Health Bill

Layla Moran Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

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

It is a pleasure—and slightly surreal—to follow the former Secretary of State, the right hon. Member for Ilford North (Wes Streeting), because he is very much an architect of the Bill, and I am sure that we would have had many questions for him about what he meant by parts of it. It was a pleasure to work with him when he was in the role, and I look forward to working with the new Secretary of State too.

We all understand what is at stake here: far too many feel that the system is not working for them. The latest British attitudes survey showed that more than half of people in this country are dissatisfied with the NHS. That should give us all pause. When the abolition of NHS England was first announced, I welcomed its boldness because our population faces enormous challenges. Healthy life expectancy has not just stalled; it has gone backwards. We are getting older and we are getting sicker—so, yes, we need to be bold. There is widespread recognition that the three shifts in the 10-year plan, to community, to prevention and to digital, are the right ones, and if achieved—and that is an “if”—they will be transformative, but along with the enthusiasm, which I share, there is a big dollop of scepticism. Twenty-five per cent of the public do not believe this plan will make any difference to them, and we must prove them wrong.

My message to this Government is this: “Focus on the plan. It is the right plan, and achieving it will be an enormous challenge. Also, please do not forget social care.” We must remember that this merger, which could risk becoming a distraction from the plan, did not start with the Bill; it started with the announcement in March 2025, and the effects are already being felt in the NHS. This was not in the manifesto, so it came completely out of the blue, with many people waking up and discovering that their jobs were at risk only from reading the news. It has been brutal. As a result, the Institute for Government told the Health Committee in our hearing just before the recess that there has been a “large drop in morale”, which is unsurprising. There has been uncertainty, poor communication and disruption. I have heard at first hand how decisions have been snarled up as key people have left, and we must learn from previous reforms that the savings often do not materialise because many of the same people who leave first end up being rehired—a point made in the Committee hearing a couple of weeks ago by the chair of NHS England, Penny Dash. So, despite my initial enthusiasm, there is much that we need to chew over.

In the six inquiries and 13 one-off sessions that our Committee has done so far, there are clear themes for change, and it is on those that I will judge the Bill. The first theme is innovation. Pilots and moonshots are good, but they should not replace evidence-based prevention and joined-up thinking. For example, the Government’s obesity moonshot focuses on weight-loss drugs, but ignores the obesogenic environment of advertising, ultra-processed foods and lifestyle pressures. It tackles the symptoms and not the cause. And too often, these pilots show promise but are then never scaled up. What a waste! Innovation should be a mindset, not a buzzword, and we should strengthen clause 6 of the Bill to ensure that the long term is embedded from the outset.

The second theme, which has come up already, is patient voice. Our inquiry into severe mental illness laid bare a system where vulnerable people feel like pinballs in a machine.

[Alex Brewer (North East Hampshire) (LD)]

In my area, children waiting for ADHD assessments—many already on the standard pathway for years—have been told that they will have to wait until 2027 at the earliest. We know this is happening nationally, because Healthwatch told us in its 2024 report. Does my hon. Friend agree that abolishing Healthwatch—the only statutory independent body holding our NHS to account—will leave the most vulnerable patients without a voice and the NHS marking its own homework?

[Layla Moran]

I do have concerns over Healthwatch; I have even more concerns over the role of the HSSIB. We cannot have it both ways: people cannot sit at desks near other people who are making decisions and at the same time be perceived as entirely independent. The perception of independence cannot be legislated for—the perception is everything, and that is my concern. Clause 15 talks about co-creation, but getting this point right is key to making the system work. There are many examples of where it has been done correctly, but all too often it is just a tick-box exercise.

The third theme is financial flows and integration. Time and again, the Committee is in rooms with local authorities, social care and the voluntary sector all saying that they know how to do this for their local area and it is the system that gets in the way. Section 75 arrangements are a good start and should be strengthened, and there is a lot of promise in the neighbourhood health plans under clause 24. Our concern is over clause 21, because if local authority representation is removed from ICB boards, then social care is not present in those first conversations. That is critical and needs rethinking.

The fourth theme is data. Recently in my surgery, I spoke to a woman called Freya-Rose, who described how repeatedly recounting traumatic experiences compounded her own suffering. The single patient record could be transformational for her and others who find recounting traumatic experiences difficult. We therefore welcome clause 47, but we must be careful about the risks, especially around sensitive data. On that, the Committee will be having hearings on the federated data platform and Palantir, which has already been mentioned today.

The final theme that has emerged in our work is inequalities, so I am excited about the potential of clause 4. I am proud of the Liberal legacy that this NHS is built on. In his seminal report, Beveridge rightly pointed to want, disease, squalor, idleness and ignorance as the five giants that needed to be slayed on the road to recovery following world war two. Obviously, we have come a long way since then, but I would argue that it is time to define some new giants, and health inequality must be one. It is self-evidently the moral thing to do, but—here is something I think the Secretary of State will like—it is also the economically wise thing to do, because study after study shows that tackling inequalities is the key to unlocking productivity in the NHS. Simply put, helping those who need it the most helps us all. This Bill needs to do more than just “have regard” to inequality; I would urge the Government to make it its core mission.

I end by simply saying what I started with: I will work constructively to help the Government make this the success that I hope they want it to be. I would urge them to think about the downsides, because there are some and they need sorting out. Above all, the Bill will be judged not by us, but by Chris and Freya-Rose, the very patients who deserve to be put at the heart of this legislation moving forward.

Health Bill

Layla Moran Excerpts

Report stage
Monday 7th September 2026 Commons Chamber

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

I thank the Minister for accepting our amendment on this issue. We pressed her and her colleagues over and over again—to the extent that we got a letter back that we honestly thought had been generated by AI, because the logic in it had no follow-through at all. I am delighted that she has listened. On what else does she intend to listen to us? In particular, there are amendments on the Health Services Safety Investigations Body, Healthwatch and health inequalities, which we will consider tomorrow, and, most importantly, the special needs amendment, which we are considering today. What else will she listen to us on?

[Karin Smyth]

I thank the Chair of the Select Committee —I can assure her that I am Karin, not Claude. She tempts me to go further on the rest of the Bill, but I genuinely thank her and the Committee; I hope she would agree that I spent a lot of time over the past months, before Report stage and Committee stage, meeting her, members of the Committee and many hon. Members from across the House. We have some provisions—we might call them simple provisions—in the Bill to democratise the NHS’s accountability, to reinforce the single patient record, and to improve the patient experience and patient safety landscape. We recognise that there is a lot of complexity within those simple propositions, and we will continue to listen to hon. Members. We want to ensure that the NHS is strengthened.

In relation to the ICBs and local authority voice, it was particularly significant over the summer to have heard from my right hon. Friend the Prime Minister about his commitment to rewiring the state and our ongoing reform to social care. With that in mind, I am pleased that amendments 60 to 62 will re-establish a requirement for ICBs to have at least one board member jointly nominated by local authorities in their area. That will sit alongside the existing duty to have a member nominated by the mayor of each mayoral strategic authority, as well as duties on ICBs and local government to work together, including on health and wellbeing boards. In Committee, we had a useful discussion about health and wellbeing boards, neighbourhoods and local accountability. I should also note that ICBs can appoint other people to their boards if they would benefit from their expertise. That is a decision to be taken locally.

Finally, let me briefly pre-empt the hon. Member for North Shropshire (Helen Morgan) by making a few comments about new clause 1. I thank her for the way she worked with me in Committee on the issue of a maternity commissioner—an issue that I think unites the House. As the hon. Member knows, we have accepted the recommendation from Baroness Amos’s national investigation into maternity and neonatal care. I can announce that, to deliver on this commitment, we will table an amendment to the Bill in the other place to establish a statutory maternity and neonatal commissioner. We are determined to get this right. For too long, too many women, babies and families have not received the care and support they deserve. The establishment of a commissioner represents a significant opportunity to strengthen accountability and champion their interests across the system. I hope that will give the hon. Member the reassurance she needs not to press her amendment.

--- Later in debate ---

[Layla Moran]

Let me start by taking up the theme of maternity, which has already been mentioned by a number of Members. I welcome the Government’s commitment to instating a maternity commissioner. I sit on the expert reference group—that is what we are called—that feeds into the maternity and neonatal taskforce, so I see how the Government are trying to pull all these different issues together. The Health and Social Care Committee has heard repeatedly, and across a number of inquiries, how important this issue is, and we need someone who is independent of Government and able to knit it all together.

Our Committee’s “Black Maternal Health” report heard how workforce shortages are undermining efforts to improve maternity care, data is lacking, and there is a culture in which women, particularly black women, are not listened to. Investment and training are needed to tackle that.

The “First 1000 Days” report found that the UK has some of the worst early years health outcomes in Europe, including in infant mortality, and we have called for proper targets for early years professionals in the long-lost workforce plan. As an aside, where is the workforce plan? I would love to see it. Locally, Oxford University hospitals provide maternity care for my residents, and indeed for my own family—baby took their first steps this weekend, finally! It was a momentous occasion.

I also reflect genuinely that there are people in my National Childbirth Trust class who did not have as good an experience as we did. They have been proactively contacted by the hospital to have an apology and an explanation given for their awful, traumatic birth, and they did not even complain. In part, that is a result of the CQC inspections and, more importantly, the inclusion by Baroness Amos of OUH and John Radcliffe hospital in her report.

I toured the hospital again this summer and heard specifically from trust leaders and midwives. They are doing everything they can to respond to all the criticisms being levelled at them by families, but they told me that there is only so much that they can do without a new building. Baroness Amos’s report said:

“The maternity and neonatal units sit across multiple floors… We saw delivery suites that didn’t have windows, that were cold, small and cramped and had pillars in the middle of them affecting where equipment could be placed”.

A large number of the suites did not have en suites. Can you imagine what it must be like to give birth in those rooms? As the Government knit together their action plan, I beg them not to forget investment, particularly capital investment, when they empower the commissioner to do their good work.

Let me move on to a few other amendments. I support the work to tackle health inequalities in new clauses 90 and 91. Our Committee hears over and over again that if we want to unlock productivity in the NHS, that is where we need to focus. I also support the campaign of my hon. Friend the Member for Newton Abbot (Martin Wrigley) and his cross-party new clause 34, which echoes the findings of my Committee. The Government really need to think again when it comes to Palantir and instead supercharge the capability of UK-based companies.

[Martin Wrigley (Newton Abbot) (LD)]

On that very point, does my hon. Friend agree that the recent NHS cost-benefit analysis showing that the Palantir project will cost £1.1 billion and deliver benefits of £800 million—a net loss of £300 million for the NHS—underlines the fact that we need to get rid of it now?

[Layla Moran]

I thank my hon. Friend for his intervention; he has been a doughty campaigner on this issue, as have other members of the Committee, including the hon. Member for Chelsea and Fulham (Ben Coleman). We also know that much of the data is based on the data being taken from Chelsea and Westminster hospital, and not much else across the country. We have a lot of questions about that contract, hence why we came to the same conclusion.

However, I primarily urge the Government please to consider new clause 85, in the name of the hon. Member for Thurrock (Jen Craft), which would impose duties on ICBs for delivering education, health and care plans. In my constituency we held a roundtable to provide evidence for our own hearing on this issue—by the way, this was based on a recommendation that came out of the Education Select Committee’s work on EHCPs, so we decided to take up the “H” bit. In that roundtable, I heard movingly from families who kept saying things like, “Everything is a battle.” One child, Stefan, suffers from multiple epiphyseal dysplasia, which affects his hips, and needs support to get around. He is very bright and desperately wants to learn. His mother was at that roundtable, and told me that, exceptionally and against school policy, he is allowed to keep a phone on him. There is no one whom the school can employ to make sure he can be wheeled from class to class, so instead what happens—and mother and school have done everything they possibly can—is that Stefan rings his mum so that she can come from home and deliver him to his next class. Ridiculously, this is the kind of thing that goes to tribunal, and then those tribunals cannot hold the ICBs to the same level of accountability as local authorities. The whole thing is nonsensical.

[Peter Swallow (Bracknell) (Lab)]

I agree with the point that the hon. Member is making. To add the voice of a member of the Education Select Committee, the Committee’s report equally found that we have to have a system where ICBs can be held to account for delivering on EHCPs.

[Layla Moran]

I am grateful to the hon. Member for his intervention, and for the work of that Committee. We are doing work together right now on children’s mental health, so I am sure we will continue to pursue this theme.

The point is that the impact was not just on that child; it was also on the mother, who could not work, and there was also the distress of having to battle the system. The mental health of both parents was affected. It does not need to be this way, and I genuinely believe that accountability is part of the answer. As such, my plea to the Government is simply to say that it is past time that the “H” part of EHCPs is put on a statutory footing, and I urge the House to support new clause 85.

[Danny Beales]

There is much to support in the Bill, and I support its ambition to enable many of the provisions of the welcome 10-year plan for the NHS. The plan is the right one; the three shifts are correct, and we have to fundamentally reform the health system if we are to meet the modern health and care challenges that we all see in our constituencies. To some extent those challenges are not new, and neither are these ambitions—we have seen similar initiatives before—but the systems, the structures, the bureaucracy and the siloed budgets push against change in the health sector. They have been a hinderance, reinforcing silos and making the same investment choices. They have prevented digitalisation, kept care in acute settings and stopped joined-up working. This Bill could and should be a key lever in overcoming those challenges, which we need to do if we are to achieve those ambitions.

I very much support the digital single patient record, which is a key ambition in the shift from analogue to digital health. We have all heard from patients who have to tell their story over and over again at every single health appointment—between care and health, between community and secondary care—so a genuine single patient record has the potential to be transformational. We have, however, heard from pharmacies and community mental health services that if this is to work, they have to have a seat at the table. While this Bill enables the architecture, I hope that the delivery will ensure that the whole of the health and care system is part of the decision-making process when the single patient record is designed. That is crucial.

Turning to the abolition of NHS England, the idea of streamlining bureaucracy at the centre is a good one, and delivering power—including decision-making power—budgets and resources locally is also admirable. Success, however, will mean the right decisions being taken at the right scale.

Health Bill

Layla Moran Excerpts

Report stage & 3rd reading
Tuesday 8th September 2026 Commons Chamber

[Dr Johnson]

As always, my right hon. Friend is absolutely right.

HSSIB has recently produced a report, which it would benefit the Government to listen to. The House will be aware that the advice and guidance service provides GPs with specialist advice, which sometimes avoids referrals. However, Ministers have made it mandatory to ask for advice before certain types of referrals, and set an aim for one in four referrals to be diverted back. The Government said that they were not rationing care or meddling with waiting lists—that there was nothing to see here, and that the Opposition were spreading misinformation—but HSSIB has published an interim report linking this process to delays in patient care, including cancer diagnoses. New clause 141 asks the Government to suspend the new process until they have properly considered it.

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

The hon. Lady may be aware that the Health and Social Care Committee has a pre-appointment hearing with the incoming chair of the CQC tomorrow morning. One question I would like to ask them hinges on the answer to another question, on which I would have loved an update from the Minister. The previous Secretary of State said that HSSIB will not be merged with the CQC until the CQC is ready, but we have never had a list from the Government as to exactly what metrics they will use to decide when that happens. That will have a bearing on what kinds of questions we ask the chair and CEO. What specifically do the Government mean by “ready”? Does the hon. Lady not see that as a problem?

[Dr Johnson]

I absolutely do. The Government have said that the CQC is not fit for purpose, yet they are now asking it to do things it did not do before, including not only HSSIB but event healthcare management, as the hon. Lady will be aware. It is absolutely right that the Government pause and think this one through again.

One of our other amendments concerns puberty blockers. One of the first rules of medicine is primum non nocere—first, do no harm—and yet here we have a Labour Government sponsoring a £10.6 million trial to put 226 physically healthy children as young as 11 on puberty-blocking drugs. That was said to make the former Secretary of State, the right hon. Member for Ealing North (James Murray), “uneasy”. Why was he uneasy? Perhaps because these are powerful drugs that could cause serious long-term harm, because most children get better by themselves, because we cannot reliably identify which children will persist with a trans identity and which will not, because the huge increase in girls experiencing gender dysphoria has not been adequately explained or because the Tavistock data has not yet been reviewed in the data linkage study. There are many reasons for concern, but I am aware that we are short of time.

It is difficult for a clinician to tell which children’s symptoms will self-resolve and which will not. As a result, we risk putting a large number of children on puberty blockers to assess the effects on, as the former Health Secretary put it, a

“very small subset of a very small group”.—[Official Report, 22 June 2026; Vol. 788, c. 56.]

That means the results of the investigation may be unreliable, and it could cause unnecessary harm to children, so why are the Government not ensuring that the data linkage study is, at the very least, done first?