NHS Corridor Care

James Naish Excerpts

Wednesday 8th July 2026 Commons Chamber

[Dr Simon Opher (Stroud) (Lab)]

I thank my hon. Friend the Member for Tooting (Dr Allin-Khan) for securing this debate and for her years of work in the A&E at St George’s. Emergency care is in crisis in the NHS, and corridor care is just an overspill because we cannot cope. That is because we are doing a few things wrong that we could remedy.

I work as a GP. I did a surgery last Friday and actually tried to admit someone. I rang up A&E and they said, “Well, I wouldn’t send them up at the moment, as we’ve got a six-hour wait.” I realised that, quite often, we do not have an operable emergency care service, and this is something we need to work on.

I will briefly go through a few causes and then a few remedies, and the remedies could be clinical as well as organisational. First, we have an ageing population. Frailty is increasing. In Stroud alone, in four years, the number of over 90-year-olds went up 29% in just that short period of time. We have an enormous cohort of very elderly and frail people. Secondly, as we have heard, we have a lack of beds due to delayed discharge—I will not say any more on that. Thirdly, we have a lack of care beds in the community to enable discharge. There is also a lack of capacity in GP surgeries for on-the-day appointments. In my surgery, 45% of our appointments are on the day, but we obviously need to increase that so we can absorb the demand in primary care.

[James Naish (Rushcliffe) (Lab)]

I have sat through the debate, and I do not believe that community pharmacy or independent prescribing have been mentioned. Does my hon. Friend, with his experience as a GP, endorse the changes that the Government are making to maximise the use of pharmacists to deal with some of the pressures that he mentioned GPs face?

--- Later in debate ---

[James Naish (Rushcliffe) (Lab)]

Thank you, Madam Deputy Speaker—I appreciate being called. Before I begin my speech, I note that my hon. Friend the Member for Worthing West (Dr Cooper) mentioned coastal communities. She was absolutely right to do so, and I will refer to rural communities, because there are equal challenges with delivering healthcare to that particular demographic.

I will start with some good news for my constituents. Last year, Nottingham University Hospitals NHS trust was named among the 10 most improved trusts in England for four-hour A&E performance, and sixth nationally for 12-hour waits. That is not a small thing; it reflects genuine hard graft by staff at Queen’s Medical Centre and Nottingham City hospital, and it earns the trust a share of a £3 million reinvestment fund from NHS England. That sounds good, but I would be doing my constituents a disservice if I stood in this place and pretended that the job was done, because just over a week ago, on 29 June, NUH declared a critical incident after the recent extreme heat drove demand across the trust far beyond what its emergency department could safely absorb. What is more, it was the fourth critical incident over the past year. At its worst, during the latest incident, there were 188 patients in the emergency department and 20 ambulances queuing outside. Patients were experiencing lengthy waits on corridors, and more people than expected were medically fit but unable to be discharged.

I recently asked the Government about this issue, and the Minister’s response was clear: corridor care was “unacceptable”, and should never become normal practice. That should not even need saying, and it is only after 14 years of drift that it did. What matters now is action, and the Government have published a national definition of corridor care for the first time and started daily reporting, so that neither trusts nor we in this place can hide the problem. Thankfully, that transparency is being backed by some new money: over £450 million is going into urgent and emergency care capacity this year alone, and £215 million of capital funding is delivering 40 new and expanded urgent care sites across England. For my constituents, this means two things locally that I genuinely welcome: confirmed funding for an expanded urgent treatment centre at QMC, and a trust-funded reconfiguration of the emergency department, because our chief executive has found the money internally to get on with that work now, rather than wait.

I was particularly pleased to be able to tell this to one of my constituents, Renee, after she contacted me to tell me about her experience in A&E. As a lady in her 70s with a long-established heart condition for which she has ongoing consultant care, after a heart attack, she found herself spending nine hours waiting for care in A&E for a condition that should have been treated immediately. Nationally, A&E waiting times are at their best level in five years, and elective waiting lists are at their lowest in three and a half years. That is progress, but it will ultimately count for nothing in Rushcliffe if a bad winter, a system failure or a staffing gap can still tip a good department into crisis extremely quickly. As such, my ask of the Minister is simple: keep funding urgent and emergency care, keep the pressure on trusts that are lagging behind, and keep listening to Back Benchers, who regularly hear about this issue from doctors and constituents at our surgeries.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.

Patient Safety Review

James Naish Excerpts

Monday 6th July 2026 Commons Chamber

[Sir Bernard Jenkin]

I 100% agree with my right hon. Friend. He will note that I will pick up on those points during my remarks.

I come back to the questions that I want to put to the Secretary of State. First, if HSSIB’s investigations are intended to continue unaffected by the transfer to the CQC, why bother with the expense of the transfer? Are Ministers simply using Dash as the pretext for what people in the Department or elsewhere in the NHS would like to have?

HSSIB was deliberately started very small, but the intention was that over time it would take over more investigations in health and replace the need for wasteful, lengthy, inexpert ad hoc public inquiries. Over the years, inquiries have proved to be a chaotic means of investigation, assembling expertise from scratch, which is then lost after the inquiry, and failing to command public confidence or to fix the system. That is why, after the 1999 Paddington rail crash, the Ladbroke Grove inquiry in 2001 established the rail accident investigation branch. Since then, despite many fatal rail accidents, there has been no public inquiry into a rail crash—nor has the public felt the need to demand one—and rail safety has improved.

Given that HSSIB is expert, full time, and can conduct much cheaper and quicker investigations than public inquiries, how can Ministers accept the Dash recommendation to abolish it? Why not consider expanding HSSIB to avoid the need for so many costly public inquiries?

Dash complains about there being far too many recommendations—yes, there are—but, as Dash itself enumerates, it is the 30 public inquiries that, in its language, have “cluttered” the “landscape” with some 1,400 recommendations over recent years. HSSIB is therefore not the source of those recommendations. In HSSIB’s first 34 months of operation, it has produced only 56 recommendations. How can Ministers use that reason to justify HSSIB’s abolition?

Dash refers more than once to

“quality (including safety) of care”.

That elides quality of care with safety. In any other safety-critical industry, safety is seen as a distinct, separate and overriding priority. It is telling that in the report, the words “including safety” are added merely in parentheses, as though safety is ancillary to quality, but that becomes justification for rationalisation while actually compromising safety.

Safety system management is intrinsic to safety and public confidence in other safety-critical activities, such as aviation, but this is alien to NHS culture. I therefore ask the Minister again: without HSSIB, which independent body will promote a coherent understanding of safety system management in health, and who is to hold the NHS and Government to account for safety failures?

[James Naish (Rushcliffe) (Lab)]

Will the hon. Member give way?

[Sir Bernard Jenkin]

Very briefly—I have a lot to say.

[James Naish]

In that case, carry on.

[Sir Bernard Jenkin]

I thank the hon. Gentleman.

Recommendation 1 in the Dash review says that the new National Quality Board should

“avoid unfunded mandates being imposed on the system without due consideration”.

Public inquiries have certainly made well meaning but unaffordable recommendations—I think of the Francis inquiry recommendation on blanket standards for minimum staffing—but it is wrong to see safety as a cost in opposition to other benefits. The cost of safety failures is astronomic, with NHS clinical negligence costing £3.6 billion a year, despite all the public inquiries. Effective safety management is about the cost-effective management of risk, not risk elimination at any cost. If the air accidents investigation branch did not balance costs with effective risk management, aeroplanes would not fly. Can the Minister therefore point out which of HSSIB’s recommendations have been too expensive to implement? If not, where is the justification for abolishing HSSIB?

Neither the NQB nor the CQC should control investigations. The AAIB cannot be prevented from making independent recommendations by the Civil Aviation Authority, the Transport Secretary or airlines themselves. Why should the NQB, which will be subject to political direction, be allowed to decide what safety recommendations should be made and what should be investigated, as Dash recommends?

On page 31, Dash incorrectly states:

“HSSIB was not able to retain the maternity programme because the Health and Care Act 2022 does not make provision for maternity investigations under HSSIB.”

Why have the Government accepted that assertion as true? It is wrong in fact and law. The new statutory HSSIB did not take on maternity and newborn safety investigations, because they were commenced without the safe space protections, so their evidence is available for legal proceedings. That is not how HSSIB operates. Since 2023, HSSIB has been conducting its own maternity investigations. Indeed, when the Amos review was established, it took on the relevant investigations from HSSIB and then relied on HSSIB for assistance with them.

With sufficient resources, HSSIB could conduct all maternity investigations much more effectively than the maternity and newborn safety investigations programme. Amos reported that MNSI investigations are not trusted by families, as my right hon. Friend the Member for Godalming and Ash (Sir Jeremy Hunt) was saying, and are not consistent or effective in identifying learning or providing accountability. Amos also says that families should have access to an independent investigation if they lose confidence in the local investigations. Without HSSIB, who will provide those independent investigations?

Finding 6 accuses HSSIB of having “expanded” its

“scope of work beyond the original remit…For example, HSSIB was originally established, along the lines of safety investigatory bodies in other industries, to look at specific cases or incidents of severe harm, but it has since broadened its work into making more systemic recommendations.”

That is what Dash says. It is complete nonsense. HSSIB is exactly equivalent to the AAIB, the marine accident investigation branch and RAIB, and was, like them, set up to conduct systemic investigations. That is why they are such effective bodies. The Health and Care Act 2022 does not limit HSSIB investigations to individual incidents. There is no reference whatsoever to “severe harm”, as Dash puts it, in the 2022 Act. It was always intended by Parliament that HSSIB should make systemic recommendations arising from the investigation of specific incidents or groups of incidents. I can say that with authority because it was my Select Committee that recommended HSSIB in the first place, and I also chaired the pre-legislative scrutiny Committee on the draft legislation, so how can Ministers give any authority to the Dash review, which claimed that HSSIB has expanded its remit, when it has done no such thing?

Recommendation 3 proposes:

“Most investigations into safety incidents should continue to be managed within provider organisations”.

This really is the fundamental flaw in Dash. Recent maternity investigations conducted by trusts have highlighted the deficiency of provider-led investigations, as Ockenden and Amos have pointed out. Do the Government accept that investigations by provider organisations are inherently conflicted? Just ask the clinicians, patients, families and patient safety organisations what they think about trusts marking their own homework. None of them has confidence, because providers are keen to protect themselves from litigation and reputational damage. How can Ministers accept the Dash recommendation that we should rely on investigations conducted by provider organisations?

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[The Parliamentary Under-Secretary of State for Health and Social Care (Preet Kaur Gill)]

I thank the hon. Member for Harwich and North Essex (Sir Bernard Jenkin) for securing this important debate. He has long taken a serious interest in patient safety, including in the importance of independent investigation. I recognise the strength and sincerity of the points that he has raised and will try to answer all of his questions.

At the heart of this debate is a simple question: when patients and families tell us something has gone wrong, does the system listen and learn, and, most importantly, does it change? Patients do not judge the system by the number of reports published, the number of organisations involved, or the number of recommendations written; they judge it by whether care becomes safer. For too long, across too many parts of the system, we have seen the same pattern: harm happens; a review follows; lessons are identified; but the change patients were promised does not always follow quickly enough. This Government are determined to change that.

Dr Penny Dash’s review was commissioned to consider whether the current landscape of organisations provides effective leadership, listening and regulation on patient safety and wider quality of care, and whether a different approach could deliver better outcomes for patients.

[James Naish]

I rise to intervene before the Minister goes down the HSSIB route, which I completely understand is the focus of the debate today. I want to put on record once more the concerns about Healthwatch and its abolition. I know there is a strong desire to see independent patient voice maintained outside the system; of course, Healthwatch was established due to issues within health structures, including, notably, the Mid Staffordshire scandal.

[Preet Kaur Gill]

I thank my hon. Friend for putting that on the record. He will know that we are in Committee stage of the Health Bill and there will later be the opportunity to debate this issue on the Floor of the House.

Nottingham Maternity and Neonatal Services

James Naish Excerpts

Wednesday 24th June 2026 Commons Chamber

[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.

Spinal Muscular Atrophy: Newborn Screening Test

James Naish Excerpts

Monday 22nd June 2026 Westminster Hall

[Alison Bennett (Mid Sussex) (LD)]

It is a pleasure to serve under your chairmanship, Mr Mundell. I thank the hon. Member for Sunderland Central (Lewis Atkinson) for opening this debate so well. I am grateful to the petitioners for securing this debate, including the 287 constituents in my own patch, and to the many families, clinicians, charities and campaigners who have worked so hard to raise awareness of spinal muscular atrophy and the importance of newborn screening. I would like to say a big thank you to them, and I truly mean that.

This issue goes to the heart of what our health service should be about: identifying serious conditions as early as possible, ensuring equal access to life-changing treatment and giving every child the best possible start in life. Spinal muscular atrophy, or SMA, is a devastating genetic condition, as the right hon. Member for Melton and Syston (Edward Argar) so eloquently set out when he shared that letter. It causes progressive muscular weakness and can have a profound impact on almost every aspect of a person’s life. Many people with SMA face significant mobility challenges, difficulties with breathing, and bone and joint complications such as scoliosis.

An SMA diagnosis can be life changing for whole families. It brings uncertainty, anxiety, and in many cases, the prospect of intensive and lifelong care needs. Historically, SMA was one of the leading genetic causes of infant mortality. Before effective treatments became available, up to 90% of babies with the most severe forms of the condition would die or require permanent ventilation before the age of two. That stark statistic reminds us just how serious this condition can be.

Thankfully, the picture today is different. Thanks to years of scientific research, medical innovation, and the determination of patients, families and campaigners, we now have treatments that can dramatically alter outcomes for children diagnosed with SMA. These advances represent one of the great success stories of modern medicine, but there is one crucial factor that determines how successful those treatments can be: timing. The earlier SMA is diagnosed, the better the outcomes. In many cases, treatment before symptoms develop can prevent irreversible damage to motor neurones and dramatically improve children’s future quality of life. Earlier diagnosis can mean the difference between a child learning to walk independently or their never achieving that milestone. That is why newborn screening matters, as all hon. Members who have taken part in today’s debate have made so clear.

The debate is about ensuring that children can benefit from treatments at the point when those treatments are most effective; it is about giving families the opportunity that comes with early intervention; and it is about ensuring that where a child is born does not determine whether they have access to life-changing care. That is why there is understandable concern about the current rollout of the in-service evaluation for SMA screening. The principle behind the evaluation is sensible, and gathering evidence and ensuring that the NHS is prepared for wider implementation are important objectives. However, the rollout to date has been inconsistent and incomplete. Some parts of the country have been included, while others, as we have heard, have not.

Families living in areas such as Oxfordshire currently have no access at all to the programme. My hon. Friend the Member for Henley and Thame (Freddie van Mierlo) has campaigned tirelessly on behalf of his constituents affected by this issue. In response to a parliamentary question that he submitted, it was confirmed that the current in-service evaluation will offer screening to about 400,000 babies. By comparison, a national screening programme would cover approximately 650,000 babies every year. In other words, under the current arrangements about one third of babies born each year will not be covered by the evaluation.

That inevitably brings up questions, and not just those asked by my hon. Friend the Member for Twickenham (Munira Wilson), who rightly said that services for rare conditions should cast the widest net possible. Why should access screening depend on geography? Why should one family benefit from early detection, while another family living elsewhere does not? If the evidence increasingly points to the importance of early diagnosis, how can we possibly justify such uneven access? Too often in our NHS, patients and families face postcode lotteries. Whether it is on access to dentists, GPs, mental health services or specialist treatment, geography can end up determining outcomes.

The Government and NHS England have acknowledged concerns about the rollout. We welcome indications that NHS England is considering whether implementation can move faster, and whether the evaluation could potentially be extended more widely. That is encouraging, but families and clinicians need greater certainty. At present, there is a lack of clarity about how long the evaluation will run, when additional sites may be added, and when a final decision on a national screening programme can be expected. Those are issues that it is reasonable to ask questions about, and people deserve answers to such questions.

The Minister might point to the need for robust evidence before national implementation. Of course evidence matters and of course changes to screening programmes must be safe, effective and carefully planned, but if the stated purpose of the in-service evaluation is to gather evidence, surely there is a strong case for gathering that evidence from as broad and representative a population as possible. A wider rollout would not only improve equity of access; it would also strengthen the evidence base on which future decisions will be made.

[James Naish (Rushcliffe) (Lab)]

A couple of my constituents with direct experience of SMA got in touch with me. The thing that they identified as being most difficult about the current arrangements with the in-service evaluation is the lack of detail about how long it will take. Does the hon. Lady agree that if the Minister could provide a level of clarity about the length of time that the ISE will run, that might give us the sense that there is forward momentum on this issue?

[Alison Bennett]

The hon. Member makes the good point that often the uncertainty and the unknown length of time for which people are in limbo matter, and I hope that the Minister can address his question when she responds to the debate.

In conclusion, the story of SMA over recent years is ultimately one of hope. Medical science has transformed what was once considered an overwhelmingly bleak diagnosis. Children who previously would have had very limited prospects now have opportunities that simply did not exist a generation ago, but those opportunities depend on timely diagnosis. The treatments exist, the evidence is growing and the need is clear. The challenge now is to ensure that every child has the same chance to benefit from those advances, regardless of where they happen to be born. Families affected by SMA deserve urgency, clarity and, above all, a system that acts as quickly as science now allows. I look forward to hearing the Minister’s response.

Pathways Study: Puberty Suppression

James Naish Excerpts

Monday 22nd June 2026 Commons Chamber

[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.

Community Pharmacies

James Naish Excerpts

Tuesday 2nd June 2026 Westminster Hall

[Rachel Gilmour]

I assure the hon. Lady that some of the most frustrating conversations I have are with my local ICBs. Properly resourced pharmacies could release a staggering 51 million primary care appointments through an expanded Pharmacy First service, prevention services and a greater role in managing long-term conditions. That is 51 million appointments freed up in general practice, allowing more people to escape the infamous 8 am scramble. Pharmacies often meet people where they are, offering more accessible services to those who might not otherwise engage with the health service at all. They are arguably the most accessible arm of the NHS.

[James Naish (Rushcliffe) (Lab)]

I have been fortunate to have a pathfinder within the independent prescribing programme in my constituency. Its data shows that only 5% of patients who use the independent prescribing pathway need to be referred to their GP, so it is exactly as she says: there are huge savings to be made. I must push the Minister, because Community Pharmacy England has said that it is

“not persuaded that sufficient investment is being made to enable the full and effective introduction of independent prescribing.”

Does the hon. Lady agree that the Minister should look at that carefully to make sure that we are getting as much as we can out of community pharmacy?

[Rachel Gilmour]

I shall come to just that point in a minute. This sounds strange now, but I am going to say it: take obesity, for example. One in three people in the UK are currently classified as obese. Obesity is estimated to cost the NHS over £11.4 billion a year, with wider societal costs to the tune of £74 billion a year. Community pharmacies are ideally placed to provide wraparound support for those prescribed weight-loss medicines as part of an NHS-commissioned service, but they need the resources and the commissioning framework to do so.

There is one aspect of this debate that receives insufficient attention, and I want to raise it briefly. The ongoing situation in the middle east has hit the pharmaceutical supply chain as much as any other sector. There were a record 219 price concessions announced for community pharmacies in May alone, with further negotiations still ongoing. The cost of medicines has risen sharply. I understand that some cancer drugs have reportedly seen elevenfold increases. Crucially, medicine shortages and record-high price concessions reflect an instability in the supply chain that is being intensified by geopolitical pressures. I put it to the Government that the growing medicine supply crisis poses serious risks to Britain’s preparedness and resilience.

Health Bill

James Naish Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[Martin Wrigley (Newton Abbot) (LD)]

I will focus on two things: the changes in data privacy and access to support a centralised single patient record, and the abolition of Healthwatch.

Healthwatch is not the same as the other regulators and it should not be amalgamated. Regulators can be amalgamated only if they have a single purpose and a single viewpoint. Healthwatch today is not a regulator but a patient advocate and there are no others in the system. Without Healthwatch, the remainder of the checks and balances come from the medical profession and the health establishment—and we have seen cases where that goes wrong. Healthwatch guards against that. It is a vital body to speak up for the patient, rather than the NHS itself.

[James Naish (Rushcliffe) (Lab)]

I have had a look at the parliamentary record; Healthwatch has been mentioned over 100 times in the past five years. One key area of focus is its reporting and the insights it provides to Members of Parliament. Does the hon. Gentleman agree with me that whatever replaces Healthwatch must retain that research focus?

[Martin Wrigley]

I absolutely agree with the hon. Member. We heard earlier how Kevin Dixon of Devon gives us excellent reports of what is happening with Healthwatch.

The modern NHS must run on data, but critically, on data that carries the consent of patients. A single patient record is undeniably critical to see the data of patients all in one place, but it must be built from a patient’s point of view, not from a centralised data-analysis point of view, and with privacy by design from day one. We obviously need GPs to see hospital data and vice versa, and ambulances to see everything that they need to help, but we do not need the new regulation to do that.

The single patient record already exists in a federated model; in Greater Manchester, Merseyside, Shropshire and more, trusts already run interoperable access for care services, GPs and hospitals. The Government admit that but claim it is partial and fragmented. They also claim that the data will remain in the systems where it currently exists. However, with the Bill, the Government are asking to remove all protection of patient data—look at proposed new sections 250E(1) and (3) to the National Health Service Act 2006 as set out in clause 47(2) of the Bill. We are asked to trust somewhere below primary legislation that it will all be okay—we should trust the regulation. It is a big-tech approach to deliver an overreaching centralised system, rather than a distributed interoperable solution.

NHS England has ignored and discounted UK sovereign systems that can and do provide what is required along with patient trust. Systems built over years with focus on patient treatment and defined use cases could be rolled out today with no change required in law and privacy by design built in from day one. Greater Manchester and others have the single patient record capability and the hard-won foundation of trust.

I will be tabling amendments to remove the relaxation of data privacy from the Bill. The measures are unnecessary if NHS England does not follow the Palantir advice and instead follows what has been proven to work in Greater Manchester, Merseyside, Shropshire and many other places. Perhaps it is an example of something that has worked in Manchester that might work everywhere.

NHS Capital Spending

James Naish Excerpts

Wednesday 4th March 2026 Westminster Hall

[Bobby Dean]

My hon. Friend makes an excellent point: this is about not just buildings, but equipment and digital and technical infrastructure, all of which are crucial to getting the NHS to operate in the way it should. She also highlights how we need to upgrade ageing equipment to a very basic level, let alone take advantage of all the opportunities that the latest innovations in new equipment could provide us with, if we were able to purchase those.

I mentioned that maintenance backlogs are soaring. They have doubled from around £6 billion in 2015 to over £13 billion in 2024. The critical thing to stress is that it did not have to be this way. The UK invested around a third less in health capital during the 2010s than other comparable nations. According to OECD data, the UK has 10 CT scanners per 1,000 people compared with an average of nearly 20 per 1,000 across Europe. We have 8.5 MRI scanners per 1,000, compared with an average of 12 per 1,000 across other EU nations, and our bed capacity is pitiful. We operate at around 2.4 per 1,000 people, compared with an OECD average of 4.4. The issue has not only been a lack of money; it has also been a lack of certainty and flexibility.

The approvals process for capital bids is slow and cumbersome. Even when capital is available, trusts often receive final sign-off so late in the year that they physically cannot begin procurement, get survey work done and start construction in time. The money therefore goes unspent not because of poor planning locally, but because the system itself creates delay.

[James Naish (Rushcliffe) (Lab)]

On that point, my local authority is currently sitting on £50 million of developer funds that it was paid, but those funds are not being spent in the local community because there is not the total money needed to invest in health, infrastructure, schools and other things. Does the hon. Member agree that that is something we must look at, to make sure that money set aside for development is spent with urgency in our communities?

[Bobby Dean]

The hon. Gentleman highlights the complexity in putting together large capital projects. Funding is not often from one source. It is from multiple sources, and everybody providing the capital needs to have greater flexibility for the schemes to become deliverable, or the funds end up getting clawed back and put elsewhere, as has been done in the past.

The yearly cycle that I speak about is important because, in the past, capital departmental expenditure limits rules—Treasury CDEL rules—have meant that any unspent capital must be returned to the Treasury at the year end. Not being able to carry it forward punishes good financial management, prevents multi-year planning and leaves trusts scrambling to spend money before deadlines, rather than investing it strategically. The result is a system where underspends exist at the same time as record levels of urgent capital need. Trusts want to invest and start work, but the system ties their hands.

The effect of all that has not been abstract. The buildings maintenance backlog includes high-risk failures: operating theatres closed due to ventilation problems, leaks near electrical systems, sewerage failures and outdated wards where modern clinical standards simply cannot be delivered. A 2022 British Medical Association survey found that 43% of doctors reported that building conditions negatively impacted patient care.

[Bobby Dean]

I do agree with my hon. Friend. I will come on to the new hospitals programme, as my constituency stands to benefit from it, too—if it comes soon enough. In the meantime, as she says, we are paying twice to pay for the repairs and patchwork, and never keeping up with the investment we need.

Ageing diagnostic equipment also means fewer scans, longer waits and more delayed diagnosis. Last year I had the pleasure of visiting my local hospital’s nuclear medicine unit, where I was shown a new machine that was driving down diagnosis times from hours to minutes. Obviously that is a fantastic sign of good capital investment, but when I spoke to the trust I was shocked to discover it is one of the only hospitals in the country with that particular piece of kit, and I thought to myself how much more productive the NHS would be if such equipment was rolled out routinely across the country as soon as it became available.

Then there is the infamy of poor IT systems. More than 13.5 million clinical working hours are lost every year due to poor IT. We have all heard shocking stories of hospitals running on Windows operating systems that we were talking to a paperclip on 20 years ago. As the age of artificial intelligence promises to transform the workplace, it would be great if the NHS could catch up with the last decade or so.

I recently met an AI developer who thinks they have come up with a solution to the elective surgery booking system. His system auto-calls patients and offers them a choice of appointment, making hundreds of calls in just minutes. They say it beats the old system on two counts. Patients usually receive a date by post without a choice, but the trial in the midlands saw “did not attend” numbers drop by 50%, which they put down to patient choice in the appointment time, and delivery was guaranteed because they had answered the phone. Think of the potential productivity gains if such technology was picked up at scale.

I have explained a little about the past state of NHS capital spending and will now turn to where the Government are today. Part of the reason for this debate is to find out where the Government think they are. It is worth saying that the Government’s stated intention has been a step in the right direction. There has been more certainty, more money and more flexibility. After the initial one-year capital settlement for 2025-26, with assurances that things would continue, the spending review confirmed capital budgets through to 2029-30. Those decisions will provide some stability, though it is still uncertain whether the Treasury clawback system remains in place on an annual basis or over the spending review period.

There was a substantial uplift of money in the year 1 allocations, but that is followed by a relatively flat commitment going forward, albeit at a higher level due to the initial uplift. I do not think we should be churlish about that—an increase in investment is inarguably good—but equally, we should not kid ourselves that investment is now at the required level. It does not fully address the inadequacy of past investment, nor does it bring it in line with international comparators. The King’s Fund has described the failure to reverse the historical underfunding by the previous Conservative Government as “extremely disappointing”. The NHS Confederation is asking for the commitment over the spending period to be doubled in real terms, from £3.1 billion to £6.4 billion.

There has also been greater flexibility, with Treasury approval now only required for capital projects in excess of £300 million, up from the previous, pitiful £50 million. The new delegated authority will cut out layers of bureaucracy and speed up delivery on the ground for ward refurbishments and equipment purchases. It will not address issues inherited in the largest NHS capital schemes, however, which brings me on to the new hospitals programme.

The programme was imagined by former Prime Minister Boris Johnson—I say “imagined”, because for some time the only place it existed was in his imagination. Conservative leaflets in my patch were emblazoned with a promise that the money had been secured for a new hospital building that would be delivered by 2024. I am sure that experience holds true for many in this room. When 2024 came, hardly a brick had been laid across the country. When the new Government came in, they told us no money had ever been allocated for those schemes.

The programme was reset by this Government, with an updated timetable and revised waves of projects. My local hospital’s building was put into the second wave, meaning that work will not begin until the 2030s, which was a bitter disappointment. Since the announcement of delay, things have gone a little quiet overall. A year or so on from the announcement, people are wondering how the programme is getting on. There are rumours that are some in the first wave are not keeping pace and could already be underspending allocations. Mostly, that is put down to the adaptation period of the hospital 2.0 model, an attempt to homogenise design across the country that is broadly welcome.

Any delays will spark questions about what will happen to that allocated spend. Hospitals such as mine will want to be at the front of the queue for any reallocation, if such an opportunity should arise. I have already mentioned my local hospital, but there is no clearer case of capital neglect than St Helier hospital in my constituency. It is as old as the NHS itself, overcrowded and cramped, and the specialist emergency care functions are simply not up to modern-day clinical standards.

Let me be clear: staff at St Helier are working heroically and patients are safe, but they are in a building that is not designed for 21st-century emergency care, with patients routinely treated in corridors. Key recommendations for improving service delivery simply cannot be implemented because there is physically not enough space. Despite tens of millions having been spent on basic repairs in recent years, the building is deteriorating faster than the trust can fix it.

The new hospital programme promised to resolve many of those issues with a new building for emergency and maternity care but, with that delay well into the 2030s, my constituents are left facing another decade of care in a building that is visibly past its lifespan.

[James Naish]

I am based on the outskirts of Nottingham, and already this year we have had three critical incidents at Queen’s medical centre, which is the main hospital in the city. They have all been based around A&E, and they were all the exact situation that the hon. Member describes. A&E has capacity for 350 patients, but it has routinely been seeing over 500. Does he agree that, in addition to the pressures he describes, there is a reputational risk to the NHS when such incidents are being declared because of physical capacity issues?

[Bobby Dean]

I agree with the hon. Gentleman, and I am sure that, like me, he hears constituents say that they do not want to attend their local A&E because they do not trust that they will be seen in time. I am sure that the figures he is describing are an undercount of the people who should be in there. Like me, he will have received emails about corridor care for some time. I had hoped that corridor care was a peak crisis moment and that it would subside, but it has become the norm and that is extremely worrying. It is not acceptable for patients, it is not fair on staff, and it is not a sustainable way to run our NHS.

If the Government are to reconsider which schemes should be in which waves of the new hospital programme, let me assure the Minister that my local trust is ready to go. Plans have been drawn up, land has been secured, and teams can move at pace. We need this, we want this, and we are ready. If that is not possible, but other pots of capital to be reallocated still remain, I make a separate plea: extend St Helier’s emergency department now. That is a smaller ask than delivering a whole new building, but it will make a big difference. The only thing more full than the corridors at my local hospital right now is my inbox, which is filling up with constituents describing their traumatic experiences.

St Helier hospital emergency department sees around 250 patients a day, with routine overcrowding leading to the trust being placed into national oversight measures. Kirsty, one of my constituents, was left anxiously waiting for her 83-year-old mum to be seen, witnessing elderly patients crying, vomiting, screaming and walking around in severe pain in the corridors. The father-in-law of Muhammad, another constituent, waited over 13 hours only to return home without seeing a doctor at all. Others have shared deeply personal details of their stories; their conditions were explained to them alongside countless others in the same corridor. It is undignified, unjust and unsafe.

The trust has come up with a plan. It believes that it can redesign the existing estate, creating a new urgent treatment centre and expanding the same-day emergency care service. By doing so, it would dramatically increase the number of patients it can see. The urgent treatment centre would be able to handle up to 30% of patients—up from 14%—and SDEC could get to 20%, up from 8%. That would prevent unnecessary overnight stays, free up hospital beds, speed up ambulance transfers, and reduce delays for patients needing hospital admission. The plan would also address £15 million of the trust’s ageing estates backlog. It is immediately deliverable; the trust believes that work can begin as early as autumn 2026. It would make an incredible difference, so I ask the Minister to make use of any influence she has over the matter to help the proposal get over the line.

Before I conclude, let me raise one further point about NHS capital expenditure that I suspect will not make me popular, but that I believe is right. The Government have tentatively re-entered the world of public-private partnership models with their announcement of neighbourhood health centres late last year. We all know how disastrous that model of financing was in the past, with the long-term costs to the taxpayer far outweighing the short-term benefits. Britain was among the first in the world to pilot such a scheme, and it failed fast.

It must be said, however, that other nations have learnt the lessons of our failures and successfully delivered social infrastructure at scale, on budget and on time. Indeed, I believe that is one of the reasons why we have fallen behind so badly. As a member of the Treasury Committee, I recently guested on a Public Accounts Committee inquiry into PPP, which concluded that if we get procurement, contract management, and the risk allocation of projects right, then we can massively accelerate the delivery of infrastructure in our country in a way that delivers real value for money for the taxpayer.

--- Later in debate ---

[Luke Taylor (Sutton and Cheam) (LD)]

Thank you, Mr Western. An MP Josh Taylor—that would be a beast, would it not? It is a pleasure to serve under your chairship. I thank my constituency neighbour and hon. Friend the Member for Carshalton and Wallington (Bobby Dean) for introducing this incredibly important debate. He and I have written op-ed articles for our shared local newspaper in recent weeks, describing our constituents’ despair at the state of emergency care and facilities at St Helier hospital.

When I posted my article on Facebook for local residents to read, somebody commented on my post to say that they were fed up of the endless discussions on the topic, and they rightly pointed out that St Helier has been a totemic issue in Sutton for decades. They angrily demanded action, not words, from us all to get something done about it. The truth is, I could not remotely fault my constituent for their outrage at the imbalance of words and action that they, and everybody in Sutton, have had to live with for far too long. This is what happens when Governments fail to act; people lose faith that the system and their politicians can deliver results. When people hear grand words but see no action, it is no wonder that politicians are the least trusted profession in the UK.

Before I was elected I was an engineer, which is one of the most trusted professions. Then, with the support of more than 16,000 of my constituents, I instantly became a member of one of the least trusted—it is a funny old world, is it not? When the policy area at hand is something so visceral as whether people and their families can go to their local hospital safe in the knowledge that it is equipped to care for them properly, that loss of faith is absolutely corrosive to all faith in politics.

[James Naish]

The Minister will know the health centre I am about to mention. It is in East Leake in my constituency of Rushcliffe, and it has been talked about for over 20 years. It has clinical rooms that are out of action because there has not been the appropriate investment. The hon. Member for Sutton and Cheam (Luke Taylor) represents a relatively affluent part of the country, but does he agree that there is something called building deprivation? The reality is that health centres are not in a good enough condition for our constituents and, irrespective of the relative affluence of an area, we still need to invest in our infrastructure.

[Luke Taylor]

I could not agree more with the hon. Member’s point. When the condition of an asset does not attract staff, particularly in more deprived areas, the challenges will be greater. Those compounding challenges are borne out visibly through the physical asset, and everything becomes much more difficult.

I should not have to be here making points about political faith and delivery—or the economic arguments that have been made by other Members—but I will make the important humane case, based on the experiences of my constituents. I recently did a health survey where residents wrote in and told me their stories. One of them was a woman whose husband spent 54 hours in A&E with sepsis, lying on a trolley in a room so small it could have been a broom cupboard. Another, who is in her late 80s, sat waiting on a chair for 10 hours after a suspected heart attack, while another woman, who was unable to sit on a chair because of her pain, had to lie on the floor crying and wait for several hours.

Almost half of those who responded to the survey said that they had waited for more than four hours in A&E at St Helier hospital. We have the NHS numbers, too: across the Epsom and St Helier trust, 18,600 people waited for more than 12 hours in 2025. That is sickening; it is an example of a system that is not working. “Sickening” is the right word: like thousands of people across Sutton, I am sick to the back teeth with the endless delays that have got us here.

There is another important angle. In almost every one of the stories I was told, there was nothing but deep appreciation for the dedicated staff on the estate, many of whom the respondents credit with saving their lives in spite of—not because of—the conditions that they find themselves in. How can we keep recruiting into the NHS or uphold its public image if these are the conditions that we are expecting staff to work in? This is normally the part of the speech where I talk about the Government’s awful inheritance from the Conservatives, but I do not feel like making that point any more, because the people of Sutton have had enough context-setting and this Government is almost two years old now.

I thank the Minister for her discussions of this topic with me and other colleagues. I feel that we are engaging openly and positively, and I want to make that very clear for the record, but I ask the Government to listen to the pleas of our constituents, and to please provide the money to expand our emergency department. At risk of returning to my point about trust, if we do not fix this, we risk a catastrophe in Sutton that might undermine the faith of my residents and the broader public in the entire model of the NHS.

My speech has been about expanding, refurbishing and fixing St Helier hospital, but there is the separate issue of the real and urgent need for the specialist emergency care hospital that our NHS and residents were promised by the previous Government. We need that too, and we need it quickly. The expansion of our A&E would complement the provision in Sutton, and it needs to be brought forward.

Pharmacy First: Withholding Payments

James Naish Excerpts

Thursday 12th February 2026 Commons Chamber

[Dr Ahmed]

I can assure the hon. Lady of our commitment to an effective primary care system up and down the country, in both rural and coastal communities. My hon. Friend the Minister for Care, whose portfolio includes pharmacy, takes his responsibilities seriously and is exploring all avenues to ensure equity of access and funding, including through the Carr-Hill formula.

The hon. Lady asks what mitigations can be employed to ensure that payments are made in extraordinary circumstances. I can assure her that I have had those discussions with my officials this morning, and they reassured me that there will be a degree of flexibility, particularly in circumstances outwith the control of individual pharmacies.

[James Naish (Rushcliffe) (Lab)]

I am very grateful for the fact that this urgent question was granted, because pharmacies have been in touch with me about their concerns. I must put another thing on the Minister’s to-do list: independent prescribing. Evans Pharmacy in my constituency has been part of the independent prescribing pathfinder programme, and only 5% of patients seen by the prescribers subsequently require GP prescribing. However, no clear funding or arrangement will be in place after March this year. Will he provide Evans Pharmacy and similar prescribers with clarity about what will happen next?

[Dr Ahmed]

My hon. Friend is absolutely right. Independent prescribers are a key and expanding part of our workforce, providing a sustainable primary care service. I am very happy for the Minister for Care to write to him with the exact funding plans for the next financial year.

Hughes Report: Second Anniversary

James Naish Excerpts

Wednesday 11th February 2026 Westminster Hall

[James Naish (Rushcliffe) (Lab)]

Thank you for your chairship, Dr Allin-Khan. I congratulate the hon. Member for Chesham and Amersham (Sarah Green) on securing this debate. I will put one family at the heart of my response: my constituent Catherine and her son Matthew, whom I mentioned in Prime Minister’s questions last February, 12 months ago.

When she was pregnant, Catherine did what any parent would do: she trusted the medical advice that she was given. She was prescribed sodium valproate, a medicine used to treat epilepsy. Matthew is now 24 years old, and as a result of that medical advice he has lifelong needs and a learning disability. He has done incredibly well, securing a part-time job and maintaining a level of independence while walking around the village where he lives.

Matthew was also incredibly proud to take part in the 2024 general election, and he voted in the hope that there would finally be redress for those affected by the valproate scandal. Matthew has since written to the Prime Minister; I put on the record my frustration at seeing how his correspondence was passed from pillar to post. It was only after several chases by me that Matthew received a response—a response entirely inappropriate for somebody with a learning disability.

Catherine and her family provide significant support to Matthew, and his life is all the richer for it. But that is not the case for all children impacted by sodium valproate, and there will come a point in time when Catherine will not be able to provide that support any longer. Catherine, and other families in the Public Gallery today, fear that day, and they want the state to ensure that specialist assessments, therapies, adaptations, lost earnings and round-the-clock care are provisioned for now, so that a secure future for their children is guaranteed.

That is why the Patient Safety Commissioner’s report is so important. It sets out a clear and workable route, and it is the responsibility of this Government to acknowledge that. Every month of delay is another month when parents are left to patch together support, fight for diagnoses, battle through fragmented services and carry costs that should never have landed on their shoulders.

Today I ask the Minister directly, as I asked the Prime Minister 12 months ago: will the Government commit to a clear timetable for implementing the Hughes recommendations? For Catherine and Matthew, the argument that the situation is complex simply does not land. Their lives are already complex—more complex than most of us can even imagine. What they are asking the Government to do is simple: accept responsibility for the scandal and act now while the redress can still be meaningful.

The question today is whether this Government—the Government who both Catherine and Matthew were desperate to see when I first met them, as a candidate—will match that urgency with action. I hope that the Minister will take seriously all the representations made today.