World Suicide Prevention Day

Liz Twist Excerpts

Tuesday 8th September 2026 Westminster Hall

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

I beg to move,

That this House has considered World Suicide Prevention Day.

I am grateful for having secured this debate, Sir Christopher, and it is a pleasure to see you in the Chair for it. This Thursday is World Suicide Prevention Day, an event marked through the World Health Organisation. Each year, 10 September provides a moment for individuals, communities and Governments around the globe to unite behind one clear, unambiguous message: that suicides are preventable.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for securing this debate on World Suicide Prevention Day. The Farm Safety Foundation has surveyed some 450 farmers under the age of 40, of whom 92% identified poor mental health as one of the leading hidden problems facing farmers today. Those challenges can be further compounded by stigma and reluctance to seek help, which are particularly prevalent in rural communities. Is the hon. Lady aware of the challenges people in rural farming communities face when trying to access mental health support? Does she agree that more must be done for that sector, who seem overwhelmingly to suffer isolation?

[Liz Twist]

I am indeed aware of that work and of the difficulties faced by the farming community, and it is important that we address those. This year, as in the last two years, the theme for World Suicide Prevention Day is “Changing the Narrative on Suicide”, accompanied by a direct call to action to start the conversation.

[Lee Pitcher (Doncaster East and the Isle of Axholme) (Lab)]

I thank my hon. Friend for the amazing work that she continues to do day in, day out on this subject. I filmed a documentary last week called “Walking Men”—it will be out later this year—about how we support local groups to get men talking on a regular basis. Will she join me in saying thank you to all the people out there who do that? Does she agree that the Government need to get behind local groups, who know their area and their people and can make a massive difference?

[Liz Twist]

I am pleased to hear about that work, and I certainly agree that it is vital that we support all those who are making efforts locally to address the issue of suicide.

Changing the narrative means a conscious, collective shift away from the culture of silence, stigma and misunderstanding that has plagued this subject for generations. It requires us to move towards openness, empathy and genuine support, to create an environment where people feel able to speak openly about their distress without fear of judgment. We must reach a point at which talking about suicidal thoughts is met with compassion rather than fear and where seeking help is viewed as a sign of strength.

[Kim Johnson (Liverpool Riverside) (Lab)]

I thank my hon. Friend for this timely and important debate. The point about changing the narrative is very important. Will she support me in congratulating Alfie’s Squad, who are here today for World Suicide Prevention Day, and all the football clubs, including Everton and Liverpool, for the work they do in engaging with people with suicidal thoughts?

[Liz Twist]

I look forward to meeting Alfie’s Squad later today; they are doing a great job on suicide prevention in my hon. Friend’s area. I will come on to the Premier League shortly.

I turn to the global statistics. The World Health Organisation calls suicide a “major public health challenge” and estimates that it claims the lives of more than 720,000 people every year. In the UK, the latest Office for National Statistics figures show that in 2024 there were 7,147 deaths registered where the cause was recorded as suicide. We know from the data that men account for three in four of those deaths, and that suicide is the biggest single cause of death for men under the age of 50.

[Amanda Martin (Portsmouth North) (Lab)]

I thank my hon. Friend for securing this important debate and for her dedication and hard work in this space. As the chair of the all-party parliamentary group for tradespeople, and having previously served on the all-party parliamentary group on male suicide and mental health, I am concerned that the construction industry faces a suicide risk 3.7 times higher than the national average. Will she join me in ensuring that the men’s health strategy moves from paper to practical action in workplaces, particularly in the construction industry? When we talk about workers coming home safely, that must mean both physically and mentally.

[Liz Twist]

Having done some work with the construction sector, I know exactly what my hon. Friend is talking about and how much attention must be paid to that issue.

Sadly, my region, the north-east, has the highest number of deaths by suicide. That is not a league table that we want to top. The latest figures put the north-east’s rate at 15.1 deaths per 100,000 people. For men who have been referred to secondary mental health services, it climbs to 157.8 per 100,000. That harsh reality demands urgent, targeted intervention.

Whenever we see such statistics in Parliament, we must immediately remind ourselves that there are real people behind the numbers. Each one of those individuals whose life was cut short leaves behind a devastating legacy of grief. The ripple effect of a single suicide spreads relentlessly through families, circles of friends and workplaces, and inflicts severe social and emotional consequences on entire communities.

[Jessica Morden (Newport East) (Lab)]

Like everyone else, I acknowledge the tremendous work that my hon. Friend does on this issue; it is inspirational. Since she mentions families, I want to take the opportunity to thank my constituent Emma Webb, who tragically lost her daughter, Brodie, aged just 16. My hon. Friend is aware of Emma, who has spent years tirelessly fundraising for and raising awareness of suicide prevention. Alongside the bands doing a benefit for the Samaritans in the pub, there is a lot of work going on locally that we should acknowledge.

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[Liz Twist]

I know that campaign, and I met my hon. Friend’s constituent as she pulled her pony along to raise money. She is doing tremendous work in that area.

Alongside the immeasurable human cost of suicide, there is a stark economic reality. Extensive statistical work conducted by the Samaritans and provided by Mind calculates the economic cost of a single suicide as roughly £1.46 million. No one in this Chamber would ever wish to reduce a human life to an entry on the Treasury balance sheet, but that figure demonstrates that proper investment in suicide prevention is an economic necessity as well as a clear moral imperative.

[Sarah Olney (Richmond Park) (LD)]

Like everybody else, I thank the hon. Lady for her incredibly important work in this field. Alongside my constituent Philip Pirie, I have been calling on the Government to launch a public health campaign to tackle the stigma around suicide. Former Health Secretaries have actively supported the call, alongside the Royal College of Psychiatrists, the Royal College of General Practitioners and the hon. Lady herself. Does she agree that the Prime Minister needs to prioritise breaking down the barriers and the stigma, and work in a cross-party way with Members of this House to support my campaign?

[Liz Twist]

I will mention the hon. Lady’s constituent later; I am aware of the great work that he has done after the loss of his son by suicide. I agree that we all need to get behind that campaign, and I have no doubt that the Prime Minister will be keen to do that too.

The statistics paint a bleak picture, but I want to focus on the positive work being done across the UK on and around World Suicide Prevention Day to prevent suicide and change the narrative. There are so many organisations and individuals working to build hope and fighting to reverse these trends, offering real, practical help and support to people who are struggling.

When we look at our statutory services, we must recognise the vital role played by our national health service. I pay tribute to the extraordinary dedication of NHS mental health staff, who work under immense pressure every single day to provide compassionate, lifesaving care to those in crisis. But NHS talking therapies and other work can support only those who are successfully referred, and a significant gap remains among those accessing that care. For instance, despite having acute mental health needs, men account for only 36% of referrals to NHS talking therapies. That mismatch shows that, even with the outstanding commitment of frontline clinicians, statutory services cannot carry the weight of suicide prevention alone. They rely on close partnerships with community and voluntary organisations to reach people before they reach crisis.

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

I commend my hon. Friend for her courageous work on this issue, and for introducing the debate today. Will she join me in thanking those organisations in my constituency, including Scott Grover’s work with his Men Walking and Talking group and the fantastic work of Steve and Talk Club? Talk Club has a lovely approach where they sit, talk and listen. They will not just ask whether people are okay; they will say, “On a scale of one to 10, how are you feeling today?”, and that opens up conversations about mental health and suicide in such a powerful way. Will my hon. Friend join me in thanking all my fantastic local groups for their efforts?

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[Liz Twist]

I most certainly join my hon. Friend in thanking her local groups for that work. It is good to hear about so much attention being given to Men Walking and Talking in local groups where they can access help. I suppose we should mention Andy’s Man Club as well, which does amazing work across the country to get men talking.

[Mr Luke Charters (York Outer) (Lab)]

I thank my hon. Friend for all her work on this issue. I struggled with my own mental health after the traumatic birth of my son, as I think she knows. It was friends and family, including my hon. Friend the Member for Scarborough and Whitby (Alison Hume), who helped me, but in York we also have fantastic local groups like Menfulness, founded by Dr Jack Woodhams. Will she praise them and thank them for getting men to talk, whether through sport, football or walking?

[Liz Twist]

I thank my hon. Friend for sharing the struggles that he has had; by talking, we can learn more about them and tackle the issue. I certainly join him in thanking Menfulness. People are doing amazing work.

I want to talk about Samaritans. Samaritans began in 1953 in the city of London, founded by Chad Varah and arising from his experience of seeing lives lost to suicide—people who had no one to speak to. He advertised a telephone number that those contemplating suicide could call to speak to someone about how they were feeling. That work continues today, and is built on by the many outreach activities and the policy work led by Samaritans. I thank the many Samaritans volunteers who continue to listen and reach out in their local area to prevent suicides, including those in my local Tyneside Samaritans branch.

Tomorrow evening, Samaritans will mark World Suicide Prevention Day with a reception in Speaker’s House, held alongside the Premier League. The Premier League is doing excellent work in using the vast reach of football to support men, encouraging open conversations among groups who traditionally do not seek help. The charity Mind has a similar commitment, and it will be marking World Suicide Prevention Day in this House on Thursday morning. I am incredibly proud to sponsor its parliamentary reception this week, which will bring together campaigners, partners and clinicians to champion Mind’s vital work in our communities and to ensure that suicide prevention remains at the very top of our legislative agenda.

[Alison Hume (Scarborough and Whitby) (Lab)]

My hon. Friend is making an excellent speech. Autistic people are three times as likely as non-autistic people to die by suicide or attempt suicide. The 2023 suicide prevention strategy for England was the first to recognise autistic people as being at a higher risk of suicide. Does my hon. Friend agree that we need an update on progress for autistic people under the strategy, and on how the Government intend to incorporate autism into future suicide prevention strategies?

[Liz Twist]

I certainly agree with my hon. Friend’s concerns about the need for action on autism. She may be pleased to hear that the all-party groups on suicide and self-harm prevention and on autism will be doing joint work on the matter in the near future. I thank her for her intervention and am sure that the Minister has heard her request for an update.

I will now unashamedly name-check several organisations in the north-east, although I do so with some trepidation because there are so many other groups that I will not be able to mention. We benefit immensely from the presence of the James’ Place charity in Newcastle, which provides specialist, rapid clinical interventions for men in suicidal crisis. The way it operates in our region is saving lives.

I highlight the incredible work of If U Care Share, which is based in County Durham. Its roots are embedded in the local community, offering emotional support and postvention care. It was formed from personal experience, following the death by suicide of one of the family, a young man, which I know still affects the family and a much wider group of people, and is still a real impetus for their work and fundraising.

I also recognise the charity SoBS, Survivors of Bereavement by Suicide, which provides peer-led support to families who are navigating an uniquely complex and isolating form of grief.

[Sir Iain Duncan Smith (Chingford and Woodford Green) (Con)]

The hon. Lady is reading out a list of very good charities; I congratulate her on securing this debate. May I draw her attention to Ripple and Alice Hendy, to whom we at the Centre for Social Justice gave an award? Her “brown shield” technical device means that every time someone searches for a harmful site, something pops up to tell them where they can go for help and support. That has had a huge effect and needs to be rolled out further into schools and so on. I know that the hon. Lady knows that charity.

[Liz Twist]

The right hon. Gentleman touches on another angle, namely the world of the internet, which provides such a challenge. The work of Ripple is important in preventing that harm, but there is so much more to do. I congratulate Ripple on its award.

Jami UK is a Jewish mental health organisation with which I have done a good deal of work; given the subject of our previous debate today, it seems particularly appropriate to mention it. It does fantastic work in London and beyond, and is a regular contributor to the APPG.

Individuals have also transformed personal tragedy into relentless campaigning. We have already heard about Philip Pirie, who has worked on an assessment of suicide risk and is now pushing for training on it to be mandatory for NHS staff. The 3 Dads Walking campaign has captured the attention of the entire country. After losing their daughters Sophie, Beth and Emily to suicide, they marched together across the UK to demand that suicide prevention be taught in schools.

[Amanda Martin]

It is amazing that my hon. Friend is highlighting the fact that, so very often, out of tragedy come amazing families campaigning. I want to raise the case of Chloe Holland and Skye Nicholls. Their families have been campaigning because their family members took their own life following coercive control. Does my hon. Friend agree that we must recognise the devastating link between suicide and coercive control, and ensure not only justice, but proper recognition and response?

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[Liz Twist]

My hon. Friend makes a really important point. I congratulate those families—“congratulate” does not seem the right word, but they are doing such amazing work in her community and it is really important to mention. My hon. Friend will be pleased to hear that part of the work plan for the APPG relates to the link between suicide and domestic abuse in its various forms. I look forward to working with her on that issue.

I mentioned 3 Dads Walking, who do absolutely fantastic work. Changes are being made to the relationships, sex and health education curriculum this year to pick up on that work and ensure that children are able to discuss suicide in a safe and age-appropriate way.

Most working adults spend a large part of their day at work, so employers clearly have a role to play. Last year, the British Standards Institution published BS 30480, the first formal standard for workplace suicide prevention. I was pleased to work on it with the BSI alongside employers, trade unions and suicide prevention experts. That guidance has now been downloaded over 13,500 times.

However, despite the immense amount of work being done by charities, campaigners and so many others, we have not yet managed to change the narrative completely. I know that I risk sounding like a broken record in this House on the issue, but while the overall figures stubbornly refuse to come down, I will continue to be a broken record. We need to bring the numbers down. As the World Health Organisation says, changing the narrative needs systemic change. As the Mental Health Foundation has argued for years, we need early intervention so that people receive support before their situation becomes acute.

[Chris Bloore (Redditch) (Lab)]

I join other hon. Members in congratulating my hon. Friend on securing the debate and on her lifetime of support for this cause. She makes such a valid point about changing the narrative and the stigma around suicide. This Government have made an incredible announcement of £343 million for walk-in mental health services. We are asking people to talk about how they are feeling and about how bad their mental health is, but they need those walk-in centres so that they can get treatment at the point that they feel suicidal. Will my hon. Friend join me in calling on my local integrated care board to ensure that Redditch, which has the highest rate of poor mental health in Worcestershire, gets the mental health walk-in centre that it so deserves?

[Liz Twist]

I am not sure I know enough about my hon. Friend’s local area to tell his local ICB what to do, but I am sure he does, and I am sure he is making the case to his local ICB for walk-in centres in his area.

The new mental health hubs and emergency centres that were announced over the summer will be a vital step forward, as my hon. Friend says, in providing community-based support through capital funding. I hope that that will be followed by the revenue funding to provide the staff and resources to deliver consistent care, and I hope that the Minister can provide a bit more detail on the revenue question; I welcome her to her new post and am glad that she is here to answer the debate. The national suicide prevention strategy has just passed its halfway point, which makes this the ideal moment to assess what is working and where we need to do more. A great many actions have arisen from the strategy, which I commend, but sadly the numbers have not shifted.

For men, who make up 75% of those who die by suicide, how can we address their specific concerns? Can the Minister say what actions will be taken to revise the strategy so that it can achieve its goal of reducing suicides? Can she also say what she will do to ensure that mental health has parity of esteem with physical health, which was the subject of another Westminster Hall debate that I secured not long ago? Will she join me and other Members in thanking all the third sector organisations and individuals who do so much to change the narrative, and recognise their importance in preventing suicide? I hope that she will continue to work closely with me and the APPG to ensure that these strategies deliver the systemic change that we desperately need.

On World Suicide Prevention Day, we reflect on what we must do to make a real difference. We can achieve that by ending the silence, funding the services and treating mental health with the urgency that it demands. That is how we will finally change the narrative, and that is how we will save lives.

Health Bill

Liz Twist Excerpts

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

I have enjoyed working with the Minister here in the Chamber, in Committee and on a one-to-one basis, and I am sure that she has the best of intentions. I hope that she has listened to our genuine concerns about patient safety during the last two days, and will consider our amendments further in the other place. Otherwise, the Liberal Democrats will continue to fight for significant improvements for patient safety as the Bill progresses to the House of Lords.

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

I welcome the Bill, and was pleased to be a member of the Bill Committee. I also welcome the Government’s new clauses, about which the Minister has spoken today.

New clause 159, to which I have added my name, seeks to address a long-standing legislative omission in our health service. I thank my hon. Friend the Member for Sunderland Central (Lewis Atkinson) for tabling it. For over a decade since the Health and Social Care Act 2012, Parliament has recognised the principle of parity of esteem between physical and mental health, but without statutory accountability that parity has remained an aspiration rather than a clinical reality.

The scale of the problem is clear. NHS data shows that 1.87 million adults and more than 576,000 children and young people currently hold open referrals for mental health services. While the Government set clear targets to reduce physical healthcare waiting lists, mental health services are excluded from these core constitutional ambitions, and the division has severe consequences. A survey conducted by Rethink Mental Illness found that 83% of patients experienced a deterioration in their mental health while waiting for support, and that nearly a third of those whose health worsened attempted suicide.

New clause 159 would require the Secretary of State to publish national waiting time standards for mental health services within 12 months of the Bill passing into law. The fact is that what is measured is addressed, so we need to give the same attention to mental health that we rightly give to physical health measures. These standards, which cover both community and urgent care, must be developed in consultation with the chief medical officer. Crucially, the new clause mandates the Secretary of State to report performance against those waiting times, alongside mental health expenditure, to Parliament every year. That will ensure that the funding that we allocate in the House is linked transparently to patient outcomes. If we do not measure waiting times we cannot manage them, and patients will continue to be left until they are in crisis before they receive support. It is time that we started to pay the same attention to mental health as we do to physical health, so that we can really achieve parity of esteem.

The Government have set out a welcome and ambitious path to rebuild our NHS, and achieving true parity of esteem is central to that mission. I urge the Minister to look closely at new clause 159 as a constructive measure.

[Dame Caroline Dinenage (Gosport) (Con)]

I will speak about new clause 41, which stands in my name.

We put enormous, unquestioning trust in those who care for the bodies of our loved ones when they die. However, in this Chamber six months ago, I told a former Health Minister, the hon. Member for Glasgow South West (Dr Ahmed), about Elkin and Bell, the Gosport funeral directors who left 46 bodies decaying in an unrefrigerated room. One of them, an elderly gentleman whose family had already paid for his cremation, was left decomposing for 36 days. I said then that the funeral sector was nothing better than a lawless wild west with no mandatory qualifications to practise, no accreditation for professionals, no licensing of businesses, no inspection of premises, and no law to fall back on when things go wrong. It was only persistence and ingenuity on the part of Hampshire constabulary that saw Elkin and Bell brought to justice. The Minister at the time told me that a decision on regulation would come in the Government’s full answer to the Fuller inquiry, and we are still awaiting.

Since then, matters have worsened. In July, Robert Bush, a funeral director in Hull, was sentenced to 20 years in prison after pleading guilty to 67 charges for bodies left decomposing in squalor. Forty-six grieving families had been reunited with the wrong ashes, but the real horror is that these will not be isolated cases. Under the law as it stands today, almost anyone can set themselves up as a funeral director.

Health Bill (Seventeenth sitting)

Liz Twist Excerpts

Committee stage
Thursday 16th July 2026 Public Bill Committees

[Karin Smyth]

I think all Committee members can recognise the importance of this issue. An acquired brain injury is a life-changing event for those affected, and for their families and loved ones. Its treatment involves co-ordination between primary, community, secondary and specialist care, and is personalised to the needs and life circumstances of the individual. Its effects are not limited to a person’s health: it can impact their journey through education, their employment prospects and so many other aspects of life. Because of that, they rightly expect coherent, joined-up support from across Government.

Therefore, as we have discussed, we are working in partnership with eight other Government Departments, ABI charities, patient representatives and the NHS to develop an ABI action plan. We also continue to work closely with the United Kingdom Acquired Brain Injury Forum, which is the umbrella organisation for brain injury charities, as the plan develops and moves towards publication.

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

I am glad to hear that work is going on, but as the Minister may remember, work has been going on for a very long time—some Opposition Members may remember that past work. The issue is clearly important to people, so we need to see action—again, it is about how we get to that end. I would like to see some commitment from the Government. I recognise that the Minister is not in charge of the acquired brain injury strategy, but could she help us by referring the issue to the relevant Minister for an urgent discussion?

[Karin Smyth]

I thank my hon. Friend for her work on and commitment to this issue, as was highlighted by the shadow Minister. I thank her also for her work on the APPG and with organisations such as Headway, to which we pay tribute for its work supporting patients and the public, and for her work with Members of Parliament and the Government on getting this right, which is legion. My hon. Friend has made similar comments in the House. The Minister responsible is continuing to work on the action plan, which I will talk about as we continue our consideration.

The new clause raises the issues of prevention, identification, acute treatment, rehabilitation, long-term support, care planning, workforce capability, data and research, all of which are being considered in the work being done across the eight Departments. The Government agree that there should be a plan, and the relevant Minister, to whom I will of course pass my hon. Friend’s comments, will be working on that.

The question is whether the proposals in the new clause are best placed to ensure that any plan will be robust, sustainable and timely for the patients it is designed to serve. I say gently to the shadow Minister that I think they are not. First, setting an arbitrary 30-day timeline for publication risks causing either an unnecessary delay or a duplicate plan. Secondly, as I hope she will appreciate, we have engaged more widely than with just the three Departments named in the new clause. As I have said, as many as eight Departments are contributing, which reflects the wide range of areas that are impacted by brain injury.

Let me give the shadow Minister the assurance that I believe she is seeking, as are others: a plan will be published as soon as possible. That plan is being developed with the breadth, rigor and pace that the issue demands and is receiving input from across the health system, as well as from other Departments responsible for supporting people with acquired brain injuries and sector-specific stakeholders and organisations. I hope that she will work with us to support the plan once it is published, in the interests of our constituents, who desperately require a new approach to ABI prevention, care and support. I ask her to withdraw the new clause.

[Dr Johnson]

The Minister said that the plan is being developed with the pace that is needed, but it is not. It was due to have been published already, but it has not been. It was due to have been published, then a later promise was made, and now she is making another promise with an uncertain date. I just do not think it is good enough. A theme of our consideration this afternoon has been all the different things the Government have promised but have failed to deliver.

[Liz Twist]

I too want to see a strategy—a strong strategy—and I will continue to talk about that, but will the hon. Lady acknowledge that the strategy has been talked about since before the general election? We needed to see action then, as we need to see action now.

[Dr Johnson]

Yes, I accept that it has taken too long, and that is the point. I assume that it must be ready to go, because the Minister has been working on having it published by the end of June, and we are in the middle of July. The Minister can inform us whether that is the case. We have reached a point where the Government keep saying “later”, “soon”, “imminent”, “in due course” and “working at pace”, but that is not helping to get this done. The new clause would force the Government to get on with it. That is what I think needs to be done, and that is why I will press it to a vote.

Health Bill (Sixteenth sitting)

Liz Twist Excerpts

Committee stage
Thursday 16th July 2026 Public Bill Committees

[Karin Smyth]

I am grateful to the hon. Member for bringing another important disease to the attention of the Committee. I agree that modern service frameworks are important tools for improving patient care. They sit at the heart of our 10-year health plan, enabling a step change in both service quality and delivery. That is why we are prioritising making rapid progress on them. The first two MSFs, on sepsis and cardiovascular disease, will be published shortly, and a further four are in development. Given the momentum, it is clear that primary legislation is not needed to drive the development of MSFs; instead, we have established a robust, expert-led process.

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

I should declare that I am an officer of the all-party parliamentary group for respiratory health. Clearly, a modern service framework is important, certainly for a constituency such as mine in the north-east that has a lot of respiratory health problems, but as the Minister said, we need action rather than legislative change.

[Karin Smyth]

Like my hon. Friend’s constituency, my constituency of Bristol South has a large tobacco industry legacy, and it is crucial to address respiratory disease in a way that looks at the whole person.

Health Bill (Fourteenth sitting)

Liz Twist Excerpts

Committee stage
Thursday 9th July 2026 Public Bill Committees

[Gregory Stafford]

I respect immensely the hon. Gentleman’s experience. He described being a young doctor, but he is still a very young doctor/politician now. Of course, capacity is an essential part of this. He is a clinician, so I will not lecture him on this, but my suggestion would be that it is not about just capacity within hospitals. The Government’s shift is to try to get people out of hospitals and into community settings as much as possible, so it is capacity within the whole system that needs to be looked at. Going back and putting loads more beds into hospitals would not somehow solve this problem or create a healthcare system that is aligned with what the Government want, which is hopefully treating more people at home. On his general point, I accept that the more capacity there in the system as a whole, the more likely we are to solve some of the problem.

That neatly moves me on to my next point, which is about the whole-system approach to this. As hon. Members have mentioned, we have a potential problem with ambulances waiting in carparks, and unfortunately, trusts gamify the system when targets are put in place—they do not admit people through the door because it will hit their targets. As my right hon. Friend the Member for Melton and Syston mentioned, that has a knock-on effect for the people sitting in the ambulances and those who are potentially not receiving an ambulance because the capacity is not there. Likewise, at the other end of the system—though I suppose it is both ends of the system—social care needs to improve significantly. I am deeply disappointed that the Government have pushed another social care review that is probably not going to report until 2028, which is kicking the can down the road. I think it is essential that we get social care correct.

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

Some excellent points have been made about corridor care; I know that all of us want to see that improved. It is a serious issue for all of our residents, and the Minister and others will be working hard to do all they can to address it. May I gently point out the irony of colleagues on the official Opposition side raising all these issues now as if they have had a Damascene conversion, when they had 14 years to try and address them? I remember raising these issues in the House when my party was in Opposition. We are not undermining in any way the concerns about corridor care, because we all care deeply about it. [Interruption.]

[The Chair]

Order. Can we have less chuntering from a sedentary position?

[Liz Twist]

I just gently wanted to make that point.

[Gregory Stafford]

I am grateful to the hon. Member; she makes an interesting point. She talks about irony, and I respond in the same manner as that which she intervened on me with a gentle response, which is to ask why, if everything was going so swimmingly well, she and the rest of her colleagues got rid of the Prime Minister?

[Gregory Stafford]

My hon. Friend is absolutely right. The public do not want to hear about the last 14 years or the rhetoric around them.

[Liz Twist]

rose—

[Gregory Stafford]

I will give way to the hon. Lady after I finish my sentence, if I may. The public want to know what the solutions are. I think we could look back through history at successive Governments since prehistory and say, “They got some things right, and they got some things wrong.” What the public want to know now is what the current Government will do. 

On the point about social care, I was not a member of the last Government, but I stood on an election manifesto commitment, as the Labour party certainly did and I think most political parties did, that essentially said that the Dilnot review had decided how we were going to deal with social care, and we were going to get on with it. It strikes me as very strange that the last Secretary of State, the right hon. Member for Ilford North (Wes Streeting), decided to have another review; he has said himself in interviews since he resigned that it looks like the stalling on social care means that we will not get any movement on it before another general election. I do not think the public should put up with that.

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[Gregory Stafford]

I will do that. As I have already said, no party has necessarily covered itself in glory with this issue. It might have taken us four years to dump it; it took the Chancellor of the Exchequer less than two weeks.

[Liz Twist]

I want to touch on the point made by the hon. Member for Isle of Wight East in his intervention. We absolutely agree that the public are concerned with what we do for the future. We are talking about a specific Bill here. There is a huge concentration of effort in getting those figures down. We absolutely agree that people want to look to the future and whether this is the way to do it.

[Gregory Stafford]

I look forward to the new Prime Minister coming in and, I hope, providing a position where the hon. Member is able to achieve some of that. [Interruption.] I note for Hansard that that received acclamation across the Committee Room.

Getting back to the Bill, as you have suggested I do, Dr Huq—I take your suggestions very seriously—the social care element is extraordinarily important. It is important to ensure that people do not enter the secondary care system if at all possible, especially through attending A&E. When I worked on the Getting It Right First Time programme, our accident and emergency reports put forward some interesting methods that could potentially help with that. Some of that has been implemented and some has not, but I recommend all hon. Members look at that report, because it contains a number of interesting proposals.

This is not only about stopping people entering the system, but about ensuring that people come out of the system in a timely manner, freeing up the capacity we have just talked about. In my constituency, Haslemere hospital had 16 step-down inpatient rehabilitation beds. Unfortunately, last year, that service was “temporarily paused”—that is how it was described, but it has been over a year now, so it has essentially stopped. That service is not happening in my constituency, which is down to the fact that it was a GP-run service and the trust could no longer get a GP who was willing to run that service.

Haslemere hospital and the Royal Surrey NHS Foundation Trust that runs the hospital have some really fantastic ideas, very much in keeping with the Government’s push towards neighbourhood health, and I fully support those proposals, but it is a shame that we have had 16 beds sitting empty for more than a year, which could have been used for rehabilitation. We as a body politic should be looking at how we can improve and expand our step-down/step-up capacity, so that people do not have to go into acute settings.

I turn briefly to the specifics of new clause 12. I am concerned about subsections (3) and (4), which talk about a tribunal system. I do not quite understand how that would work. The way it is set out almost gives it an adversarial, inquiry-type, case-by-case element. It would include patients, bereaved or affected families, and frontline NHS staff. I can see how that kind of body might work if one was investigating a failure around a single patient or at a single trust, but I would be grateful if the hon. Member for North Shropshire could expand on how she sees the national report coming forward and then a group of people being selected to interrogate it. It is also not clear what would be the consequences of the interrogation, or otherwise, once it has happened.

Health Bill (Fifteenth sitting)

Liz Twist Excerpts

Committee stage
Thursday 9th July 2026 Public Bill Committees

[Sojan Joseph]

I absolutely agree, and I can give an example. Last week, as part of the ICB’s new independent neighbourhood health centre, one of the GP practices in my constituency started to proactively go and see all elderly patients. It is not just giving those patients appointments when they fall ill; it is proactively visiting them. We need that kind of support so that we can prevent illnesses and prevent people from needing to go to hospital.

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

Does my hon. Friend agree that, as well as the physical aspects of health and extending life expectancy, we need to look at preventive measures for mental health? That will ensure that people live as good and full a life as they can, and receive the treatment they need. Does my hon. Friend see that as integral to any public health strategy?

[Sojan Joseph]

My hon. Friend makes a sensible comment. I work closely with her on mental health, and she is absolutely right. Some of the policies the Government have introduced, such as giving children early access to mental health provision, will be absolutely vital to prevent them from becoming unwell later on. The Government are also rolling out a new mental health strategy focused on prevention, which will be important. We need to be more lean and productive, rather than creating more managers and committees.

--- Later in debate ---

[Karin Smyth]

I am grateful to hon. Members for bringing this discussion to the Committee. The Government are clearly committed to enabling people to live longer. It is one of the successes of recent years that, at the foundation of the health service, the average life expectancy was I think 60 or 62, while, now, it is in the early to mid-80s. That is a massive change in the last 80 years or so.

As well as improving the healthy life expectancy of the population, we are determined to address the stark inequalities that blight our nation’s health. We know that the most disadvantaged in society often face the biggest health challenges, and that the current model of care works least well for those who already experience disadvantage, who are also far more likely to have complex needs.

In fact, my own entry into working for the NHS, back in the 1990s, was on the back of the 1980 Black report, which some Members might remember well. The then Conservative Government sat on that for ages; it was such an awful reflection on the first 35 years of the health service, that health inequalities had not improved, that they sought not to publish it. That struck me as so shocking that it led me to want to pursue a life doing something about it.

I see that in my own constituency, where the legacy of the tobacco industry—which my hon. Friend the Member for Bury St Edmunds and Stowmarket mentioned—has led to a very high prevalence of smoking-related disease. In some parts of my constituency, that is up to 34%.

[Liz Twist]

I would point to examples such as in the north-east of England, where the work on smoking has been incredibly effective and still continues, and makes that real shift and change. Does my hon. Friend agree that it is those practical examples that we need to see, and to support along the way?

[Karin Smyth]

I thank my hon. Friend for that point about prevalence in the north-east. Often, the prevalence of these diseases is also to do with post-industrial work, which many people had to do without concern or knowledge about the effects on their health.

My hon. Friend the Member for Croydon East mentioned practical examples as well: the opening and building of things such as community diagnostic centres in places that are accessible and open to the public, and neighbourhood health. That is entirely the drive that we have: for services where people are, and where the greatest health need is, and not expecting people to travel.

In terms of smoking, one of the greatest legacies of the last Labour Government was of course the ban on indoor smoking. My mother was a barmaid for all her adult life; it is hard to imagine that people were just standing there at her place of work, blowing smoke at her while she was working. I tell my children, “Yes, we used to sit on aeroplanes with people smoking,” and that, unbelievably, some people smoked at the back of buses on the way back from school, and so on and so forth. It is really quite shocking.

The Tobacco and Vapes Act 2026, which we have also talked about in this Committee, is also a real testament to the work of this House, but didn’t it take a long time, Ms Lewell? I pay tribute to the right hon. Member for Richmond and Northallerton (Rishi Sunak) for pursuing that in the face of great adversity from his own party at the time. That was not, obviously, by the Members present, who all have a high concern about health, but perhaps by others on the Conservative Benches at the time, and then indeed in the Lords, who sought to thwart it—thwart is a strong word in this context; obviously, they made their points, but they sought to stop that Bill making progress at various stages.

Some of my colleagues were coming back at different times, saying that they were working on the Tobacco and Vapes Bill, and I said, “What, still? Really? Has it not come through yet?” That showed how hard it is, when something so well evidenced and so supported by public health experts, on something so detrimental to public health—particularly for people living in poorer communities, such as the one I represent in Bristol South—still takes such a time to get through.

--- Later in debate ---

[Karin Smyth]

My hon. Friend clearly highlights the advantages for his constituents and the importance, particularly for that university and universities across the country, of such outward-facing arrangements, which benefit constituencies in many ways, not only through employment, but through the pharmaceuticals and medical devices, and so on, that help all our constituents.

New clause 76 specifically references the trade arrangement between the United States and the United Kingdom. That landmark partnership with the United States Government on pharmaceuticals pricing and tariffs is in the best interest of UK patients, supporting the NHS and the economy. As a result of the changes to the UK’s medicines pricing, NHS patients will get improved access to lifesaving treatments. New medicines have already been recommended under the updated approach, including a brain cancer drug available to patients as young as 12 and a last-resort treatment for a rare, aggressive stomach cancer—something that I think the entire House and the Committee would support.

[Liz Twist]

I want to emphasise a point that has already been made, which is the positive impact of the agreement for people with rare and undiagnosed conditions. As the Minister will know, I have worked with a number of those organisations, and this is certainly an opportunity for innovative treatments to be funded, as they might not have been before. I thank the Minister for that.

[Karin Smyth]

Again, this is an area of work that my hon. Friend has led on for many years, as I have seen, often when many others have not been around to support it. With so many organisations and charities lobbying on behalf of so many people who are desperate for rare diseases in particular to be highlighted—those diseases that affect a small number of people, many of them children—that work is crucial. Her work in leading in this place is exemplary. That is exactly where we aim to get by working with our partners in difficult circumstances. Trade deals and negotiations are necessarily difficult—otherwise, they would be easy—but the hard work yields results for people. As I have said, this Government have taken an outward approach to working with our partners and with industry.

We have already taken steps towards achieving our commitments, most notably increasing the NICE cost-effectiveness threshold. The Government previously updated Parliament in two ministerial statements, and of course MPs quite rightly have the option to continue to table parliamentary questions. Officials should be able to produce confidential advice for Ministers, to inform trade or other negotiations, and we must maintain that confidentiality in this case, as the impact assessment contains commercially sensitive assumptions. It is scenario-based and remains linked to live policy development. On that basis, I ask the hon. Member for Winchester to withdraw the new clause.

--- Later in debate ---

One of the most significant wins we have had since I was elected was keeping Chesil Lodge day centre open, which is an adult daycare centre that Hampshire county council was trying to close. We had dozens of people who were carers coming forward saying that if that centre shut, they would struggle to continue in their caring role without respite care. We are very pleased that it has been kept open, and carers have expressed their gratitude. They can now carry on caring for their loved ones thanks to regular respite care once a week, which they say is completely life changing.

[Liz Twist]

It is a pleasure to serve with you in the Chair, Ms Lewell. I listened with great interest to the hon. Member for Winchester talking about the new clauses; they have a great deal of similarity to new clause 89, in the name of my hon. Friend the Member for Shipley (Anna Dixon). We all know that it is absolutely vital to look after our carers. They do a huge amount of work to support us and make sure that people are kept at home and cared for.

New clause 89 covers a number of issues, and would create a duty on health bodies to provide information and advice to unpaid carers and task the Secretary of State with providing that service. It would ask first for information about medicine and medicine records, which we talked about a few days ago. Beyond that, it asks for information about services and support available from the NHS to help in their role as carers, and about support for their own needs and health, which are hugely important. It also asks for information about the support available to them and how to get more advice in their role.

I will not go over all the arguments again, but we heard about Carers UK’s “State of Caring” survey in 2025. Some 29% of carers say that they need more information and advice about caring, such as support with clinical tasks or managing someone’s condition. Many of them provide support with medication and administering it. Many also monitor blood pressure or sugar level, dress wounds and use equipment. In all these new clauses about carers, the discussion is about how we can best support carers in that role. They have a vital role, and I know that the Government recognise the important contribution they make to healthcare, so it is important that we consider the issue here.

--- Later in debate ---

[Karin Smyth]

When the hon. Lady gets back to her constituency, I am sure she will be campaigning heavily on behalf of her constituents.

We acknowledge the need to support carers’ health and wellbeing, but we do not think new clause 16 is necessary, because the existing legal framework already requires the system to support them. The new clause duplicates existing duties and risks adding complexity, rather than improving support in practice. Carers are explicitly referenced in the NHS constitution, which establishes the principles and values of the NHS in England and sets out the aim of improving the health and wellbeing of the population. The Secretary of State for Health, all NHS bodies, private and voluntary sector providers supplying NHS services, and local authorities in the exercise of their public health functions are required by law to take account of the constitution in their decisions and actions. Local authorities and NHS bodies also have a duty of co-operation in respect of their functions relating to carers.

Finally, under the Bill, the Secretary of State will take on NHS England’s role in promoting the involvement of each patient in decisions relating to their illness, care or treatment. That duty includes the involvement of carers and representatives.

[Liz Twist]

As the Minister says, many people in this room have had experience of being a carer for a family member. She said that there is already a legal framework, but carers are clearly saying that they need a bit more. How will the Government ensure that we provide not just words and legal documents, but help on the ground?

[Karin Smyth]

I was just moving on to talk about some of the work beyond the legislative framework.

Beyond the legislative framework, our focus is on delivering practical improvements because, as my hon. Friend says, that is absolutely what people want. We are committed to ensuring that carers have the support they need. Through measures in the 10-year health plan, we are already equipping and supporting carers by making them more visible, empowering their voices in care planning, joining up services and streamlining their care tasks by introducing a new My Carer section on the NHS app. We are also working with Ministers from the Department for Work and Pensions, the Department for Business and Trade and the Department for Education to consider how best to recognise and support unpaid carers. The Government are preparing a cross-Government action plan for unpaid carers, to be published this year.

--- Later in debate ---

[Karin Smyth]

I thank my hon. Friend for his description of what has happened in Kent, which has been under Conservative administration for so long. He is absolutely right about the White Paper. The hard work that my right hon. Friend the Secretary of State and the ministerial team have done across the country, regardless of the local political administration, is exemplary. I will come on to talk about the tribunals.

The Government’s SEND reforms aim to transform outcomes for children and young people with SEND and their families, ensuring that the right support is available at the right time and preventing needs from escalating or reaching crisis in the first place. That is why the reforms aim to build a system that parents can trust with collective responsibility in local areas and strong partnership working across education, health and care. That is what parents expect us to be doing.

[Liz Twist]

I recently held consultation meetings on the proposed SEND reforms in Blaydon and Consett. The message from parents was clear in both places: they wanted greater integration of health into EHCPs. I welcome the Government’s commitment to asking ICBs to work more closely with local authorities to develop SEND reform plans and tackle this issue. Does the Minister agree that it is important for ICBs to take that on board?

[Karin Smyth]

I thank my hon. Friend for going to hear directly from her constituents. She is right: that message is fairly consistent. Last year, my hon. Friend the Member for Bristol East (Kerry McCarthy), my right hon. Friend the Member for Bristol North West (Darren Jones) and I played a pivotal role in bringing our ICB and local authorities together as local Members of Parliament. That was a result of our experience with parents and constituents. Members of Parliament from across the House—this is not a party political point—can bring parents together to highlight this issue and use parliamentary power to bring together organisations that sometimes do not listen or know the best way to communicate. Our role in that has been pivotal. The Secretary of State for Education has taken that learning forward across the country.

That is why we are taking the steps to deliver the programme. ICBs have been asked to work with local authorities to develop local SEND reform plans. Those plans will lay the foundation for long-term reform, enabling ongoing monitoring of progress, and draw on knowledge, skills and lived experience held locally. That builds on work that is under way to improve accountability and set expectations of joint working, which is what parents and families expected to happen, but was not happening. Each ICB is expected to have an executive lead on SEND. The NHS medium-term planning framework for the next three years made it clear that ICBs and providers must meet their statutory duties and support delivery of the reforms.

Ofsted and the Care Quality Commission will continue to check how local services, including health, work together for children and young people and hold them accountable. We will also update the SEND code of practice and publish new guidance so that local SEND partnerships have clearer expectations to work to. That is why we have not proposed changes to health and social care appeals to the SEND tribunal or made the decisions binding. This reflects the need for ICBs and NHS providers to retain the flexibility to plan services across their wider populations and prioritise support according to clinical and population need. This aligns with our commitment in the 10-year health plan to create a new NHS operating model where ICBs are the strategic commissioners of local healthcare services. It is worth noting that while tribunal decisions on health and care are non-binding, local authorities and ICBs are expected to follow them, and in most cases do. If they do not follow recommendations, they must send a response setting out the next steps they have decided to take and why.

There is no doubt that health and social care have crucial roles in SEND reforms, with shared ambitions across education, health and care for earlier intervention and support. I reassure the Committee that we are exploring further opportunities to strengthen accountability, as stated in the SEND consultation document. We are considering responses to the consultation, which closed on 18 May, and will set out our next steps in due course. For those reasons, I ask the hon. Member for Winchester to withdraw the new clause.

Health Bill (Thirteenth sitting)

Liz Twist Excerpts

Tuesday 7th July 2026 Public Bill Committees

[Karin Smyth]

I think that the record will show that I have taken several interventions in recent days, and I will continue to do so. I have been very clear that we have some fundamental disagreements on philosophy and approach. I will desperately try not to veer into the next groups, but it may be tricky. I am sure that you will steer me through, Ms Lewell.

I want to pick up on some good, helpful points that have been made. I pay particular tribute to my hon. Friend the Member for Lichfield for the comments he made. I appreciate that certain areas, particularly Mid Staffs, have elicited a lot of debate and concern. I commend him for following that through on behalf of his constituency. I know that other Members in Staffordshire want to understand how the Government’s future plans will address their very real concerns. That is also true of other areas that have experienced shocking scandals, as we call them. I take that very seriously.

I will pick up on the question of independence that we veered into before, which was mentioned by the hon. Member for Sleaford and North Hykeham. She highlighted her concerns and the issues raised by my right hon. Friend the Member for Makerfield, and I heard what she said. Independence was also raised by the hon. Member for Winchester and my hon. Friend the Member for Lichfield. We therefore return to that point about independence and, as my hon. Friend said, about being in the room, making those decisions and changing the entire culture of the organisation to do something different.

The question is then whether bringing the functions of Healthwatch to the national level is the right method. Again, I commend work on that and the individuals involved in it. Hon. Members mentioned Jacob Lant of National Voices and the King’s Fund, which have worked with us very well to challenge us and try to make this legislation better. I really appreciate their work, and we will continue to talk with them.

The hon. Member for Farnham and Bordon mentioned GIRFT. I cannot help but respond to his point, because he suggested that being inside NHS England has somehow made it less effective, and I could not disagree with him more. It is not because he has left and is here; his presence is obviously missed at GIRFT and welcomed here. To be serious, every meeting I have with NHS England and everything we are attempting to do in reforming outcomes for patients on the ground involves GIRFT. It is now at the very heart of what NHS England does. By coming inside the organisation, it has done exactly some of the things we want to do: drive cultural difference and change inside the organisation, rather than being outside of it. As I said before, this is a slightly philosophical argument and political argument. I appreciate that there are views on either side, but that is absolutely our intention.

On the patient experience directorate, we recognise that public trust will be crucial. We need to ensure that there is system learning across the piece. The patient experience directorate has to earn the trust of the public and parliamentarians, so we will design it to operate transparently and sit at the centre of decision making rather than at its margins. Ministers will be accountable for and answerable to Parliament on the work of the patient experience directorate. It has to focus on the voices that are too often overlooked. The central priority of the directorate will be to reach under-represented and seldom heard groups and to ensure that engagement is accessible, inclusive and proactive, so that the experiences of vulnerable people help inform and shape the decisions that affect their lives.

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

I was flattered to hear my comments on Second Reading quoted by the hon. Member for Sleaford and North Hykeham, but I think she has misunderstood me. My question to the Minister was and still is about how we maintain within the new arrangements the ability to speak up on behalf of others. Could the Minister comment on that?

[Karin Smyth]

I thank my hon. Friend for making the intention of her comments clear to the Committee. It is right that we need to build trust in patient voice and experience. We will pick up on that in our debate on local healthwatch branches, because that is perhaps where Members of Parliament are particularly important.

At a national level, there are many voices and organisations continuing to review the issue and challenge the Government, including through reports, meetings with Ministers and in Parliament, highlighting the good work that they do and numerous Committees. Health Ministers appear before the Public Accounts Committee, the Health and Social Care Committee and Lords Committees; I have appeared before the Science, Innovation and Technology Committee. That is an important way of ensuring that the Department and the new experience directorate will be accountable.

I recognise the important contribution that Healthwatch has made in capturing patient insight and informing the design and delivery of services, but we do not believe that new clause 78 is necessary. It is inconsistent with the purpose of the Bill. I am aware of the views of the hon. Member for North Shropshire, but the Government’s policy is to abolish Healthwatch and ensure that patient and public voice is more directly connected to decision making. It would therefore not be appropriate or consistent to legislate for a specific funding level for organisations that would no longer exist, or to constrain how funding is deployed to support the new arrangements.

Health Bill (Thirteenth sitting)

Liz Twist Excerpts

Committee stage
Tuesday 7th July 2026 Public Bill Committees

[Karin Smyth]

I think that the record will show that I have taken several interventions in recent days, and I will continue to do so. I have been very clear that we have some fundamental disagreements on philosophy and approach. I will desperately try not to veer into the next groups, but it may be tricky. I am sure that you will steer me through, Ms Lewell.

I want to pick up on some good, helpful points that have been made. I pay particular tribute to my hon. Friend the Member for Lichfield for the comments he made. I appreciate that certain areas, particularly Mid Staffs, have elicited a lot of debate and concern. I commend him for following that through on behalf of his constituency. I know that other Members in Staffordshire want to understand how the Government’s future plans will address their very real concerns. That is also true of other areas that have experienced shocking scandals, as we call them. I take that very seriously.

I will pick up on the question of independence that we veered into before, which was mentioned by the hon. Member for Sleaford and North Hykeham. She highlighted her concerns and the issues raised by my right hon. Friend the Member for Makerfield, and I heard what she said. Independence was also raised by the hon. Member for Winchester and my hon. Friend the Member for Lichfield. We therefore return to that point about independence and, as my hon. Friend said, about being in the room, making those decisions and changing the entire culture of the organisation to do something different.

The question is then whether bringing the functions of Healthwatch to the national level is the right method. Again, I commend work on that and the individuals involved in it. Hon. Members mentioned Jacob Lant of National Voices and the King’s Fund, which have worked with us very well to challenge us and try to make this legislation better. I really appreciate their work, and we will continue to talk with them.

The hon. Member for Farnham and Bordon mentioned GIRFT. I cannot help but respond to his point, because he suggested that being inside NHS England has somehow made it less effective, and I could not disagree with him more. It is not because he has left and is here; his presence is obviously missed at GIRFT and welcomed here. To be serious, every meeting I have with NHS England and everything we are attempting to do in reforming outcomes for patients on the ground involves GIRFT. It is now at the very heart of what NHS England does. By coming inside the organisation, it has done exactly some of the things we want to do: drive cultural difference and change inside the organisation, rather than being outside of it. As I said before, this is a slightly philosophical argument and political argument. I appreciate that there are views on either side, but that is absolutely our intention.

On the patient experience directorate, we recognise that public trust will be crucial. We need to ensure that there is system learning across the piece. The patient experience directorate has to earn the trust of the public and parliamentarians, so we will design it to operate transparently and sit at the centre of decision making rather than at its margins. Ministers will be accountable for and answerable to Parliament on the work of the patient experience directorate. It has to focus on the voices that are too often overlooked. The central priority of the directorate will be to reach under-represented and seldom heard groups and to ensure that engagement is accessible, inclusive and proactive, so that the experiences of vulnerable people help inform and shape the decisions that affect their lives.

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

I was flattered to hear my comments on Second Reading quoted by the hon. Member for Sleaford and North Hykeham, but I think she has misunderstood me. My question to the Minister was and still is about how we maintain within the new arrangements the ability to speak up on behalf of others. Could the Minister comment on that?

[Karin Smyth]

I thank my hon. Friend for making the intention of her comments clear to the Committee. It is right that we need to build trust in patient voice and experience. We will pick up on that in our debate on local healthwatch branches, because that is perhaps where Members of Parliament are particularly important.

At a national level, there are many voices and organisations continuing to review the issue and challenge the Government, including through reports, meetings with Ministers and in Parliament, highlighting the good work that they do and numerous Committees. Health Ministers appear before the Public Accounts Committee, the Health and Social Care Committee and Lords Committees; I have appeared before the Science, Innovation and Technology Committee. That is an important way of ensuring that the Department and the new experience directorate will be accountable.

I recognise the important contribution that Healthwatch has made in capturing patient insight and informing the design and delivery of services, but we do not believe that new clause 78 is necessary. It is inconsistent with the purpose of the Bill. I am aware of the views of the hon. Member for North Shropshire, but the Government’s policy is to abolish Healthwatch and ensure that patient and public voice is more directly connected to decision making. It would therefore not be appropriate or consistent to legislate for a specific funding level for organisations that would no longer exist, or to constrain how funding is deployed to support the new arrangements.

Health Bill (Tenth sitting)

Liz Twist Excerpts

Committee stage
Thursday 2nd July 2026 Public Bill Committees

[Karin Smyth]

I am grateful to the hon. Member for Winchester for bringing this discussion to the Committee. I will turn to amendments 9 and 10 along with new clause 27, which address similar points. These amendments would require integrated care boards to increase their spending on mental health services at least in line with their growth in their total programme funding. Amendment 10 would enable the Secretary of State to implement financial penalties for non-compliance, and new clause 27 would also place the mental health investment standard, or MHIS, on a statutory footing by requiring the Secretary of State to specify an annual increase in the proportion of mental health expenditure for each integrated care board and require integrated care boards to meet that level of expenditure.

I want to be really clear with the Committee: mental health remains a priority for this Government, and the Government are already making record investments in mental health services. Spending on mental health continues to increase in real terms and is forecast to reach a record £16.1 billion in 2026-27. That represents a real-terms increase of around £140 million, compared with 2025-26 and around £900 million of real-terms growth since 2023-24.

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

The Minister has pointed to some improvements. She will know there is real concern about parity of esteem between mental and physical health, including the ways that we measure them. The Government have already done a great deal, but would the Minister say how we can ensure that parity of esteem between mental and physical health is achieved using the powers in clause 43?

[Karin Smyth]

I thank my hon. Friend for that and for her work on this issue. She is absolutely right: parity of esteem is critical, and we are committed to a spending increase to deliver it. I will come on to some of the points that she quite rightly made.

Although I do not think he was speaking on behalf of the Select Committee, the hon. Member for Farnham and Bordon took us through some of the concerns of his Select Committee. The Government have put a formal standard and a financial safeguard in place through the mental health investment standard, and as set out in NHS England’s medium-term planning framework, we expect all integrated care boards to meet the standard over the next three years, and all are currently forecast to do so. For this period—2026-27 to 2028-29—the standard has been set on real funding growth, meaning that funding is expected at least to keep pace with inflation.

Meeting the mental health investment standard remains essential to delivering the Government’s ambitions on mental health, including achieving full national coverage of mental health support teams in schools and colleges by 2029, and expanding access to NHS talking therapies. The Government’s approach is to maintain strong protections for mental health investment, while giving local systems the flexibility to focus on outcomes and deliver services that meet the needs of their communities, which, as we have heard this morning, are very different. However, workforce increases and funding alone will not deliver the improvements the public and patients rightly expect in mental health care and support.

Demand for mental health support has risen rapidly, as we all know from our constituencies, with long waits and too many people unable to access the right support when they need it. We need a new approach that reduces waiting times, improves care quality and promotes early intervention and prevention in mental health. That is why we are developing a new cross-Government mental health strategy for England that will transform mental health care into a system that responds and intervenes earlier, reduces waiting times for support and ultimately supports people to participate fully in education, work and community life.

[Liz Twist]

I wonder whether, as part of that strategy, the Government will look at waiting times for mental health services, as we have heard of the considerable delays. That issue is important to everyone, but especially young people. Will the Government look at that issue and get waiting lists down?

[Karin Smyth]

Again, my hon. Friend makes an important point. Of course, the rising demand and the ways that waiting lists are managed and supported locally will have to be a critical part of any strategy. Also, as we have said in our elective reform plan, giving people information so that they can understand what is happening in their local systems is part of the wider patient experience work that we are going to do.

The Government are committed to prioritising the delivery of mental health services. That is why we have a standard already ensuring that mental health spending keeps pace in real terms, while allowing systems discretion to make additional investment in the way that best meets local needs. The amendments would place an inflexible financial requirement in statute. A more effective and overarching approach will be delivered through our cross-Government strategy. For those reasons, a further statutory duty is unnecessary and I ask the hon. Member for Winchester to withdraw the amendment.

Health Bill (Eleventh sitting)

Liz Twist Excerpts

Committee stage
Thursday 2nd July 2026 Public Bill Committees

[Gregory Stafford]

Precisely. These questions need to be thought about when the Government are creating this system.

As hon. Members have described in their speeches and in their amendments, the system could contain much wider information, including highly sensitive information about disability, safeguarding, care assessments, addiction, pregnancy, military service, caring responsibilities and many other personal matters. This is not simply about a hospital record; it is about bringing together health and social care information. That makes it even more important—indeed, essential—that safeguards be clear and robust.

That leads me on to my fourth issue, which is confidentiality. The Bill says that where information is processed under the regulations, doing so will not breach any duty of confidence. I think that that is a significant legal challenge and change. Confidentiality has been one of the foundations of healthcare. Of course there are already situations in which information can and should be shared, but where Parliament is creating a new legal basis for disclosure, it is reasonable to expect strong safeguards alongside it.

That brings me to my next concern. The Bill says that the Secretary of State must have regard to the need for “adequate safeguards”. That is welcome, of course, but the Bill does not say what those safeguards are. There is nothing in it about role-based access controls, audit logs or whether patients would be able to see who had looked at their records. There is nothing about minimum cyber-security standards, about how inappropriate access will be detected or about independent oversight. Those matters may appear later in regulations or in guidance, but they are not guaranteed in the Bill.

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

I thank the hon. Member for his clear summary, at the start of his speech, about what we are discussing, which is the regulations. He and other Members have rightly pointed out many issues that need to be resolved, but does he agree that the proper way to work through this very detailed and very real concern is through the regulations, which will come with expert advice and ensure that we cover all these points properly?