Oral Answers to Questions

Karin Smyth Excerpts

Tuesday 21st October 2025 Commons Chamber

[Steve Darling (Torbay) (LD)]

5. What progress his Department has made on the implementation of the new hospital programme.

[The Minister for Secondary Care (Karin Smyth)]

The Conservative Government’s promise of 40 new hospitals by 2030 was a fantasy—there was no funding beyond last March. In January, we published a realistic plan that put the programme on a credible and sustainable footing. We are committed to delivering all the schemes in the programme and are moving at pace with funding in place for design work, construction activity and business case development.

[Steve Darling]

The Conservatives still have not apologised for the appalling state that they left our NHS in. Torbay hospital is the third oldest hospital in the United Kingdom. It has a tower block wreathed in scaffolding to stop bits of it falling off rather than it being under repair, and it has sewage leaks throughout. Sadly, it needs significant investment, which has been kicked into the long grass. A senior manager described the situation only this week as “dire”. Will the Minister meet me and hospital representatives to explore how we can achieve the investment to turn this round?

[Karin Smyth]

The hon. Member makes an excellent point; it was echoed by Lord Darzi in his report about the state of our hospitals, and I know many hon. Members have similar problems. I have visited many such hospitals and would be happy to discuss the matter with him further. I remind him that, of course, the Torbay and South Devon NHS foundation trust has been provided with £7.3 million from the estates safety fund for works at the hospital, and we are absolutely committed to ensuring that it will be developed in line with the programme.

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

6. What recent progress he has made on reorganising the NHS.

[The Minister for Secondary Care (Karin Smyth)]

We are putting the final nail in the coffin of the hon. Member’s party’s disastrous Lansley 2012 reorganisation—so bad that it made me become an MP. We are abolishing the world’s biggest quango, NHS England, along with 200 other bodies. The question is: why did the Conservatives not do that when they had the chance?

[Rebecca Smith]

Yesterday I met Lila, a sixth-form student at Coombe Dean school, who raised the issue of long waiting lists for mental health services for children and young people across Devon. What action has been taken as a result of the Government’s policy of reorganising the NHS to reduce the unacceptable delays in mental health diagnosis and treatment for children and young people, particularly in constituencies such as South West Devon?

[Karin Smyth]

All of us as constituency MPs are fully aware of the state of mental health services, particularly for young people, which is why my hon. Friend the Minister for Care is working at pace on our manifesto commitments to support young people, particularly through schools. We also understand the difficulties that her ICB in particular has with its financial situation—something we are also targeting as part of our reforms to ensure that ICBs develop services for local people in line with the expectations that we have set them.

[Rachael Maskell (York Central) (Ind)]

Likewise, in York, children and adolescent mental health services are just not working for children, who are left on waiting lists often with no management or treatment. In order really to achieve reorganisation in our NHS, would our Government look at local authorities commissioning mental health services, to deliver such services and to meet the holistic needs of young children’s development and mental health wellbeing?

[Karin Smyth]

Again, I echo comments on the state of mental health services, as the hon. Member has done. As it says in our manifesto, we are committed to those 8,500 extra mental health support workers in local areas such as hers. It is important that commissioners work closely with their local authorities on mental health services, and I know my hon. Friend the Minister for Care is ensuring that that happens as part of the reforms we are undertaking.

[Mr Speaker]

I call the shadow Minister.

[The Secretary of State for Health and Social Care (Wes Streeting)]

We have.

[Karin Smyth]

As my right hon. Friend has just said, we have delivered on that commitment. The hon. Member talks about the reorganisation being a distraction. If her party had focused taxpayers’ money on patient services rather than ballooning bureaucracy, with costs increasing both among providers and through ICBs, we would not have inherited the mess that we did, and would be able to roll out programmes more effectively. We have committed to doing that.

[Dr Caroline Johnson]

I thank the hon. Lady for her answer, but I would like her to check and perhaps update the guidance for GPs and the websites that continue to say that it is only available to 80-year-olds who turned 80 after 1 September 2024, which is not all people over the age of 80.

Reorganisation is affecting delivery elsewhere, too. The Secretary of State also promised that the continued roll-out of fracture liaison services would be one of his first priorities. How many new fracture liaison services have opened since the general election?

[Karin Smyth]

On the hon. Lady’s first point, this Government, unlike the previous Government, do believe in experts, and we follow the clinical advice that we are given. On her second point, as she is so keen on reading our manifesto commitments, the commitment was to do that by 2030. It is currently 2025. Our reforms to ICBs and providers, bringing NHS England inside the Department of Health and Social Care to make it more democratically accountable for taxpayers, will reverse the shocking increase in funding that the previous Government put into a leaky bucket. We are fixing the foundations of the NHS. We are targeting resources at people in line with our 10-year plan.

[Natasha Irons (Croydon East) (Lab)]

7. What assessment his Department has made of the potential impact of NHS online on waiting times.

--- Later in debate ---

[Ian Lavery (Blyth and Ashington) (Lab)]

12. What steps he is taking to ensure that frontline NHS services are supported following the potential introduction of new public-private partnership contracts.

[The Minister for Secondary Care (Karin Smyth)]

Let me be clear: this Government will always protect the NHS and have the service free at the point of use for everyone. This Government are determined to shift health out of hospitals and into the community, as set out in the 10-year plan, and neighbourhood health services will be fundamental to delivering this shift, so it is right that we look at a range of options to provide the best care for people across the country. Let me reassure hon. Members that all proposals are subject to robust, value-for-money assessments to ensure taxpayers get the best possible return on investments in our health services.

[Ian Lavery]

May I begin by congratulating the Secretary of State on his actions in trying to repair our cherished NHS following 14 years of Tory destruction? We must learn from past mistakes. The private finance initiative was a huge, expensive mistake—an absolute disaster—with £80 billion repaid for an investment of £13 billion. Will the Minister reassure the House that the lessons of PFI have been well learned, and that they are well and truly in the past and in the dustbin?

[Karin Smyth]

I thank my hon. Friend for his words of encouragement and congratulation. I assure him that lessons have been learned; we will ensure value for taxpayers’ money in all future proposals.

[Pippa Heylings (South Cambridgeshire) (LD)]

I meet regularly with GPs in my constituency, and they have highlighted that they do not yet have clarity or certainty about the role and resources that they will have in the roll-out of services from hospitals to communities and neighbourhood health services. Will the Minister meet me to provide that clarity to our GPs and assure them that they will be at the table during that roll-out?

[Karin Smyth]

It is absolutely the role of the hon. Lady’s local integrated care board to ensure that it involves all partners, particularly primary care, in the exciting roll-out of neighbourhood health services, which I think they welcome. I am happy to discuss that further with her.

[Richard Burgon (Leeds East) (Lab)]

14. What steps his Department is taking to tackle wasteful spending in the health service.

[The Minister for Secondary Care (Karin Smyth)]

As well as the record investment that we put into the NHS, we are ensuring that we get a better bang for the taxpayer’s buck. Under the Conservatives, for example, the NHS was paying £3 billion to recruitment firms for agency shifts. We have cut agency spending by a third and are abolishing it altogether, with the savings reinvested in staff pay and treatment for patients. That is just one example of how our reform agenda is good for patients and for taxpayers.

[Richard Burgon]

Private finance initiative deals did huge damage to NHS budgets. Despite receiving just £13 billion in assets, NHS trusts were saddled with more than £80 billion in PFI debts—most of that is still being paid back. We have even seen some hospitals spending more on PFI debts than on medicines. If they really want to cut out waste and avoid a PFI-style disaster 2.0, will the Government rule out using private finance for the new network of new NHS clinics, as has been floated?

[Karin Smyth]

As I answered in response to my hon. Friend the Member for Blyth and Ashington (Ian Lavery), we will absolutely ensure that we learn the lessons of the last Government’s failure.

[Tim Farron (Westmorland and Lonsdale) (LD)]

Does the Minister agree that it is completely wasteful to make cancer patients who need to go for chemotherapy in Carlisle on a Wednesday but who live in, say, Kirkby Stephen to have to travel to Carlisle on the day or on the day before to get their bloods taken? Why is that? Because the local hospital will no longer fund the local GP surgery in Kirkby Stephen or Appleby to take their bloods there. Is it not wrong that those GP surgeries can no longer provide secondary healthcare blood services in their own settings in people’s own communities?

[Karin Smyth]

As he often does, the hon. Gentleman highlights in his own very rural constituency some of the fundamental problems at the heart of our NHS. That is why we are reforming it, ensuring that we move hospital services from hospitals into the community and developing neighbourhood health services. We are also looking at the financial flows in the system that lead to these sorts of perverse incentives and funding arrangements, which do damage to his constituents, as they do to many others and to rural and coastal communities. That is why we highlighted that in the 10-year plan. We need to see the end of such examples.

[Josh Newbury (Cannock Chase) (Lab)]

15. What steps he is taking to ensure that women have access to menopause treatments on the NHS.

--- Later in debate ---

[Naushabah Khan (Gillingham and Rainham) (Lab)]

T4. A Channel 4 “Dispatches” documentary recently went undercover at an ambulance centre in my constituency of Gillingham and Rainham. It showed exhausted staff working under difficult circumstances—the result of years of Tory neglect and mismanagement of our NHS. Does my right hon. Friend agree that after the chaos under the last Government, this Administration will put staff and patients first? Will the relevant Minister come to my constituency to meet healthcare providers and discuss our local challenges?

[The Minister for Secondary Care (Karin Smyth)]

We know that there have been issues with the urgent emergency care response. We are absolutely committed to supporting ambulance trusts to continually improve the patient experience. The urgent emergency care plan for 2025-26 is backed by nearly £450 million of funding. I am happy to discuss that further with my hon. Friend.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

--- Later in debate ---

[Leigh Ingham (Stafford) (Lab)]

In my constituency of Stafford, Eccleshall and the villages, I recently ran a survey, which had a whopping 99% response rate, in support of an urgent treatment centre in my constituency. Would the Minister agree to meet me to discuss urgent treatment provision in my constituency?

[Karin Smyth]

My hon. Friend does an excellent job in her constituency. I meet her regularly to discuss issues in her constituency, and I am very happy to discuss the provision of urgent care centres with her.

[James Wild (North West Norfolk) (Con)]

Greater transparency about NHS data should be used to drive improvements, so what assessment has the Health Secretary made of the impact on the Queen Elizabeth hospital in King’s Lynn of being forced to make savings of £18 million this year? What impact will that have on the need to reduce waiting times for A&E and cancer treatment, as identified in the league table that he published?

Healthcare: Bolton

Karin Smyth Excerpts

Wednesday 15th October 2025 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairship this afternoon, Ms Lewell.

It was a valiant effort from the hon. Member for Hinckley and Bosworth (Dr Evans) to raise things such as top-down reorganisation and the state in which the Conservatives left the health service after their 14 years in government. It is as a result of that record that I am delighted to have my hon. Friend the Member for Bolton North East (Kirith Entwistle) here, alongside such strong representation from Labour, following the electorate’s verdict on the last 14 years only 14 months ago. She has been an excellent campaigner since joining Parliament, and securing this important debate is part of that. I am grateful to other hon. Members for taking part.

As a result of the action taken by my hon. Friend the Member for Bolton North East in securing this debate, I met the chief executive, Fiona Noden, and the local ICB to understand, in a more granular fashion, some of the issues I expected my hon. Friend to raise. She was right to thank the staff—both at a leadership level and across the board in Bolton—for their great work. I commend that leadership for meeting regularly, and my hon. Friends the Members for Bolton North East and for Bolton South and Walkden (Yasmin Qureshi) for meeting regularly with those leaders. That happens in my own patch, but it does not happen everywhere. As I often say, it is a really valuable local relationship, because it makes hon. Members more informed and NHS managers better leaders as well.

As we have heard so eloquently, the NHS faces pressures all over the country, including in Bolton and north-west England. Our 10-year health plan is designed to fix that. I thank my hon. Friend the Member for Bolton North East for holding one of those important consultation events. They were very powerful. As a result of the work that she and others have done to bring the patient voice directly to Government and make it a fundamental part of the plan, I think our plan has widespread support. I hope her constituents can hear their voices reflected in the plan that we have developed: it is about access to healthcare for everyone, no matter where they live or how much they earn. We must make sure that our health service is based on that need.

The three shifts—hospital to community, treatment to prevention, and analogue to digital—will ensure that community and neighbourhood health services get the investment they need and that patient communication is more joined up. We are also working with the NHS to make the tough choices that are needed to get it back on its feet.

We will create an NHS where patients have more control, staff have more time to care, bureaucracy is reduced, power is devolved and the health inequalities that we have so sadly heard about again this afternoon are narrowed. That includes creating a new operating model with fewer, larger ICBs, enabling them to harness a shared budget of sufficient size to improve efficiency and reduce running costs. It is a 10-year plan, but of course we are already seeing some improvements and we have set key targets and milestones along that trajectory. As my hon. Friend the Member for Bolton South and Walkden said, we cannot all wait 10 years. We have to see that improvement along the way.

Child health is crucial. We have heard about the inequalities and poverty that many children in Bolton experience. That is why the Government have committed to raising the healthiest generation of children ever, and will soon publish an ambitious strategy to reduce child poverty, tackle the root causes, and give every child the best start in life.

A huge part of realising our ambitions for the NHS is about improving access to dentistry services. The Government understand that, which is why extra urgent dental appointments are being made available across the country, including in Greater Manchester. That is expected to deliver an extra 17,897 urgent dental appointments across 2025-26. Additional dentists have also been recruited in areas that need them most, and we are committed to delivering fundamental contract reform before the end of this Parliament.

All of that will deliver better dental care for everyone in England, including those in Bolton. We also recognise that we need to go further to improve the oral health of children, which is why we are providing funding to local authorities to roll out the targeted, supervised toothbrushing programme for three to five-year-olds. As a result of the programme, Bolton has received over 32,000 donated products to implement supervised toothbrushing alongside an additional £127,000 this financial year.

Hon. Members rightly raised the issue of RAAC at Royal Bolton hospital, which is obviously deeply concerning for staff and patients. Let us be very clear: the safety of patients and staff has to come first. Each trust with RAAC issues has invested significant levels of NHS capital to mitigate safety risks. Locally, the Bolton NHS foundation trust has received over £9.5 million to mitigate the RAAC risk and for eradication works at Royal Bolton hospital. The trust will continue to have access to further necessary funding for RAAC removal, enabling the hospital to complete development and modernisation upgrades.

Hon. Members also raised the important subject of women’s health. As part of our work in this area, we are tackling waiting lists, of which gynaecology is a substantial part. We will see those waiting lists come down and we will soon make emergency hormonal contraception free in pharmacies, but we know that there is much more to do for women. That is why we will look at where we can go further and reflect that in an updated women’s health strategy to better meet the needs of women in Bolton and across the country.

This year the Secretary of State announced a rapid national independent investigation into NHS maternity and neonatal services. He will also chair a maternity and neonatal taskforce to develop the action plan based on the investigation’s recommendations. I am happy to report encouraging local initiatives such as Bolton’s new maternity and women’s health unit, which is set to open in early 2027, as well as a focus on paternal support and investment in strong community-based care and specialist parental mental health support, which we know is so important.

Issues around mental health were raised this afternoon. Mental health support in maternity is made possible only by strong mental health services across the board. That is why we are transforming mental health services. We have heard about Opposition Members serving on the Public Bill Committee and we thank them for their work. We need to build new dedicated mental health emergency departments, improve outreach, and increase overall funding to benefit Bolton and the rest of the country. That includes transforming mental health services in 24/7 neighbourhood mental health centres, building on the existing pilots, and investing up to £120 million to bring the number of mental health emergency departments up to 85.

We also heard about urgent and emergency care this afternoon. We will be publishing an urgent and emergency care plan. The plan will reduce A&E wait times, provide almost £450 million of capital investment for same-day emergency care and mental health crisis assessment centres, and get more ambulances back on the road. The local picture is promising. In Bolton, 12-hour wait times are down compared with a similar time last year, and meaningful infrastructure improvements are being delivered. We are not complacent, however, and we know the situation is not acceptable for people.

A large part of the contributions was about improving general practice and recognising the need for people to feel they have access to it, because that is where most people have contact with the health service. That improvement is a crucial part of our agenda. It is heartbreaking to hear about patients not getting the testing or treatment they need, and of course Leah and her son should not have had to endure that shocking ordeal. I hope that they are getting the support they need, and I am sure that my hon. Friend the Member for Bolton North East will be supporting them.

On access, my hon. Friend will be aware that part of our negotiations with doctors has been about increasing online access, which was rolled out on 1 October. That is helpful to know if that is available in her patch. New funding for the advice and guidance scheme is helping GPs to work more closely with hospital specialists to access expert advice quickly and speed their patients through the system, so they get care in the right place as soon as possible.

[Dr Luke Evans]

Hearing Leah’s story was very concerning and upsetting. When it comes to further online access, one of GPs’ biggest concerns is about what to do with the emergencies that may come in through a computer at 6.20 pm as a result of that access, having to make that assessment when the system is supposed to be closing, and the ability to move GPs to take them away from face-to-face consultations to deal with online access. How will the Government square the circle of access versus patient safety? That is at the crux of the dispute.

[Karin Smyth]

The shadow Minister opens up a discussion that could take some time. Clearly, practices regularly manage emergency situations. The system that we have put in place aims to make sure that patients have access during the day. Different practices will obviously have different opening times—that is a matter for the local system—but I know that if an emergency comes forward, practices all over the country do all they can to make sure that patients are safe. There are also disclaimers on their websites about the times of operation and so on. If there are any individual cases that he wants to raise, we will look at them, but that urgent emergency interface is a matter of negotiation locally and I think most practices understand how to manage it.

I am pleased to report that we are investing more than £1 billion extra in GP services and £82 million in the primary care workforce to ensure that places such as Bolton get the resources and GPs they need. On infrastructure, a new £102 million fund will create additional clinical space across more than 1,000 practices in England. As a result of those efforts, 8 million more appointments have been delivered this year compared with last year. Our shift to a neighbourhood health service is exactly about the joined-up, accessible and locally accountable care that we all want to see, and that my hon. Friend the Member for Bolton North East rightly highlighted. That is also what staff in the system want to see.

On waiting lists, we published our elective reform plan to deliver the change that we promised at the last election. Between July 2024 and June 2025, we delivered more than 5 million additional appointments compared with the previous year. There has also been a reduction in the number of people on the waiting list of over 200,000. I think patients and members of the public are seeing and feeling that progress, and although there is a long way to go, staff are starting to feel it too.

Since June 2024, the number of people on the waiting list at Bolton NHS foundation trust has reduced by more than 7,000, and the number of patients waiting over a year has more than halved. Those are tangible improvements in a very short time, and we thank the staff for their hard work to achieve that. Patients deserve better, but they are seeing progress. We know there is more to be done.

I thank hon. Members for bringing their knowledge and experience of Bolton’s health services to this debate. I know that they and my hon. Friend the Member for Bolton West (Phil Brickell) will continue to advocate strongly on behalf of the people of Bolton, continue to work closely with local leaders, and continue to hold the Government to account for the promises we are making. That conversation between local Members of Parliament about what is actually happening on the ground, which we all hear about in our inboxes, in our surgeries and when we talk to local people, is an important part of what they are doing to raise these issues. I hope that my response shows how much the Government are committed to addressing these issues and working to improve healthcare for the people of Bolton.

Health and Social Care Update

Karin Smyth Excerpts

Monday 13th October 2025 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

I would like to inform the House of several updates from the Department of Health and Social Care over the conference recess.

National Commission on the Regulation of Artificial Intelligence in Healthcare

This Government have established the national commission into the regulation of AI in healthcare. This marks a major step forward in the Government’s mission to make the NHS the most AI-enabled healthcare system in the world.

This is a bold new initiative to lead the UK’s efforts in shaping safe, effective, and trusted AI regulation. The national commission will advise the Medicines and Healthcare products Regulatory Agency, our globally renowned healthcare product regulatory body, on the development of a new regulatory framework for AI and software as medical devices, to be published in 2026. This framework will ensure the UK is the fastest and safest place to bring AI-driven health technologies to market, supporting both NHS transformation and building public trust, while positioning the UK as a global hub for health tech investment and providing valuable insights for our international partners.

The national commission will consist of a diverse panel of experts, including clinicians, patient representatives, international experts, innovators, and regulators. The national commission will be chaired by Professor Alastair Denniston (Head of the UK’s Centre of Excellence in Regulatory Science in AI and Digital Health), with Dr Henrietta Hughes (Patient Safety Commissioner) as deputy chair.

Cloud Based AI tool

The Department of Health and Social Care, through the National Institute for Health and Care Research, is partnering with NHS England to create the AI research screening platform, a single, secure national infrastructure where AI tools can be installed, tested, and integrated with local screening services for research across all NHS trusts.

AI could transform NHS screening by improving early detection, speeding up diagnosis, and easing pressure on staff. Yet progress is limited: many promising tools remain stuck in pilots because there is no reusable, scalable digital infrastructure to evaluate them. Each study currently requires bespoke IT systems that are costly, slow, and unsustainable.

AIR-SP will enable large-scale, rigorous evaluation by comparing AI analysis of screening images with standard clinical pathways. The platform will support multiple NHS, academic, and industry-led research studies, accelerating safe AI deployment.

Building on the NHS digital screening programme, the initial focus will be on mammograms, retinal images, and lung CT scans, with future expansion to other imaging data. As part of the life sciences sector plan, AIR-SP will strengthen the UK’s position as a global leader in health AI, delivering faster diagnoses and better outcomes for patients.

Fair Pay Agreement

The Government intend to introduce the first-ever fair pay agreement for adult social care in 2028, backed by £500 million in funding to improve pay and terms and conditions for adult social care workers. This will complement the wider programme of workforce reforms under way to reform adult social care by improving recruitment and retention and giving staff better recognition for their vital work.

The funding is part of the £4 billion available for adult social care in 2028-29 and will be given to local authorities to support providers in improving pay and terms and conditions.

A public consultation on the design of the fair pay agreement process is now open until 16 January 2026. The consultation will inform the development of regulations, intended to be laid in 2026, establishing the adult social care negotiating body composed of employer and employee representatives. Negotiations are expected to begin in 2027, with implementation of the first FPA expected in 2028.

Over this Parliament, alongside our changes to the minimum wage and new measures in the Employment Rights Bill, care workers will receive one of the biggest upgrades in their pay, rights and conditions in a generation.

NHS Online

On 30 September, the Government announced they will be setting up an “online hospital”, NHS Online—a significant reform to the way healthcare is delivered.

This innovative new model of care will not have a physical site; instead, it will digitally connect patients to expert clinicians anywhere in England. It will give people on certain pathways the choice of getting the specialist care they need at home, having chosen to be referred to NHS Online by their GP. The first patients will be able to use the service from 2027.

NHS Online is part of achieving the Governments ambitions outlined in the 10-year health plan, which holds a radical and sustainable vision for how we think about elective care, with digital being the default and hospital attendances the exception.

NHS Online will help to reduce patient waiting times, delivering the equivalent of up to 8.5 million appointments and assessments in its first three years, four times more than an average trust.

Patient choice remains central to care. In-person care will always be available for those who prefer and for those whose care needs require it. NHS Online will free up capacity for face-to-face appointments.

[HCWS955]

Independent National Maternity and Neonatal Investigation

Karin Smyth Excerpts

Monday 15th September 2025 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

I am announcing today the 14 hospital trusts that will be looked at as part of a rapid, independent, national investigation into maternity and neonatal services. In June, the Secretary of State for Health and Social Care, my right hon. Friend the Member for Ilford North (Wes Streeting), announced this urgent investigation because of concerning patterns in baby deaths and maternal mortality, and because of the extremely harrowing and traumatic stories that bereaved families brought directly to the Secretary of State and the Department.

The Secretary of State asked Baroness Valerie Amos to chair this review—a former diplomat with vast leadership experience and a passion for driving change. Baroness Amos has selected the 14 trusts for local investigations, based on a range of factors. These include data and metrics, such as data from the Care Quality Commission maternity patient survey and MBRRACE-UK perinatal mortality rates, as well as criteria to ensure: a diverse mix of trusts; variation in case mix, trust type, and geographic coverage; and provision of care to individuals from diverse backgrounds, including consideration of social, economic and racial inequalities, family feedback, and where previous investigations have taken place.

From smaller hospital trusts to those operating in our bigger cities, the 14 trusts will help Baroness Amos and her expert advisers to assess maternity and neonatal units of all shapes and sizes. Rest assured that the voices of women and families remain at the heart of this process, as evidence is gathered directly from those with lived experience. I know that for families who are carrying a traumatic burden from what they have gone through, helping us shape this is yet another extremely difficult process to bear. The Secretary of State and I are incredibly grateful to all the families who have taken part and fed into this investigation.

To be clear, this is not about naming and shaming trusts. Expecting parents should not be discouraged from visiting their local hospital, wherever it is, because of this investigation. Hard-working maternity staff should know that this is a sincere and focused effort to support trusts across the country by giving them the tools to provide the best possible care. The Secretary of State has now agreed the final terms of reference with Baroness Amos, and these will be published today.

The 14 hospital trusts are:



Barking, Havering and Redbridge University Hospitals NHS Trust

Blackpool Teaching Hospitals NHS Foundation Trust

Bradford Teaching Hospitals NHS Trust

East Kent Hospitals NHS Trust

Gloucestershire Hospitals NHS Trust

Leeds Teaching Hospitals NHS Trust

Oxford University Hospital

Sandwell and West Birmingham Hospitals NHS Trust

Shrewsbury and Telford Hospital NHS Trust

The Queen Elizabeth Hospital, King’s Lynn

University Hospitals of Leicester NHS Trust

University Hospitals of Morecambe Bay NHS Foundation Trust

University Hospitals Sussex NHS Foundation Trust

Yeovil District Hospital NHS Foundation Trust / Somerset NHS Foundation Trust

The investigation will start detailed work with the 14 trusts straight away, looking closely at the care for women, babies and families. There have already been a raft of reviews and reports, and Baroness Amos and her team will draw on these to create one clear, national set of actions to improve care across the country.

Importantly, the investigation will gather evidence directly from women and families, including fathers and non-birthing partners. This evidence will inform recommendations and result in an initial set of findings and recommendations by December 2025.

Baroness Amos will develop one clear set of recommendations for achieving consistently high-quality, safe maternity and neonatal care. The chair will be supported by a small team of expert advisers and will engage regularly with affected families throughout the investigation process.

This investigation is separate from the National Maternity and Neonatal Taskforce, which the Secretary of State will chair, and will take forward the recommendations of the investigation, forming them into a national action plan to drive improvements across maternity and neonatal care. These recommendations will supersede the multiple existing actions and recommendations already in place.

[HCWS923]

Non-surgical Aesthetic and Cosmetic Treatments

Karin Smyth Excerpts

Thursday 11th September 2025 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship this afternoon, Sir Desmond. I thank the hon. Member for Bromsgrove (Bradley Thomas) for securing today’s debate on this important issue, and other Members for their contributions. This is an area of significant interest to colleagues, and indeed the public.

I think this may the first time the hon. Member for Bognor Regis and Littlehampton (Alison Griffiths) has spoken formally for the Opposition, so I congratulate her on that, and I wish her colleague, the hon. Member for Sleaford and North Hykeham (Dr Johnson), well. She made the point that we had been slow. Let me make the point gently back to her that this is an issue I inherited and that, as people will know if they have read Lord Darzi’s report—if they have not, I really commend it to them—both the breadth and the depth of the inheritance for me and my colleague, the Secretary of State for Health and Social Care, is sometimes beyond description.

I was therefore determined to make progress on this issue, and was absolutely delighted to be able to announce in August that we will, as a Government, step in to regulate in this space. As colleagues will know, doing a press round on an August morning is often not the highlight of everyone’s day, but I was humbled by the responses from families, journalists and campaigners—those women who have shared their stories over many years. I pay tribute to many of them, particularly lots of young women journalists who have taken those stories and told them so powerfully.

The response to that announcement, and the interaction with journalists, was humbling. Indeed, it was a pleasure to make those announcements in my home city of Bristol, where some surgeons have been campaigning on this issue for 20 years, and for them to see what has happened and that the Government are prepared to move in. We are really aware of this issue, and I thank hon. Members for the cross-party support for us moving in this area. We have all seen those troubling headlines about the devastating consequences of unsafe cosmetic practices, and all our inboxes have been inundated by constituents who rightly expect us to make things safer. I am grateful to those who have shared their stories about what can go wrong and who have pushed for action.

I have particular concern for parents who are worried by what their children see on social media, as we have heard this afternoon: young women and girls who are made to feel unhappy in their own bodies by what they see online and feel the need to go through risky and unregulated procedures to ease their concerns. Also as we have heard this afternoon, people think the industry is regulated and are shocked to find out that it is not

The Government of course back small businesses. We recognise the benefits that the industry brings to people and communities. I am also mindful that the sector is full of female entrepreneurship. It is an industry led by women, largely for women, and is a success story to be celebrated, especially in the face of fierce competition from medical tourism. Getting a cosmetic procedure can be a very positive experience—a point made by my hon. Friend the Member for Calder Valley (Josh Fenton-Glynn) and others. The sector is growing to meet a demand, as more and more people seek to take advantage of the increasing availability and affordability of cosmetic treatments. That is a good thing, but for too long the sector has been left with little in the way of safeguards. We need to balance the priority of public safety without stifling creativity and innovation.

My hon. Friend the Member for North West Leicestershire (Amanda Hack) made some excellent points. She visits salons to talk to women—there might also be an occasional man running one of those salons, and we want to work with them, too. She talks to them so that she is informed. I encourage her and others to keep sharing views from the frontline, because people want to do a good job and we are keen to hear from them.

So what are we doing? First, we will prioritise developing legal restrictions on high-risk cosmetic procedures, as we outlined in last month’s response to the consultation. I urge anyone listening to this debate to look at “The licensing of non-surgical cosmetic procedures in England”. High-risk procedures include the so-called liquid Brazilian butt lift, which tragically led to the death of Alice Webb in September last year. Her Member of Parliament, my hon. Friend the Member for Stroud (Dr Opher), has been talking to me about these issues since he became a Member.

Bringing the restricted high-risk procedures into the Care Quality Commission’s scope of registration will mean procedures being performed only by suitably qualified, regulated healthcare professionals working for providers who are registered with the CQC. We will come down like a ton of bricks on providers who flout the rules, with tough enforcement from the CQC.

Secondly, the hon. Member for Bromsgrove raised a really important point about qualifications. He is right that it is currently far too easy for someone with minimal or no training to set themselves up as a practitioner. We will introduce a local authority licensing scheme in England for lower-risk cosmetic procedures such as botox and lip fillers. This was widely supported by many people who responded to the 2023 consultation started by the last Government on the scope of licensing. That consultation received over 11,800 responses. Licensing will ensure consistency of standards and allow action to be taken against practitioners who fail to comply with the requirements. All practitioners will be required to meet rigorous safety training and insurance standards.

Local authorities will run and enforce the scheme, under which it will be an offence for anyone to carry out specific non-surgical procedures without a licence. I understand the excellent points made by many Members about local authorities. It will be an offence for anyone to carry out procedures without a licence. If the rules are breached, businesses risk fines or financial penalties. Detailed proposals will be set out in the consultation in the new year, which will seek views from local authorities on suitable enforcement powers and costs. Many hon. Members here who are experienced in local authorities know that we need to do that carefully with them. We also understand that that will add to local government’s workload, so we will work with them closely to understand what support, training and resources are required as we try to strike the right balance and ensure that councils have enough time to prepare and implement proposals safely across England and to swiftly protect public safety. That will be an ongoing discussion as we go through the next stage of the process.

Licensing will allow people to be confident that the practitioner they choose to perform their procedure has the skills to do so safely. For those in the sector who do the right thing, as so many do, this will protect their businesses and position them as trusted providers in a regulated market.

The hon. Member for Bromsgrove also warns about so-called lower-risk procedures falling through the gap. I can assure him and other hon. Members present that we will work closely with all our partners on where we should set the bar to make ensure that the measures we introduce to protect the public encompass all necessary procedures, and that all legislative safeguards are proportionate and informed by a careful evaluation of risk. As I said, we will prioritise action against the highest-risk procedures first. We look forward to setting out the changes in a detailed public consultation early next year.

In terms of the impact of regulation, I want to make it clear that this is not about stopping people from getting treatments altogether; it is about preventing the cowboys, the crooks and the chancers from exploiting people. We want to support legitimate and safe businesses to continue to provide treatments while, as the hon. Gentleman mentioned, saving taxpayers from footing the bill when things go wrong.

I began my remarks by talking about societal pressures and the influence of social media. Children and young people can be particularly vulnerable to concerns around body image. The Advertising Standards Authority places a particular emphasis on protecting young and vulnerable people. In 2022, new rules came into effect across all media, including social media, banning ads for cosmetic procedures being directed at under-18s.

To meet the challenges of regulating online, the ASA has rebalanced its regulation away from reactive complaints casework and towards proactive tech-assisted gathering, monitoring and enforcement, using artificial intelligence to proactively search for problematic adds and ensure that children are not being influenced by inappropriate and irresponsible marketing.

Choosing to go through a cosmetic procedure is a serious decision, which requires a level of maturity to undertake an informed consideration of the risks and benefits. That is why many procedures should never be performed on children who are still developing physically and emotionally. In England, it is already illegal to give botox or fillers for cosmetic reasons to under-18s unless it is done by a qualified healthcare professional and approved by a GMC-registered doctor. We want to extend this level of protection, and will be introducing further age restrictions on a range of cosmetic procedures.

This is a UK-wide issue, and it is good to see the hon. Member for Strangford (Jim Shannon) in his place. I thank him for his kind words. I can assure him and others that we are working closely with the devolved Governments to understand and share information on approaches being taken across the country. We are pleased that Scotland is also considering similar information, and I have been really encouraged, in my conversations with officials, to learn about the relationship between our officials and the shared learning that is going on with colleagues in Scotland. This is a really complex area and it is changing all the time, with new things coming on board.

The changes we make will affect livelihoods, and it is essential that we get the balance right, given that we know that people are at risk and the sector is expanding. Government action must be proportionate to protect public safety without restricting the legitimate activities of those businesses. We want to collect data, gather more evidence and give businesses their say through the public consultation. That will take time, but we will leave no stone unturned and work tirelessly with expert partners and people across the sector. The proposals will be taken forward through secondary legislation, and therefore subject to parliamentary process in the usual way before legal restrictions or licensing regulations can be introduced.

My hon. Friend the Member for Putney (Fleur Anderson) raised an issue around implants. She has been a fantastic campaigner for her constituent, Jan Spivey. I know that she has been in touch with my hon. Friend about that, and has played a key role in ensuring that this issue, along with others, received due parliamentary attention in previous Parliaments when women raised the issue. I myself am due to appear before the Women and Equalities Committee, which has an interest in this issue and PIP. We will certainly want to work with them and await the outcome of their review, to see whether any further work is needed in that area.

I thank the hon. Member for Bromsgrove for raising such a vital issue and all hon. Members for their contribution. Due to different things happening in London, many parliamentarians who would have liked to be here this afternoon cannot. The hon. Gentleman did excellently by getting in early after the announcement.

It is our duty in this place to protect people like Alice Webb from unqualified practitioners who cut corners, while backing British businesses that do the right thing. This is something we take seriously. Colleagues will want to hold us to account as we deliver, and I give hon. Members my commitment that we want to work with colleagues as we develop these regulations. We want to get them right, and that will take time. This is complex, as people understand. I look forward to working with colleagues to make this a success.

Urgent Care Centres: Hillingdon

Karin Smyth Excerpts

Wednesday 10th September 2025 Commons Chamber

[The Minister for Secondary Care (Karin Smyth)]

I am grateful to the hon. Member for Ruislip, Northwood and Pinner (David Simmonds) for securing this debate. He mentioned that his wife works in the system, so I pay tribute to her for her service in the local trust.

As the hon. Gentleman alluded to, I am a Hillingdon girl; it is where I was brought up. My brother was born in Hillingdon hospital, some 59 years ago. It was a great pleasure to be there recently with my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales). Some years ago, I predicted that we might have a Labour MP there, so after being around the area for a long time, I am personally very pleased to see that.

The hon. Member for Ruislip, Northwood and Pinner tempted me to move into the wider areas of what are rightly a to-ing and fro-ing on some of the bigger pressures in that part of north-west London and into Hertfordshire. I will not go into that, but it is absolutely right that hon. Members use this platform to share their campaigning on behalf of their constituents.

Service changes such as these are always hard and they are rarely popular. I have been the Member of Parliament for Bristol South for more than a decade, and before that I was an NHS manager, so I have seen many service changes and reconfigurations over the years. Like the hon. Gentleman, I was also a non-executive director in a past life. All the changes that I have seen were done through good consultation, with strong clinical leadership and a good clinical case, and involved patients and the public.

I strongly believe that patients, public and staff are often ahead of the wider system and sometimes of politicians in knowing the balance of the money, the funding, the good value for taxpayers’ money, clinical outcomes and safety. If they are managed well, those conversations and the sorts of debates we are having tonight can often yield better results than maintaining the status quo or decisions made behind closed doors. I am familiar with such debates, as like many of us I often found myself standing where the hon. Member for Ruislip, Northwood and Pinner is, advocating for my constituents against changes that I thought were not in their best interest or not clearly communicated. He was right to secure this debate.

[David Simmonds]

I agree with every word that the Minister has said about how we get good decisions in the interests of local people, but does she share my concern that there has been no public consultation about this decision at all? There has been very limited engagement even with local residents’ associations about the process and, for the staff involved, there has been some—shall we say—degree of ambiguity about what decisions have been made at each stage of the process. Does she agree that it would be wise at this stage, as a very minimum, to pause, to think again and to undertake that public consultation, so that the NHS managers tasked with making the decisions fully understand the impact on the local community?

[Karin Smyth]

I will comment on that later. I understand that there is a meeting on Friday, to which I will allude.

In preparing for the debate, I met representatives of the trust, and I am grateful to those in the local NHS for their time in giving some further background. The trust is clear that it would be more efficient for urgent care services to be consolidated at the site in Hillingdon, bringing forward the urgent care nurse practitioner service at Mount Vernon into the urgent treatment centre at Hillingdon hospital. The rationale for having urgent treatment centres alongside A&E is well established clinically.

The hon. Gentleman referenced the 10-year plan—I am pleased he is such a fan—and the direction of travel. I am pleased to say that the trust also believes that people are better served by primary care hubs, so that more responsive care can be delivered closer to where people live. Three such hubs are being developed in Hillingdon, one of which will be in Ruislip. I am sure that he welcomed the announcement this week of the roll-out of the first of the 43 hubs, including the one in Hillingdon, which will deliver the neighbourhood health services model.

[Danny Beales]

Despite some of the heat in the debate, the misquoting of things that have been said and the unfortunate politicisation of this important local issue, about which there is general agreement among Members of all parties and in the community, the consensus that I hear is that people want more accessible services, more locally. There is a need for three hubs—the system wants that—and I am pleased that the Government have announced funding and prioritised Hillingdon. I have also heard that there is a potentially greater role for community pharmacies in providing urgent services and care. Does the Minister agree that more can be done by primary care providers across the board in Hillingdon and elsewhere?

[Karin Smyth]

I agree with my hon. Friend that that is the direction of travel that we want to see in all of our constituencies across the country.

The long-promised rebuild of Hillingdon hospital will be delivered by this Government as part of wave 1 of the new hospital programme. The money is guaranteed and construction will start between 2027 and 2028. We are already helping the trust to prepare for when we get spades in the ground, and it was a pleasure to visit the trust recently with my hon. Friend the Member for Uxbridge and South Ruislip.

The hon. Member for Ruislip, Northwood and Pinner raised the issue of consultation. I understand that there is a meeting with the trust, the integrated care board and the local authority on Friday, and I am sure that he and other hon. Members will be part of that. It is entirely proper for a Member of Parliament to raise issues about changes in their area—that is part of our democracy and democratic accountability. Now that this Government have put the new hospital programme in order, it is also proper for the House to hold us to account on its progress.

[John McDonnell (Hayes and Harlington) (Ind)]

I will try to attend the meeting on Friday, but the Minister must appreciate that there is an element of scepticism about the future, in particular about what is happening with this unit. It confirms in my mind that if you stand still long enough, things will come around time and again. In our constituencies in Hillingdon, we have gone from cottage hospitals that provided immediate care for minor injuries, as well as having beds, which were closed, to being promised Darzi units, which we never saw, to looking forward to the hubs themselves. On Friday, I want to be able to convince people that there is a comprehensive plan that will be held to and properly invested in, because people will be very sceptical about the closure of a unit without the confidence that the architecture will be in place to meet the needs of our constituents. The petition has garnered such a large number of signatures because of that concern.

[Karin Smyth]

I understand what the right hon. Gentleman says. I have seen some of those promises made and not delivered over many years. It is important that Members of Parliament are involved and that there is a wide conversation with the ICB and the trust around those changes and the development that they make towards delivering the 10-year plan.

My right hon. Friend the Prime Minister announced that we would bring together NHS England and the Department for Health and Social Care precisely because we think that democratic accountability for £200 billion of taxpayers’ money is important. However, that accountability does not mean micromanaging, or intervening in every difficult decision that the ICB makes. We expect local NHS organisations to make changes and to reconfigure their services as best needed by the people they serve. That is in line with the direction outlined in the 10-year plan.

My right hon. Friend the Secretary of State for Health and Social Care has received several requests to intervene on a number of issues. Having looked at them thoroughly and assured himself that patient safety and access were guarded, he has decided not to intervene in nine reconfigurations. Getting our NHS back on its feet is a team effort, and we have to trust local NHS leaders to deliver. Decisions that affect the people of Hillingdon should be made in Hillingdon—it is not for someone sat behind a desk in Whitehall to make those decisions for them.

Having said that, I want to assure colleagues that that does not mean we will give local leaders a blank cheque to do whatever they like. Yesterday, we published a data tool and league tables that make NHS performance open and accessible, to inspire improvement and deliver a better NHS for all. Those NHS organisations that are doing well will be rewarded with greater freedoms, such as in how to spend their capital, and those that demonstrate the best financial management will get a greater share of capital allocation. We want to move towards a system in which freedom is the norm and central grip is the exception, in order to challenge poor performance.

Improving services for patients should be rewarded; the quid pro quo is that there will be no more rewards for failure. Undertaking the reforms we have set out to make as a Government will require a good deal of trust between central Government and local leaders, and we will build that trust only by showing those local leaders that we trust them to get on with the job and make difficult decisions where necessary.

[David Simmonds]

Will the Minister give way?

[Karin Smyth]

I am going to pursue this point, if I may. Debates about service changes and reconfigurations have gone on since the birth of our NHS. I understand that they are really important for local people, and I understand the level of discussion about this issue and—as the hon. Gentleman has outlined—the wider impact on areas such as Watford. It would be easy for this Government to make ourselves popular by sacking some managers and promising people that services are never going to change, or that they will never close in any part of the country, but we were not elected on a populist platform, and it would not be in patients’ long-term interests not to reform and modernise the system.

We are building an NHS that is fit for the future. That is what the 10-year long-term plan is based on—moving services from hospital into the community, from analogue to digital, and from sickness to prevention. We expect local NHS leaders to make that happen. They must do so with local clinical leadership in the best interests of the populations they serve, and they must do it with the public—we expect open and transparent communications going forward. Local politicians have an important role in that, which Members present in the Chamber have demonstrated ably, and will continue to do so. I would be very happy to maintain contact with the hon. Member for Ruislip, Northwood and Pinner. The wider implications of the issues he has raised need to be outlined to him, and I commit to writing back to him about the consideration that is being given to those wider implications. I note his concerns, and I am happy to continue working with him.

Question put and agreed to.

Integrated Care Boards: Running Costs and Boundary Alignment with Strategic Authorities

Karin Smyth Excerpts

Tuesday 9th September 2025 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

Today I am updating the House on progress towards reducing the running costs of integrated care boards and the Government’s ambition to align the boundaries of integrated care boards and strategic authorities where feasible.

We have committed to reducing the running costs of ICBs and to redirect this funding to frontline services. To deliver this, our “10 Year Health Plan” sets out that ICBs must focus on their role as strategic commissioners, ensuring the best possible value in securing local services that improve population health and reduce inequalities.

In directing ICBs to focus on strategic commissioning, we are reducing duplication of functions that are undertaken by other NHS organisations such as performance management and assurance, freeing up vital resources.

To deliver a reduction in running costs in this financial year, a number of ICBs will cluster together to share leadership and functions; clustering ICBs remain legally separate organisations with their own financial allocations. It will mean that during this financial year the number of ICB senior leadership teams will go from 42 to 26.

In the longer term, there will be fewer, larger ICBs enabling them to harness a shared budget of sufficient size to improve efficiency and reduce running costs. Our ambition is for these ICBs to be coterminous with one or more strategic authorities wherever feasible, a commitment made in the “English Devolution White Paper” and reaffirmed in our “10 Year Health Plan”.

Aligning public service boundaries facilitates service integration, harnesses the opportunities of strategic planning between the NHS and strategic authorities, and supports delivery of a “health in all policies” approach.

I am today announcing the first of these new ICB footprints. These will come into effect on 1 April 2026 and are:

Norfolk and Suffolk ICB

Essex ICB

Hampshire and the Isle of Wight ICB

Surrey and Sussex ICB

North West and North Central London ICB

Thames Valley ICB

Central East ICB (Hertfordshire, Bedfordshire, Luton, Milton Keynes, Cambridgeshire and Peterborough).

In the case of Thames Valley ICB and Central East ICB, we are progressing with these new ICB footprints on the understanding that these may be reviewed in future to allow for alignment with any future strategic authorities, and newly established unitary authorities resulting from local government reorganisation.

Next summer, as local government reform progresses, we plan to decide further ICB mergers and boundary changes to come into effect on 1 April 2027.

The Department of Health and Social Care, alongside NHS England and the Ministry of Housing, Communities and Local Government, will continue to work closely together, and with ICBs and their local partners, to ensure future changes to ICB footprints achieve the best outcomes for patients and citizens. ICB leaders will continue to engage with all local partners, including Members of this House, on the further development of plans, as we stride towards delivering the ambitions set out in our “10 Year Health Plan”.

[HCWS915]

NHS Performance Data Tool and NHS Trust League Tables

Karin Smyth Excerpts

Tuesday 9th September 2025 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

I am updating the House about the publication of a data tool and league tables that make NHS performance under the NHS oversight framework open and accessible. This delivers a commitment in the “10 year health plan for England: fit for the future” to publish new league tables and as part of our plan for change, ensuring our investment in the NHS delivers meaningful outcomes, greater efficiency, and real value for patients.

At last year’s NHS providers conference, the Secretary of State for Health and Social Care announced league tables as part of our plan to stop rewarding failure and to create a better and more transparent health service. We know that this is more important than ever, and the public expect better care and value following the record investment in the NHS made by this Government. This is why today NHS England has published these league tables, along with a data tool that gives a high-level view of the performance of NHS trusts. With this, the public will be able to see how their local NHS organisations are performing, including data on key areas such as urgent and emergency care, ambulances and electives—data that MPs and peers can also draw upon. Everyone can now see for themselves how their local services are doing and better hold their local NHS organisations to account.

The top trusts will be rewarded for their performance with greater autonomy, including the ability to reinvest surplus budgets into frontline improvements, such as diagnostic equipment and hospital repairs. We are also introducing a new wave of foundation trusts, which will give the best-performing trusts more freedom to shape services around local needs.

Meanwhile, trusts facing the greatest challenges will receive enhanced support to drive improvement, with senior leaders held accountable through performance-linked pay. The best NHS leaders will be offered high pay to take on the toughest jobs, sending them into challenged services and turning them around.

This is not a “name and shame” exercise; we know that there is amazing work carried out every day in every NHS organisation, and the information we are releasing will shine a light on the achievements of the frontline and back-office staff who push hard every day to improve the lives of everyone in this country. We are publishing these tables to drive high-level performance changes and, where needed, to inform difficult conversations about organisational performance, to inspire improvement and deliver a better NHS for all. We are also improving the fundamentals of oversight through the NHS oversight framework, which NHS England published on 26 June. It sets out a revised transparent approach to the oversight of integrated care boards and trusts following feedback from these organisations and wider system partners. The streamlined set of metrics within the new framework will enable systems and providers to focus on the recovery that we know the NHS needs, while maintaining quality, safety and patient experience. Trusts will be placed into one of four segments based on their performance against these metrics. The framework explains how NHS England will use the segmentation of providers to inform incentives and consequences for performance, and support improvement.

This is a transitional year for ICBs, as they transform in line with NHS England’s model ICB blueprint to focus on strategic commissioning and implement plans to meet the running cost reductions the Government require. We have decided, therefore, that they will not be scored, segmented or ranked this year. NHS England will still conduct annual assessments of ICBs to review how well each is performing its statutory duties, and will introduce ranking in the next performance year, 2026-27.

The league tables, data tool and underpinning framework are an important first step in both the recovery and the transformation of our health service in line with the 10-year plan. We will continue to refine our approach to both the league tables and the data tool in the light of feedback from the NHS, experts, and the public. They will make what the NHS is good at—and what it needs to improve—more visible to the public, so that they can hold us to account for its successes and failures.

[HCWS916]

Covid-19 Vaccination Harm

Karin Smyth Excerpts

Wednesday 3rd September 2025 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is an absolute pleasure to serve under your chairship today, Ms Lewell. I am speaking today on behalf of the Minister for public health and prevention, my hon. Friend the Member for West Lancashire (Ashley Dalton), who cannot be here for other parliamentary reasons. I know that she agrees with me that debates such as this are important to uphold the British people’s trust in public health measures, so I thank the hon. Member for Christchurch (Sir Christopher Chope) for securing it.

I want to start by giving some assurance, particularly to people watching at home. We know that over 53 million people, following the example of Her late Majesty the Queen, took the jab during a once-in-a-generation health emergency, and that covid vaccines helped to keep millions of people out of hospital and, in many cases, saved lives. It is important to remember that the vast majority of people who took the jab did not suffer adverse effects. The hon. Member for Christchurch has made some of those points publicly, and I am grateful for that. However, that does not mean that we should turn a blind eye to the rare and tragic instances where things have gone wrong, as he eloquently highlighted.

I want to take the opportunity to pay tribute to some of the campaigners, Kate Scott, Sheila Ward and Kelly Hatfield, for their tireless campaigning on this issue, and to Gareth Eve and the family of John Cross, all of whom have raised the issue of vaccine injury with my ministerial colleagues. Their loved ones took the vaccine because they wanted to protect their families and the NHS.

Today, those brave campaigners are still fighting for all people who suffered adverse reactions. They are not statistics—as hon. Members have said today, they are people. They are our constituents. Their voices must be heard. I am glad that they continue to have the opportunity to raise their concerns with the Secretary of State for Health and Social Care and with my colleague, the Minister for public health and prevention. The conversations are difficult, but they are essential to making Whitehall understand where the system falls short and where we can make a meaningful difference. It is not just a question of making sure that systems are in place to support people when things go wrong. As the hon. Member for Christchurch outlined this morning, it is about maintaining public confidence in our health service and vaccination programmes. That is what is at stake in this debate, and that is why it is helpful that he secured it.

That said, I do not think I will be able to assure the hon. Gentleman on the exact timelines that he asked for. However, I assure him that we are neither being complacent nor playing hard to get, as he said of even his own Government. Indeed, I echo the Secretary of State’s comments to the right hon. and learned Member for Kenilworth and Southam (Sir Jeremy Wright) back in June.

We are taking tangible steps to improve the administration of the vaccine damage payment scheme. As hon. Members know, the VDPS is a statutory route through which those who have suffered serious harm as a result of vaccination can apply for financial support. The scheme has been in existence for many years, but since the covid-19 vaccination campaign began, there has been a rise in the number of applications. That is to be expected, given the record number of vaccinations given in such a short timeframe, but it has put pressure on the processing time. That is why the Department has been working with the NHS Business Services Authority, the administrators of the scheme, to modernise operations, improve the experience of those who apply for an award and process claims at a faster rate. To get that done, additional medical assessors have been appointed and the application process has been digitised.

The NHS Business Services Authority has also been working to improve the return rate of medical records from the healthcare providers required to assess claims through engagement with NHS institutions and using subject access requests as needed.

With regard to the ongoing work, we recognise that concerns about the scheme go wider than the application process. We have heard those calls from the hon. Member for Christchurch, other Members present and campaigners, and, as he references, during the covid inquiry hearings, when the Government were asked to look at issues such as the eligibility criteria for the scheme and the current award amount. Last September, the Secretary of State met campaigners to discuss that issue, and ministerial colleagues have had further meetings since. In those meetings, my colleagues set out that although any changes to the scheme would be a cross-Government decision, our door remains open to campaigners and we will do everything we can to keep progressing this at pace.

I recognise that individuals and their families who have suffered harm following vaccination are waiting on a more detailed update, but I reassure them that the Secretary of State and Ministers are continuing to look at the issues and a range of options. I reiterate the comments that the Secretary of State made at Health questions. We want to be clear in our response. I will not be able to offer the hon. Member for Christchurch the timeline that he wants today.

[Sir Christopher Chope]

The Minister says she cannot give us an exact timeline. Could she give us an approximate time? Is this going to be finished before the end of this year, for example? That is not an exact timeline, but it would be an indicative timeline. And when she talks about various options, can she not explain which of those options are being considered or which ones are not being considered? For example, is increasing the £120,000 payout being considered? Is reducing the disability threshold from 60% being considered? Is disapplying the three-year limitation period for the bringing of civil claims being considered? Please can we have a yes or no to those things? We are not asking for the decisions on those, but we are asking whether they are being considered or not.

[Karin Smyth]

The hon. Gentleman tempts me to give more details, which I cannot do today. But I will take back to the Department that broader request for timelines and what things are being considered. I will make sure we get back to him on that as a result of this debate.

On the Medicines and Healthcare products Regulatory Agency, the hon. Member for Christchurch and the right hon. Member for Tatton (Esther McVey) asked about the effectiveness of the MHRA in monitoring harms. The MHRA is globally recognised for requiring high standards of safety. Vaccines used in the UK are authorised only once they have met robust standards of effectiveness, safety and quality.

Once approved, the comprehensive post-market surveillance of a vaccine begins, where the benefits and risks of the vaccine are very closely monitored. The MHRA collects data through the reporting of adverse reactions by the public and healthcare professionals to the yellow card scheme, as well as from other information sources domestically and internationally.

As hon. Members know, a dedicated team of scientists constantly reviews the information to look for safety issues or rare adverse effects. All reports of adverse events, alongside other information, are analysed and reviewed continuously to identify trends and patterns that may require action, with any information indicating a possible new safety concern thoroughly evaluated. Updated advice for healthcare professionals and patients is issued where appropriate.

The covid-19 vaccines have been scrutinised continuously since roll-out, with the MHRA having implemented a proactive surveillance strategy for monitoring the safety of all UK-approved covid-19 vaccines.

I just want to end by saying that the vaccine programme—

[Sir Christopher Chope]

Obviously, the Minister has a brief that has been given to her by officials on behalf of the Minister with responsibility for public health, the hon. Member for West Lancashire (Ashley Dalton), who is not able to be here. Can this Minister give me some assurance that I, together with my colleagues who have participated in this debate, will be able to meet the relevant Minister, so that we can go over some of this stuff? I realise that this Minister does not have the discretion to be able to respond to this debate, but the public health Minister would have that discretion, so can she guarantee that we can fix up a meeting, please?

[Karin Smyth]

The hon. Gentleman is of course a very experienced campaigner, and he asks his question absolutely appropriately. I know that my hon. Friend the public health Minister is very happy to meet people and discuss this, but I can also assure the hon. Gentleman that the Secretary of State is very much looking at this personally as well. I will take that request for a meeting with the public health Minister back to the Department, and I am sure that she will be happy to do that.

The vaccine programme was an immense contribution to public health during a once-in-a-lifetime health emergency, and many of us remember the sense of relief that we and family members felt when we got that text with the invitation to come forward. But for a small number of people and their families, it brought pain, loss and hardship. We must never forget them, and our responsibility as a Government is clear. We are absolutely committed, as I have said, to further work to improve the scheme, as well as to continue to engage with those who are affected and have suffered vaccine harm, to consider how the system could better reflect their needs. That does include the issues raised by the hon. Gentleman, and other colleagues here today, on behalf of all our constituents.

Question put and agreed to.

Oral Answers to Questions

Karin Smyth Excerpts

Tuesday 22nd July 2025 Commons Chamber

[Laura Kyrke-Smith (Aylesbury) (Lab)]

3. What assessment he has made of the potential impact of the 10-year health plan for England on perinatal mental health.

[The Minister for Secondary Care (Karin Smyth)]

The 10-year health plan sets out ambitious plans to boost mental health support across the country, including for women during the perinatal period. During the year to April 2025, a record 64,805 women accessed maternal mental health services or specialist community perinatal mental health services, such as those at the Whiteleaf centre in Aylesbury. The Department for Education is also investing £500 million to roll out Best Start family hubs to all local authorities in England, which will also support new mums.

[Laura Kyrke-Smith]

I am really grateful to the Minister for her answer and for her focus on this. I would like to ask about midwives, who do incredible work supporting parents and babies, including identifying and supporting women who are facing mental health challenges. We desperately need more of them, yet the Royal College of Midwives has found that eight out of 10 student midwives who are due to qualify this year are not confident that they will find jobs. What steps is the Minister taking to ensure that newly qualified midwives are able to find work?

[Karin Smyth]

I recognise my hon. Friend’s great work in this place to support women on this issue. We recognise that newly qualified midwives are experiencing challenges in gaining that first role. That is partly due to the record number of midwives in post and to better retention rates. NHS England is working with employers, universities and regional midwifery leads to help midwives find those roles after qualification and to transition into workforce, and we will keep a close eye on that with them.

[Alex Easton (North Down) (Ind)]

In assessing the impact of the 10-year plan on perinatal health for England, can the Minister assure us that the lessons learned will be shared across the rest of the United Kingdom, to enhance care quality and reduce regional disparities, especially in Northern Ireland?

[Karin Smyth]

The hon. Gentleman makes an excellent point about the important need to share the learning across the United Kingdom, and I will make sure that we do indeed make efforts to do that.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Jess Brown-Fuller (Chichester) (LD)]

Over the weekend, The Guardian reported that the number of women dying in the perinatal period had risen sharply since 2015. Families that have been failed, and health professionals feel that whether it is perinatal depression or unsafe births, lessons are not being learned and the same errors are repeated in review after review. Alongside the inquiry that the Secretary of State has launched, will the Government immediately implement every action from the Ockenden review and put an end to this national scandal in maternity service?

[Karin Smyth]

The hon. Lady has raised a really important issue. She highlights the work that the Secretary of State is putting in place to address these issues and finally bring all that together to produce a plan that will assure people, and we are working at pace to ensure that those recommendations are implemented.

[Greg Smith (Mid Buckinghamshire) (Con)]

4. If he will make an assessment of the potential merits of siting a neighbourhood health centre in Long Crendon, Buckinghamshire, as part of the 10-year health plan for England.

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[Gareth Snell (Stoke-on-Trent Central) (Lab/Co-op)]

7. What steps his Department is taking to improve electronic patient record systems in the NHS.

[The Minister for Secondary Care (Karin Smyth)]

My hon. Friend will know that trusts have responsibility for securing—using the approved procurement framework—an appropriate electronic patient record system that delivers all the core capabilities set out in the digital capabilities framework. Since 2022, £1.9 billion has been invested in digital transformation, including in the roll-out of EPRs to NHS trusts that do not have one and in support to optimise existing ones.

[Gareth Snell]

The Minister will be aware that my hon. Friend the Member for Stafford (Leigh Ingham) and I have been working on a replacement system for the University Hospitals of North Midlands NHS Trust in north Staffordshire, which would improve public and patient experience, and productivity, at those hospitals. Will the Minister meet us so that we can consider how further to unlock that funding to improve productivity and patient experience in good time?

[Karin Smyth]

I commend my hon. Friend, and our hon. Friend the Member for Stafford (Leigh Ingham), for their diligent work with their trust and local system. Progress is being made on that EPR, which will have huge benefits. I will ensure that he has a clear outline of progress to the final planned operating of the go-live date for that issue. I am happy to meet him.

[Mike Martin (Tunbridge Wells) (LD)]

Blocked beds cost Pembury hospital £18,000 every night, yet discharge teams have to manually phone care homes to place people there. My constituent Debbie has created a dashboard—it is basically like Skyscanner—to accelerate discharges by matching discharged patients to care beds. It has already received seed funding of £200,000 from Kent county council, and could save up to £7 million a year in Pembury alone. Will the Minister meet me and Debbie to discuss that idea?

[Karin Smyth]

The hon. Gentleman highlights the serious problem of staff operating in an analogue age in the NHS, which we keenly highlighted in the 10-year plan. We want to move the system into a more digital age. We would be very happy to hear more about the scheme that he outlines and the great work that staff are doing to get over some of the problems that they are working with.

[Ms Julie Minns (Carlisle) (Lab)]

My constituent Lee Armstrong contacted 111 when he was suffering from an Addisonian crisis. Lee and his partner provided full details about his condition to 111, and when his condition worsened, they called 999, but what neither Lee nor his partner knew was that the electronic record details given to 111 would not be available to 999, and neither would his patient records. As a result, the ambulance was not dispatched with the urgency required and Lee died. Will the Minister set out how the improvements in the digitisation of electronic records will cover the integration of the 111 and 999 services so that lives like Lee’s can be saved?

[Karin Smyth]

My hon. Friend outlines a horrific case in her constituency, where she has been a fantastic campaigner since last year. Information sharing between 111 and 999 already exists in many places. We want standards in place to ensure that that happens safely across the country. That is a key part of what we are trying to do in our 10-year plan by bringing together single patient records and records within systems. I am very happy to follow up with her in more detail on the case she mentions, if that would be helpful.

[Edward Morello (West Dorset) (LD)]

Many GPs say that their buildings are not fit for purpose and lack digital infrastructure. Without fully integrated electronic patient records and better systems, including the electronic prescription service across all hospitals and community trusts, we risk wasting time and money while increasing pressure on frontline staff. Will the Minister outline the steps being taken to full integrate the electronic prescription service across all settings in Dorset?

[Karin Smyth]

The hon. Member highlights the importance of getting this right not only from hospital to discharge but, crucially, in primary care, where 90% of patient contacts happen across the system. That is why a central plank of our 10-year plan has been moving the entire system from the analogue to the digital age. We have allocated £10 billion, particularly in this spending review, to address this issue and make sure we get this right for the system and for patients.

[Kate Osamor (Edmonton and Winchmore Hill) (Lab/Co-op)]

8. What assessment he has made of the potential impact of the 10-year health plan for England on the prevention of ill health.

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[Josh Babarinde (Eastbourne) (LD)]

10. What steps his Department is taking to improve car parking provision at NHS hospitals.

[The Minister for Secondary Care (Karin Smyth)]

The Department has published guidance that trusts are expected to follow to manage the provision of car-parking spaces for patients, hospital users and staff. Responsibility for hospital car parks lies with each individual trust, and provision must be managed alongside the existing policy, providing free parking for those in the greatest need.

[Josh Babarinde]

Parking at Eastbourne district general hospital, where I was born, is woefully inadequate. The car park is often full, so patients have to park way away up the Rodmill hill, and car park services are crumbling. More than that, lower-banded NHS staff now face a near doubling of car parking charges to cover the cost. Given that the Government have delayed investment in our new hospital and, therefore, in a new car park until the 2040s, what support will they provide in the meantime to upgrade our DGH car parking facilities without our NHS heroes being expected to foot the bill?

[Karin Smyth]

As the hon. Gentleman knows, the discussions about any advanced works arising from the new hospital programme are ongoing. I am very happy for the Department to continue to discuss with the trust how future investment can best meet the needs of the future.

[Rachel Taylor (North Warwickshire and Bedworth) (Lab)]

University hospital Coventry and Warwickshire suffers from really poor car parking facilities. I have had to take both my parents there over recent years to use its specialist cardiology services. The poor quality of those car parking facilities causes additional stress for patients visiting those services, which they can ill afford when they have suffered strokes or heart attacks. It is becoming extremely vital that something is done, so will the Minister meet me and other local MPs to discuss the crisis in car parking at the hospital?

[Karin Smyth]

The provision of car parking remains an issue for trusts. I recognise the stress caused by trying to get patients to hospital, particularly if they have mobility problems. I commend the many hospitals across the country that have really good active travel plans and are working with their local communities to resolve some of these issues. We need to hear more from the trust about what provision it is putting in place to serve my hon. Friend’s constituents.

[Perran Moon (Camborne and Redruth) (Lab)]

11. What steps his Department is taking to tackle health inequalities across the country.

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[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

Eight years ago, Weybridge community hospital burned down. After a long journey, the replacement finally received planning consent last week; all it needs now is for the Secretary of State to sign the cheque on the dotted line. Will he do so as soon as possible?

[The Minister for Secondary Care (Karin Smyth)]

The business case for the rebuild of the health centre has been submitted to NHS England for review, and NHS Property Services will in parallel be asked to approve the capital funding. Subject to those approvals, a new health centre will be fully completed in 2027.

[Will Stone (Swindon North) (Lab)]

Phlebotomists across the country play a vital role in our NHS. Will the Minister consider making the job role band 3 across the nation to ensure that everybody is paid fairly?

[Karin Smyth]

Phlebotomists are paid on an “Agenda for Change” pay scale, which is underpinned by the job evaluation scheme. It is something the Secretary of State and I discussed with the trade union Unison last week; I should declare that I am a member of Unison. It is working closely with the trust in question, but I am happy to discuss the matter with my hon. Friend further.

[Dr Danny Chambers (Winchester) (LD)]

Many carers have told me how much they rely on respite care to protect their own physical and mental health so that they can continue to care for their loved ones day in, day out. The wonderful Chesil Lodge day centre in Winchester has recently been threatened with closure, and I have been fighting alongside constituents to keep it open. How will the Department ensure that respite services such as those at Chesil Lodge are consistently available and are not subject to a postcode lottery? Can I also—