that way, we will have clinical evidence from which we can draw conclusions and on which we can base future decisions. The number has been chosen so that the evidence can be relied on in the future to take decisions about whether, and if so how, to continue the use of these treatments.

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

A parent cannot consent to their child engaging in sexual activity and soon they will not be able to consent to their child having a social media account, so why does the Secretary of State think that a parent should consent to drugs being administered to their child to supress their puberty and alter their sexual development?

[James Murray]

We are following clinical advice. We are ensuring that there is a triple lock on the consent for children and young people to be involved in this trial, involving the consent or assent of the young person themselves, parents or guardians, and the NHS care team—the national multidisciplinary team that I mentioned earlier. That is how this trial ensures that there is a high bar for being involved in it and that all aspects of a young person’s life are considered before they are approved.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

I thank the Secretary of State for the manner of his responses.

Four years, three-and-a-half years, four years, six-and-a-half years, four years, three-and-a-half years, four-and-a-half years, five-and-a-half years, three years and nine months—those are the waits faced by young people in Dorset supported by Space Youth Project between their referral to the gender identity service and their very first appointment. None of them will qualify for this trial, and many will have gone into adulthood still waiting, despite commitments of more treatment and clinics. While I support the criteria for the trial as detailed in the statement, there is an inadequate capacity in the system, which is leading to even more distress for these children and their families. Will the Secretary of State update us on this issue? Most teenagers will be excluded from the trial, so they need to hear how they will be supported.

[James Murray]

There is a fundamental difference of approach between me and the hon. Lady. The reason for the trial is not to ensure that young people on the waiting list can get access to treatment; the trial is to find an evidence base on which to take future decisions about whether young people should be offered treatment and, if so, in what way. Talking about waiting lists and the trial combines two things that, in my view of the world, really do not have a relationship in this context.

[Suella Braverman (Fareham and Waterlooville) (Reform)]

No child is born in the wrong body. The scandal of thousands of children being put through irreversible medical intervention such as puberty blockers causing infertility, among other harms, has gone on for more than a decade, and it will go down as one of the worst examples of state failure in our history. Officials advise and Ministers decide. Why does the Secretary of State not use the considerable executive power vested in him personally to overrule his official advice, pause the puberty blockers trial and put child safety first?

[James Murray]

This trial has been paused since earlier this year while the MHRA worked to strengthen the safeguards. Those stronger safeguards are now in place, which gives greater protection to young people who are involved in this trial. As I mentioned in my remarks earlier, one of my responsibilities as Health Secretary is to interrogate the detail to ensure that safeguards are adequate. I take that responsibility particularly seriously when it involves children and young people, and that is to ensure that we have the highest possible safeguards against harm of anyone involved in this trial.

[Jim Allister (North Antrim) (TUV)]

The Health Secretary told us that his bottom line was to protect children, but he also conceded that puberty blockers can affect adversely bone density and brain development, so why is he taking the risk? Our 11-year-olds are not guinea pigs; they are children entitled to grow up without state-sponsored harm. Surely that should be the starting point.

[James Murray]

The reason for having this trial is to establish whether there are in fact benefits to this treatment for some children and young people as well as what the risks of harm are. I believe it is right, on balance, to proceed with this clinical trial to get clinical evidence on the basis of having the highest possible protections against a greater risk of harm to children and young people involved in this trial.

Oral Answers to Questions

James Murray Excerpts

Tuesday 9th June 2026 Commons Chamber

[Mr Speaker]

Welcome, Secretary of State.

[The Secretary of State for Health and Social Care (James Murray)]

Thank you, Mr Speaker.

This Labour Government were elected to build an NHS fit for the future. As Secretary of State, I am accelerating modernisation, but health inequalities start long before people access the NHS, so our focus on prevention in the 10-year health strategy is crucial, as is the work of this Government to address wider inequalities, including in housing, air quality and getting more people into work.

[Perran Moon]

I warmly welcome the Secretary of State to his place. Oversimplified indices of multiple deprivation scores do not reflect the difficulties in caring for people in rural and remote coastal areas such as Cornwall. The Government are committed to neighbourhood health, but funding is getting caught up in integrated care board management structures and not flowing to GP practices, which should be delivering the care. How can the Government ensure that neighbourhood funding does not get held up by ICBs and flows to where it has the highest impact?

[James Murray]

My hon. Friend is absolutely right. Funding must not be held up; it must get to the frontline to help patients, his constituents and people across the country. We are supporting ICBs to work differently with providers to identify and meet the needs of their communities on a new population-based approach. We are also reviewing the outdated GP formula for the distribution of funding to ensure that, for the first time in two decades, it will accurately reflect need and ensure that deprived communities get their fair share.

[Will Stone]

I represent some of the most deprived parts of Swindon, yet residents are having to travel across town to get access to healthcare. What is the Secretary of State doing to address that?

[James Murray]

My hon. Friend is right to point to the fact that the current model of care works least well for some of those experiencing the greatest disadvantage. I am pleased that we have joint commissioning arrangements of more than £28 million in place between the NHS and Swindon borough council, which will help to tackle issues for those most at risk. As I mentioned in response to the question from my hon. Friend the Member for Camborne and Redruth (Perran Moon), we are reviewing the funding formula for the resources of GP practices for the first time in two decades. That is a crucial step to ensuring that we have a fairer distribution of resources across the country.

[Layla Moran (Oxford West and Abingdon) (LD)]

The Health and Social Care Committee’s most recent report into healthy ageing highlights the unacceptable 20-year gap in healthy life expectancy between the most and least deprived areas of the country. It also points out that physical activity can be as effective, if not more effective, in treating the ailments of older life than pharmaceutical intervention. That is why we recommend that the Government target the least active groups to narrow that gap and embed activity into clinical practice.

I welcome the Secretary of State to his place. We are yet to have our first conversation, so let us have our first meeting, in which we might discuss this issue and more, as well as how to embed tackling inequalities into the whole of the national health service.

[James Murray]

I look forward to working constructively with the hon. Lady in her role as the Chair of the Health and Social Care Committee. She is absolutely right to point to the importance of embedding prevention and healthier lifestyles in the way that we approach healthcare in this country. Although we talk a lot and passionately about the NHS, health is not just about the NHS; so many determinants of health start long before people access the NHS. In our 10-year health plan, there is a huge focus on tackling obesity, smoking and ensuring that people have more active and healthier lifestyles, because that is the way to reduce pressure on the NHS and ensure that people across the country live healthier lives.

[Alison Griffiths (Bognor Regis and Littlehampton) (Con)]

West Sussex county council’s health and adult social care scrutiny committee has concluded that the closure of Zachary Merton hospital in Rustington “constituted a significant variation” in services. Given the statutory requirements for consultation—promised, but never delivered—when can residents expect a decision on my call-in request?

[James Murray]

I thank the hon. Lady for raising the situation in her constituency. For all of us as MPs, our first job is to raise matters that pertain to our constituents, and healthcare is among the most important services that they receive. I will ask my team to look further into the points that she raises and get back to her.

[Mr Speaker]

I call the shadow Minister.

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

Does the Secretary of State agree that state-funded healthcare should be provided to all children based on clinical need, not economic or educational status?

[James Murray]

It is an essential part of our NHS and its founding principles that the NHS is available to all on the basis of need, not their ability to pay. That is a fundamental principle that we in the Labour party support. I know that some Opposition parties have been moving away from that recently and seeking to privatise the provision of our health service and move to an insurance-based model, but Labour Members believe that all people, including children, must get healthcare based on their need rather than their ability to pay.

[Dr Caroline Johnson]

I thank the Secretary of State for his answer. Does he therefore share my concern at reports that some children are being turned away from state-funded healthcare because they are not attending a state school? Will he look into those reports and ensure that he makes provision for children who are not attending state schools to receive the healthcare they need?

[James Murray]

I am surprised by the hon. Lady’s remarks, because where a child goes to school should have no bearing on their ability to access NHS services. If she would like to write to me with further details, I would be happy to look into that matter.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

The former Secretary of State, the right hon. Member for Ilford North (Wes Streeting), recognised an appalling culture of medical misogyny and basic, everyday sexism within the NHS. As such, it was extremely disappointing to see that the new women’s health strategy was inferior to the men’s health strategy. The men’s health strategy received 60% more funding for new initiatives and has a named academic network, a formal research mandate aligned with the National Institute for Health and Care Research, and a commitment to publish a one-year accountability report with named, responsible organisations and formal timeframes for every action. It also commits specific funding to trials and pathfinders. As it stands, the women’s health strategy has none of those things. It contains no specific, measurable, time-bound target to reduce the backlogs in endometriosis care, nor does the NHS 10-year plan include endometriosis, polycystic ovary syndrome or fibroids in its prevention agenda. Can the Secretary of State explain why?

[James Murray]

The renewed women’s health strategy was a really important achievement under the previous Secretary of State, which updated the approach of this Government and reflected the differences in healthcare that women too often receive. If I might offer a personal reflection, since I have become Secretary of State, one issue that many women have raised with me is that they do not feel the health service adequately listens to them, takes their pain seriously, or gives them the right pathways to get the treatment they need. That must change, and this Government will change it.

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

4. What assessment he has made of the adequacy of progress on implementing the suicide prevention strategy for England.

--- Later in debate ---

[Robbie Moore (Keighley and Ilkley) (Con)]

6. What steps he is taking to increase access to care in the community.

[The Secretary of State for Health and Social Care (James Murray)]

This Government’s focus on shifting from hospital to community will benefit millions of people and increase access to care. This shift is underpinned by new community diagnostic centres that now deliver faster, more accessible care at 109 sites, 12 hours a day, seven days a week. By 2030, we will have opened 120 new neighbourhood health centres. This expansion will transform community access for those who most need it.

[Robbie Moore]

Back in 2023, the Conservative Government signed off £3.4 million for Keighley to build a new health and wellbeing hub to improve care in the community. We have plenty of brownfield sites and funding is secured, but we are progressing at a snail’s pace, with progress being made incredibly slowly. We are now in mid-2026, and no planning application has yet been submitted. Will the Secretary of State meet me so that we can unlock the project and get it delivered?

[James Murray]

This may not be the first project initiated under the last Government that has not exactly run ahead at the fastest pace possible. We need to ensure that neighbourhood health provision is delivered as quickly as possible across the country. Our plans to increase the number of neighbourhood health centres will focus on areas with below-average healthy life expectancy, ensuring that rural towns and deprived areas receive help most rapidly. Part of that will involve the shift from hospital to the community to prevent ill health before it occurs, as I mentioned in an earlier response.

[Cat Eccles (Stourbridge) (Lab)]

Last year I campaigned with the community and local councillors to save the Crystal dementia centre in Stourbridge. The centre provides community support for dementia patients and their carers, employs dementia advisers and assessors, and offers day services to many local people. Sadly, however, since we saved the centre Dudley council has sought to close it by stealth, preventing new assessments and preventing new users from joining. Does the Secretary of State agree that this is a disgraceful way for the council to act, which goes against the Government’s mission to provide quality care close to home, and will he meet me to discuss the matter further?

[James Murray]

It does sound concerning that that decision has been taken. I urge all councils to work with their local integrated care boards and other parts of the NHS system to ensure that healthcare of that kind is provided in areas where people can access it, as part of our plan to make certain that healthcare is available throughout the country.

[David Reed (Exmouth and Exeter East) (Con)]

7. What assessment he has made of the adequacy of the provision of health services for men.

[The Secretary of State for Health and Social Care (James Murray)]

Too many men lead too much of their lives in poor health and face barriers to access to health services. We have published England’s first ever men’s health strategy to get men speaking about their physical and mental health, and we are getting on with implementing it. From partnering with the Premier League to investing in the men’s health community fund, we are meeting men where they are, and helping them to lead longer, healthier lives.

[David Reed]

The NHS itself says that prostate cancer often has no symptoms at first, and Prostate Cancer UK says most men with early prostate cancer have no symptoms at all. The Government’s TRANSFORM trial exists because current detection methods are recognised as inadequate. Why does Government messaging still point men towards early symptoms that they are unlikely to have, while cancers that could be cured are becoming cancers that cannot?

[James Murray]

Let me be really clear in my advice to any man who is worried about prostate cancer, whether he has symptoms or not: go and discuss it with your GP. Testing is available when GPs recommend it, and I would recommend to no man that he should worry about it in silence, sit at home and fret about what might be going on.

The wider, targeted screening programme to which the Government have agreed is based on the evidence from weighing up the benefits of screening versus the harm that it can cause. We know that, at present, if cancerous cells are identified and treatment follows—for example, removal of the prostate—it leads to permanent urinary incontinence in 20% of cases and in two thirds of cases to permanent erectile dysfunction.

[Steve Darling (Torbay) (LD)]

8. If he will make it his policy to retain Healthwatch.

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[Josh Babarinde (Eastbourne) (LD)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health and Social Care (James Murray)]

The NHS matters deeply to me, to every one of my colleagues and to people right across the country. That is why we are not wasting a second in driving delivery and pushing forward with extending prostate cancer screening to protect men at most risk, appointing a new national maternity adviser to give every woman and baby a safe birth, and accepting the Mann review recommendations to rid the NHS of antisemitism and all forms of racism. Last week, with my hon. Friend the Minister for Secondary Care, I took the NHS modernisation Bill through its Second Reading. As Secretary of State, I am determined to accelerate modernisation and build an NHS that is fit for the future.

[Josh Babarinde]

Following power outages at Eastbourne district general hospital that left operations and birth services suspended, hospital bosses submitted a strategic bid for more than £10 million to the estates safety fund to urgently fix the problem, which was rejected. How does the Secretary of State expect our hospital to provide consistent and safe care to patients if the power goes out?

[James Murray]

I am aware of the issues at Eastbourne district general hospital. Patients, staff and visitors deserve better than power cuts and electrical failures, which is why this Government have set out a credible and deliverable plan to deliver the new hospitals programme. I would gently remind the hon. Gentleman and his constituents that many of the problems that the NHS estate faces today stem from its being starved of £37 billion of capital investment in the 2010s, when the Lib Dems were in government.

[Peter Swallow (Bracknell) (Lab)]

T2. One of the biggest barriers to accessing community healthcare in Bracknell Forest is constituents not being able to get routine diagnostic procedures done at their local GP or health centre, and instead having to travel. One constituent with cancer was told that he had to go to Guildford for a simple blood test. How will the introduction of a single patient record help to break down some of those barriers?

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[Stuart Andrew (Daventry) (Con)]

I begin by welcoming the Secretary of State and the Under-Secretary of State for Health and Social Care, the hon. Member for Birmingham Edgbaston (Preet Kaur Gill), to their places.

The Secretary of State was in the Treasury when it imposed VAT on compassionate access medicine programmes, which provide some patients—especially children with cancer—with a vital last chance to access treatment. The policy has already led to the closure of one scheme. Will he now commit to abolishing this tax before any more follow suit?

[James Murray]

One thing I learned when I was in the Treasury is that decisions about tax are taken by the Chancellor at fiscal events, so I am certainly not going to start taking decisions about taxation in my new role at the Dispatch Box today. The broader point is how important it is to ensure that we have the medicines that we need for the future. That is why this Government are investing so much in research, development and innovation, to ensure that we have the drugs and medicines we need for the healthiest possible population in the future.

[Stuart Andrew]

I am sorry, but that was simply waffle. This matter needs decisive action now; these drugs are absolutely critical to some children. This cancer drugs tax has already closed one scheme, and companies are making real-time decisions now about whether to continue programmes in the United Kingdom. The Secretary of State must urgently get the Treasury to exempt compassionate use medicines permanently, so that the patients in most need can get these vital drugs, which, in some cases, are simply their only hope.

[James Murray]

I have explained the position about decisions on tax. More broadly, it is critical that we have the medicines of the future that we need. One of my very first visits as Secretary of State for Health was to a company that is using AI to determine new opportunities for medicines and drugs to tackle cancers and some of the other illnesses that people face. Making sure that we are investing in businesses—British businesses—to drive that innovation is crucial, not just to the future health of our country but to economic growth.

[Mary Glindon (Newcastle upon Tyne East and Wallsend) (Lab)]

T3. At the age of six, Ellis Lake was diagnosed with metachromatic leukodystrophy, which is treatable if diagnosed early. His parents Tracy and Luke are campaigning for newborn screening for the disease. The UK National Screening Committee did not recommend screening in its last review of the condition, but it did outline that it was gathering more evidence. Will the Minister look at how the process can be expedited?

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[Helen Morgan (North Shropshire) (LD)]

A damning report by the Royal College of Emergency Medicine has estimated that more than 15,800 deaths were associated with long waits in emergency departments in 2025—I think we all agree that figure is an outrage—but the Government still have not published reliable data on long waits and corridor care despite promising to do so by the end of May. Will the Secretary of State tell the House what the Government are trying to hide? Will they adopt Liberal Democrat calls to end corridor care within a year by freeing up beds throughout hospitals and in social care to end the blight of excess deaths in overcrowded accident and emergency departments?

[James Murray]

Let me be clear that corridor care is unacceptable and undignified and we are committed to eradicating it. We have begun by getting specialist teams to go into the worst offending trusts to ensure that we are getting rid of corridor care in those places. The NHS now has a national definition of corridor care for the first time ever. We will publish data on that shortly, because the first step in getting a grip of the problem is to be open and transparent about its scale.

[Nadia Whittome (Nottingham East) (Lab)]

T4. We all know that social care is in crisis, with huge staff shortages, unmet needs and councils’ finances being pushed to the brink, so it is disappointing that the King’s Speech did not contain anything on social care. Given that the full Casey review is not expected until 2028 and that implementation is estimated to take up to 2036, what steps is the Minister taking now to alleviate pressures in the system? Will the Government expedite social care reforms so that we can meet our manifesto commitment on a national care service?

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[Dr Al Pinkerton (Surrey Heath) (LD)]

The relocation of Frimley Park hospital in my constituency is a £1.8 billion project, but none of the costs of the essential infrastructure to enable the new site to go ahead have been costed or budgeted for. The chief executives of the hospital simply have said that those costs will have to come from the new hospital programme contingency fund. Does the Secretary of State agree that that is no way to start a project of such size, scale and significance, and will he meet me to address those concerns?

[James Murray]

The hon. Gentleman is persistent in raising this issue—he has also raised it with me in the lunch queue. It clearly matters to him, and indeed to hon. Friends on my side of the House—

[Mr Speaker]

Order. I say to the hon. and learned Member for North Antrim (Jim Allister) that he should not walk in front of the hon. Member for Surrey Heath (Dr Pinkerton) when the Secretary of State is answering him. Please show each other respect.

[James Murray]

The hon. Member for Surrey Heath can rest assured that this Government are focused on the new hospitals programme, which is now credible and deliverable after what we inherited from the previous Government, and that we will get those hospitals in place.

[Kirsteen Sullivan (Bathgate and Linlithgow) (Lab/Co-op)]

On Thursday I will chair the all-party parliamentary group on endometriosis’s first evidence session of our inquiry into endometriosis in the workplace. We will look at the experiences of women living with the condition and at the lack of timely treatment for chronic symptoms and how this impacts them in the workplace. Will the Secretary of State commit to reviewing our recommendations, once they are published later this year?

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

Epsom and St Helier hospitals need urgent funding now, not just patchwork repairs. In 2024, 600 operations were cancelled due to ventilation issues and the situation is only going to get worse, so will the Minister address the backlog of hospital repairs now to ensure that patients and staff have safe and modern facilities in Epsom and Saint Helier hospitals?

[James Murray]

Under this Government, we have increased capital investment in our NHS estates, including hospitals. Under the previous Government, that was sorely lacking, which stored up the problems we are experiencing today. There is a huge amount that we need to invest in, to ensure that the NHS is fit for the future, but we also need to reform the service, which is why modernising the NHS is a key priority for me and this Government.

[Chris Webb (Blackpool South) (Lab)]

At the beginning of the year, Blackpool had the worst 12-hour A&E waiting times in the country, but thanks to the tireless work of local NHS staff, that has been reduced by 43%. However, we face some of the biggest challenges in the country with health inequalities, deprivation and the 21 million visitors that come every year, so will the Secretary of State agree to meet me and the chief executive officer of our hospital to talk about what support we can get to bring these numbers down, so that residents in Blackpool can get the care they need?

[James Murray]

I am very happy to work with my hon. Friend to tackle health inequalities in his area. As he rightly highlights, our investment in the NHS and in the wider health of the nation is specifically about tackling health inequalities such as those that he raises, which affect the life chances of his constituents.

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

The crisis in social care is particularly bad in my constituency on the Isle of Wight, partly because of our unique geography but also because the Government have reduced funding to our local authority. Our council is now looking at discharging patients to the mainland, away from family and friends, which is completely unacceptable. Will the Government recognise our unique challenges as an English island and help provide a social care solution that recognises the challenges that we face?

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[Mr Speaker]

Order. I have to get through the questions from others, so Members have to help me by asking shorter questions.

[James Murray]

I can reassure my hon. Friend that the Government respect the Supreme Court decision. We are considering it carefully, and will set out updated guidance shortly.

[Paul Holmes (Hamble Valley) (Con)]

Waiting times for cataract operations in my constituency are rising hugely because the local ICB and its AI system have stopped offering services through all the advertised providers, and the ICB has scrapped its contract with Specsavers, meaning that only GPs can diagnose the problem. Will the Minister have a look at the local problem and intervene so that we have the widest and best range of providers to reduce those waiting lists?

[Adam Thompson (Erewash) (Lab)]

Particularly for people with a very low body mass index or an eating disorder, the use of app-based fitness classes for hours of ultra-high-intensity exercise every day can lead to addiction. When I wrote to one brand to ask about implementing access limitation tools in its app, it was dismissive. Will the Secretary of State consider reviewing whether such tools could be mandated to support those with eating disorders?

[James Murray]

I thank my hon. Friend for raising that issue—it is an important angle on a problem of which we are all aware, but in a slightly different context, given some of the modern features that are available on the devices in our pockets. I will look into it further and pick it up with him in due course.

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

Many Members in this place will be all too familiar with the trauma of a miscarriage; for some, the tragedy occurs more than once. Scotland is the first nation in the UK to implement a miscarriage patient charter, based on the so-called Tommy’s graded model of miscarriage care. Will the new Secretary of State—I welcome him to his place—outline whether the Westminster Government are considering replicating that system in the rest of the UK?

[James Murray]

I thank the hon. Gentleman for raising that incredibly sensitive and important issue. As a Government, we want to ensure that, through the NHS, we are supporting women who suffer miscarriages and their families. We will make sure that we have the right provision to support them, and that the NHS and wider health system are there for them when they need that help.

[Sonia Kumar (Dudley) (Lab)]

Dudley has high levels of deprivation and health inequality. That is why I am campaigning to bring healthcare to Dudley town high street. Will the Minister meet me to discuss how we can leverage the 10-year plan to reduce health inequalities in Dudley, and does he agree that we need a healthcare hub?

[James Murray]

I definitely agree that my hon. Friend is a formidable champion for her constituency. She is absolutely right to raise the importance of easily accessible healthcare in places such as high streets. I am keen to ensure that the 250 neighbourhood health centres we have announced—with 120 by 2030—are delivered as quickly as possible. That is part of our plan to ensure that healthcare gets right into every local neighbourhood and community. I look forward to discussing that further with my hon. Friend.

[Sir Desmond Swayne (New Forest West) (Con)]

May I have a meeting to discuss my parents, carers and babies Bill, which affords support to the Best Start family hubs and healthy babies programme?

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

There are half a million coeliac sufferers in the UK, but there is little understanding of the condition, which is massively underdiagnosed. Can I invite everyone here—even you, Mr Speaker—to the drop-in session that I am doing on Tuesday 16 June with the campaign? In particular, can the campaign have a follow-up meeting with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson), as she has been a long-standing advocate for the campaign and gets it?

[James Murray]

It is welcome that my hon. Friend and constituency neighbour has raised this matter in the Chamber, drawing it to the attention of many Members on both sides of the House. I do not want to speak on behalf of my fellow Minister, but I am getting a nod from her—we will be happy to pick this up with my hon. Friend in future.

[Jim Allister (North Antrim) (TUV)]

On a point of order, Mr Speaker.

Antisemitism and Racism in the NHS: Mann Review

James Murray Excerpts

Thursday 4th June 2026 Written Statements

[The Secretary of State for Health and Social Care (James Murray)]

Today I am publishing the outcome of Lord Mann’s review into antisemitism and other forms of racism in the NHS, alongside the Government response.

The review was commissioned in October 2025 to examine how the NHS, employers and UK health regulators identify, report and respond to antisemitism and other forms of racism, and to ensure that both patients and staff are better protected from discrimination and abuse. The Government welcome the publication of the review and are grateful to Lord Mann for his detailed and thorough work. We have considered the recommendations in full and our response sets out in clear terms that we are fully supportive of all the recommendations in the Mann report.

In the wake of a series of horrific attacks on the Jewish community across the country, the Government are clear that tackling antisemitism is the responsibility of the whole of society—including the health service.

The review finds that racism, including antisemitism, remains a persistent issue within the NHS and wider society, with discrimination affecting both staff and patients, undermining confidence in services and the experience of care. It finds that unacceptable levels of antisemitism have led to extreme consequences, with some Jewish patients reporting not wishing to present for treatment, and Jewish staff considering leaving the NHS. The review is equally clear that other forms of racism and discrimination against NHS patients and staff are at unacceptable levels, and that NHS employers are the first line of defence and must be taking urgent action.

Lord Mann’s report sets out a comprehensive set of recommendations to strengthen accountability, improve reporting and investigation processes, and embed an anti-racist culture across the health system. These include:

Strengthening leadership accountability for tackling racism, including through the NHS oversight framework and the forthcoming staff standards;

Improving the quality and transparency of data, including through the workforce race equality standard;

Enhancing processes for reporting and investigating incidents, including clearer national guidance and improved capability;

Ensuring greater consistency across professional regulators in addressing racism; and

Strengthening training and development, including mandatory education on racism and cultural competence for NHS leaders and staff.

The review also emphasises the importance of clear definitions of racism to support consistent understanding and action across the system.

As part of the Government response to this review, today I am also asking NHS England to adopt the UK Government definition of anti-Muslim hostility and set clear expectations that every trust, integrated care board and arm’s length body does the same, as part of our wider efforts to tackle all forms of racism and religious hatred in the NHS. Use of this definition will support more consistent identification, reporting and response to anti-Muslim hostility across health and care sectors.

We will deliver meaningful changes based on the recommendations of the review that are for the Department of Health and Social Care and NHS England. This work must be supported and reinforced at all levels of the healthcare system. This includes working closely with NHS England, regulators and other system partners, as well as with affected stakeholders, to assess how all of the recommendations can be implemented optimally—to ensure NHS staff and patients are kept safe from hate.

A copy of the report and the accompanying Government response are available on gov.uk.

[HCWS91]