Health Bill

Martin Wrigley Excerpts

Report stage
Monday 7th September 2026 Commons Chamber

[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.

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[Dr Simon Opher (Stroud) (Lab)]

My remarks will focus mainly on new clause 69, which is in my name. Getting rid of NHS England is one of the best things that this Government have done. As working clinicians, we can at least now get away from so much admin and management.

My amendment is a simple one about self-care and health literacy. Demand for healthcare has increased enormously. Since 2019, for example, GP consultations in Stroud have gone up 30%. When I started work as a GP, patients saw me on average three times a year; it is now about eight times a year. Indeed, A&E attendance has gone up 20% over the last decade, yet the health of the nation remains the same. This is the demand side of the NHS that we very rarely discuss, and this is what I am asking the Secretary of State to address.

Let me turn to the causes of this increase in demand. There is a concept in medicine called the symptom iceberg. Most of us get symptoms every day, but we do not go to the doctor. We only go to the doctor when we have certain symptoms, and it is a very small number of symptoms, but that has increased over the last 20 years. Then there is the role of something that we call lay referrals; people used to have mums who lived next door, but now they are often much further away. We are socially isolated in an atomised society. We also have a much higher expectation for our health. We cannot fault that, but it means that, for example, people go to the doctor with very minor things. There are also factors such as AI. In my surgery, we use AI, but I believe that creates its own demands. There is also good old Dr Google, who in this country is consulted over 50 million times every year—and those who go to Dr Google usually end up thinking that they have cancer or need an ambulance, so that is clearly driving demand.

There are also doctor factors. If we carry on treating sore throats with antibiotics, people will carry on coming back. Earaches generally get better, and people do not usually need to see a doctor for headaches. We are over-diagnosing and over-medicalising everything. NHS factors includes the algorithms for 111 and litigation. I would also like to talk about health literacy. That means knowing about our health, and understanding that we are not always in totally good health, but we do not have to consult the health service just because we are feeling a little bit low or a little bit tired.

One of my colleagues in Stroud, Dr Hugh van’t Hoff, started Facts4Life, a school-based education service that goes into schools. In the last 10 years, he has worked with over 200 primary schools. He has shown that if we teach young children about health and how it is normal sometimes to feel tired or have a sore throat—stuff like that—we can reduce consultations in the NHS. We can also teach children how to understand information on the internet, so that when they look at statistics, they know what they mean, instead of thinking, “Ooh, my risk of cancer has been doubled by doing this.” That is really important.

We are also over-medicalising patients. In this country, 9 million patients in England alone—one in five adults—are on antidepressants. That is a scandal.

[Martin Wrigley]

On interpreting statistics, does the hon. Gentleman agree that when it comes to data, GP confidentiality—in respect of the Palantir federated data platform, for example—is critical, certainly when we come to the single patient record, and that the Bill should not reduce confidentiality or data privacy to achieve the single patient record?

[Dr Opher]

I thank the hon. Member for that comment. He is right. NHS and GP data is a massive resource for our scientists in this country, and I agree with him that it should be owned by the UK. It should be a sovereign wealth issue. I would like to ensure that we realise that over time.

I will return to over-medicalisation. I would like to try to divert patients with mild to moderate mental health symptoms to social prescribing, such as access to nature, arts and culture and exercise—and indeed comedy. Let us try to reduce that figure of 9 million on antidepressants, so that people do not have to come back for review. There would be fewer harms, such as suicide, in the first couple of weeks. Let us also look again at neurodivergence, and try to look for a way of not medicalising so many children with the condition.

If we are serious about reducing waiting lists and making the NHS sustainable for the future, we cannot focus only on supply; we must address rising demand, too. Giving people the knowledge and confidence to look after their own health will empower them, free up clinicians to care for those who need them most, and ultimately build a healthier population. That is what new clause 69 seeks to achieve. I urge the Government to accept it.

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

I rise to speak to my new clause 108, because the public rightly expect any company entrusted to operate within our national health service to meet basic standards of ethical conduct, both inside and outside the NHS. In my experience as parliamentary lead on the Hillsborough law, I regularly met members of the public who were shocked that a duty of candour that would compel public officials to tell the truth to the people they served did not already exist. I believe that many of my constituents will be equally shocked that the basic principles of ethical accountability are not already enshrined in Government procurement policy, but they are not.

New clause 108 is not radical. It is a straightforward safeguard requiring the Secretary of State to review the NHS procurement framework and ensure that companies with proven involvement in violations of international law or breaches of internationally accepted standards of business conduct cannot be offered public contracts. Those standards include the UN guiding principles on business and human rights and the OECD guidelines on multinational enterprises. What exactly is there to disagree with? They ask the bare minimum of businesses: that do not contribute to harm, that they carry out proper human rights due diligence and that are transparent about how they handle the data of the people they serve. Yet we currently have a company operating at the heart of our NHS infrastructure, through the federated data platform, that fails to meet that basic standard. I am talking about the US tech firm Palantir.

Palantir has consistently refused to publish a formal human rights impact assessment for its software used in Israel’s assault on Gaza, in violent ICE detentions in America, and in its use of NHS staff and patient data. Such a lack of transparency is not a technicality but a serious failure to meet the standards in the UN and OECD guidelines. I first raised concerns about Palantir’s NHS contract in a letter to the then health Secretary in August 2023, and these concerns have been echoed by many, many others. I am pleased that Parliament has started to push back, with calls from numerous Committees for Palantir to be dropped.

I also fully support new clause 34, tabled by the hon. Member for Newton Abbot (Martin Wrigley). Patients trust the NHS with the most sensitive information they possess.

[Martin Wrigley]

Does the hon. Member agree that it is a fundamental principle of anything like the SPR that it must have privacy by design at the centre of it, and that therefore a firm such as Palantir—which has a US, slightly cavalier and somewhat casual attitude to how data privacy should be controlled—should not be allowed anywhere near it?

[Ian Byrne]

I fully agree; I have signed the hon. Gentleman’s amendments and we have been in many Committees speaking on this issue.

New clause 108 provides a proportionate and evidence-based mechanism to address this issue. The new clause does not name or target any individual company. It would establish a clear and principled test, rooted in international law and internationally accepted standards, that every contractor must meet. If a company such as Palantir cannot meet that test, it should never hold contracts in our NHS or with Government Departments. I have repeatedly urged the Government to trigger the 2027 break clause in Palantir’s contract to operate the federated data platform. I make that call again tonight.

It is only through a measure such as new clause 108 that we can ensure that companies such as Palantir cannot operate in our public services again. It should be accepted, but the principle behind it should not end with the NHS. It should apply across every Government Department, led by the Cabinet Office. The Cabinet Office’s report on social value and procurement, published last month, was welcome, but it contained a glaring omission: a clear ethical foundation. My clause would provide that crucial and much-needed safeguard, ensuring a legislative framework that prevents companies with records like Palantir’s from securing public contracts in the future.

Last week, I visited the Vatican and spoke with officials about how the United Kingdom could lead the world in the ethical use of artificial intelligence and advanced technologies. Tonight, my Government have a real opportunity to put a marker down and demonstrate that Britain intends to be at the forefront of that global movement. I look forward to helping them achieve that if they adopt my new clause. Let us make it clear that scrutiny, transparency and respect for human rights are not optional extras in public procurement, but conditions of entry for any company seeking to serve NHS workers and patients. That is what new clause 108 calls for, and that is the change that will be welcomed in Liverpool West Derby, across our country and, indeed, in the halls of the Vatican. I look forward to the Government’s response.

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A lot of constituents have contacted me about Palantir—both patients and GPs, who are very worried about how the contract works and how Palantir operates. Medical data is hugely sensitive. People have to be confident that it is being managed by a company that they can trust. Palantir does not meet those criteria. It is an incredibly expensive contract, as we have heard, and it does not deliver the value for money that we need. More importantly, people do not trust it, and we are talking about their medical records, so the contract has to be with a company they trust.

[Martin Wrigley]

Does my hon. Friend agree that that element of trust is even more important when we get the single patient record, and critical to enabling GPs and medical professionals everywhere to use it, and patients to trust it?

[Charlotte Cane]

I absolutely agree. The single patient record is so important to make the NHS work efficiently and effectively, and to help it treat patients better. To achieve that, patients have to trust that the data is being well protected, and I am afraid that a lot of the people I talk to, including GPs—who are obviously critical in convincing patients that Palantir is safe—do not trust it. We have to pull out of the contract with Palantir. Will the Minister please consider that, please consider the issues faced by rural areas, and please, please, please get us some NHS dentists in Ely and East Cambridgeshire?

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[Karin Smyth]

I am going to move on, because there is a lot to get through.

My hon. Friend the Member for Bexleyheath and Crayford (Daniel Francis) made a powerful speech, based on his own experience and the terrible experiences of his constituents. I will write to him about what we want to do with ICBs to make that situation better.

I now turn to new clause 56, tabled by the hon. Member for Mid Sussex (Alison Bennett). I also thank my hon. Friend the Member for Blaydon and Consett (Liz Twist) for her ongoing work on, and interest in, carers throughout the passage of this Bill. I can assure the House that the Government fully recognise the importance of supporting carers’ health and wellbeing, including ensuring that they can take breaks from their caring responsibilities where needed. The Care Act 2014 already includes duties to assess and address carers’ current and future needs, and of course, we want to ensure that carers get the full benefit of the single patient record. To achieve this, we intend to use our regulation powers, which are already in the Bill.

The topic of inequalities has been highlighted a lot today. We are committed to ensuring that local areas are empowered to make decisions, tackle the specific health challenges they face and make real progress on health inequalities. I want to reassure the House that reducing health inequalities remains a priority for this Government. I know that the Chair of the Health and Social Care Select Committee, and the Committee as a whole, takes a great interest in this issue, and we are committed to working with them. I thank my hon. Friends the Members for Stoke-on-Trent South (Dr Gardner) and for Uxbridge and South Ruislip for their championing of this important issue and for our meeting last week.

I am not, however, convinced about new clause 91. Our focus is, and must remain, on delivering improvements in health outcomes, supporting prevention and tackling the causes of ill health, rather than creating additional statutory red tape. We already have a wide range of duties from the 2006 Act, and we have a new duty on combined authorities. There was a duty on ICBs in the Health and Care Act 2022, and there is a duty on foundation trusts. We have the public sector equality duty, as well as our commitment in the 10-year health plan. Again, the issue is making it work and empowering local leaders to do just that.

I commend the work of my hon. Friend the Member for Lewisham East (Janet Daby) on the APPG on sickle cell and thalassaemia, and I will write to her specifically on the issues she raised. She talked about specialised commissioning, a topic that was also raised by my hon. Friend the Member for Middlesbrough and Thornaby East (Andy McDonald). We know that this is an ongoing concern across many areas, and I commit to keeping in touch with them and with other Members.

Turning to women’s health—including mental health—and maternity services, again, I can assure the House that this is a priority for the Secretary of State. That is why we published the action-focused renewed women’s health strategy. It is why we are undertaking a single national action plan on maternal health, overseen by the national maternity and neonatal taskforce, to drive improvements where it matters to families, clinicians and other experts. I know that many Members of this House are committed to improving mental health, but I take this opportunity to thank my hon. Friend the Member for Sherwood Forest (Michelle Welsh) for all her work in this area as the national maternity adviser.

Opposition Members mentioned the Hughes report, and I assure the House that the Government recognise the importance of providing a response. I do not have time to go into all the ongoing work at the moment, but I commit to doing so at the earliest opportunity. [Interruption.] The Conservatives had a long time. The hon. Member for Sleaford and North Hykeham (Dr Johnson) says that they were about to do it before the election, but that is not what we found when we came into power. The Conservatives left us a lot of work to do in this and many other areas, but we are committed to doing it.

Fertility services and reducing inequalities in maternity services has been raised by my hon. Friend the Member for Stockport (Navendu Mishra) and the right hon. Member for Stone, Great Wyrley and Penkridge (Sir Gavin Williamson), who has been a tireless advocate in this area, as have many others. I have recently written to him. NICE guidelines inform how ICBs should commission in this area, but I know that things are not uniformly implemented. We will continue to work with ICBs to evaluate the next steps.

There was a lot of discussion on primary care, and dental access across the country in particular. We are committed to rebuilding dentistry in England, but actions speak louder than words. We are making great strides in improving access, ensuring an urgent care safety net across the country, reforming the dental contract and developing a 10-year workforce plan. More broadly, we think it is right that under this Bill, primary medical services become the responsibility of ICBs. They have the right knowledge of their areas to make commissioning decisions, and that includes on eye care. They have responsibility for all primary medical services, but rightly they will be accountable to the Secretary of State for their performance.

The right hon. Member for Godalming and Ash (Sir Jeremy Hunt) is right that we will say that he could have dealt with the issues he raises while he was in power, but we do not always say that, and he is absolutely right about continuity of care. I have also visited the practice he talks about in Horfield in Bristol, and not just because I was on the primary care trust board when the 2004 changes happened. Broadly, Bristol does have different standards on some of these issues, and that highlights our point. We do not need to put some of these provisions in legislation. Exactly this sort of good practice can be shared in local systems through neighbourhood care plans, neighbourhood work and the work in primary care networks.

The single patient record is fundamental to the Government’s mission to create a modern, joined-up NHS that puts patients at the centre of their care. On amendments 26, 42 and 43, I assure Members that the overarching purpose of making regulations to create and operate the single patient record is limited to the direct care of patients, and clause 51 is already explicit about that. Crucially, the clause does not create any new data sharing gateways for secondary purposes such as planning and commissioning, so these amendments are not necessary. On data safeguards, the security and privacy of people’s health and social care data are paramount. As Members would expect, we will build the strongest safeguards into the record. On new clause 32, I can assure Members that the SPR will be designed to protect personal data by default, with the highest standards of cyber-security and information governance ensuring that only the right people can access the right information at the right time and only for the right reasons.

Finally, I have heard how important it is that the single patient record is accessible and inclusive. I thank my hon. Friend the Member for Battersea (Marsha De Cordova) for amendment 87 and the important work she is doing to publicise this hugely important area. I assure her and Members that we are confident that the Bill is drafted to enable information related to support needs and reasonable accommodations to be included in the SPR. The Department will have regard to the accessible information standard as the SPR is developed.

We are also committed to tackling digital exclusion. We have considered that as part of the single patient record equality impact assessment, and work is already under way to help address barriers around connectivity, skills and confidence. I heard what my hon. Friend the Member for Middlesbrough and Thornaby East said about the need to engage him and others about the single patient record as we go forward.

On the federated data platform, decisions about public contracts must be made through fair, open and non-discriminatory processes. That is governed by UK procurement law, which recognises certain international treaty obligations. NHS England is reviewing the federated data platform contract to determine whether it should continue with standard contract management processes. It will look at evidence of delivery and the impact of the platform, and that should be the basis on which a contract continuation is decided.

[Martin Wrigley]

Will the Minister give way?

[Karin Smyth]

I will not. We have heard a lot from the hon. Gentleman, and I want to make some clear points to the House this evening.

We have heard a great deal of discussion about commercial processes, and Members—including the hon. Member for Newton Abbot (Martin Wrigley)—have raised important points about data security, governance and ethical standards of contracts, and support for domestic suppliers and for voluntary, community and social enterprise organisations. Contracts involving NHS data and digital services must be subject to proper scrutiny. The Government’s approach is to assess risks on the basis of the nature of the data, service and supplier access. Crucially, we already have the tools that we need to carry out appropriate due diligence through legal powers and robust contractual provisions.

I agree with the spirit of new clause 108, tabled by my hon. Friend the Member for Liverpool West Derby (Ian Byrne). I fully recognise the importance of ensuring that the NHS does not inadvertently support exploitation or rights abuses. UK legislation already incorporates some international laws: for example, the Human Rights Act 1998 incorporates the European convention on human rights into UK law. Similarly, we can use existing legislation and guidance to exclude suppliers from NHS procurements. Both the Procurement Act 2023 and the provider selection regime allow us to exclude providers when there has been serious misconduct or illegality. For instance, we could exclude a supplier under the Procurement Act for breaches of modern slavery and/or human trafficking laws. We have very high standards and expect all suppliers —including whichever companies go on to provide the single patient record—to meet them.

On a related note, the Chancellor has already written to the Secretary of State to ask that the NHS procurement better support British industry. In the light of that, the Secretary of State has commissioned, within the health family, a review of strategic procurement pipelines to find opportunities for the new social value model to support more British jobs, skills and innovation. The First Secretary of State, my right hon. Friend the Member for Sheffield Heeley (Louise Haigh), who is leading work on procurement across Government, would be happy to meet my hon. Friend the Member for Liverpool West Derby as part of this important work as it progresses, and I can assure him that the actions that we take will be fully in line with the principle of international law.

Health Bill

Martin Wrigley Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[Martin Wrigley (Newton Abbot) (LD)]

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

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

[James Naish (Rushcliffe) (Lab)]

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

[Martin Wrigley]

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

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

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

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

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

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[Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)]

I know of a quite frail diabetic patient with cancer, who underwent several operations as well as complicated chemo in London. He eventually decided that he was well enough to take a short holiday, so he went to Cornwall on the train. Unfortunately, shortly after arriving he was found in a state of collapse by his daughter, and taken to the nearest hospital late on a Saturday night. The doctors had no access to his medical notes, and no answer when they called the hospital in London, so they were puzzled. That situation is familiar to doctors. Patients are incredulous when they are told that we are unable to see all their medical records: “Surely everything is on the computer?”

As a surgeon before becoming an MP, I worked in at least three different hospitals. There was no compatibility between the records, which meant that transferring care was complicated and hazardous. I would be asked to advise on a patient from another hospital, relying on a dictated note from the referring doctor, but I could not access the clinical records, the results of investigations such as the pathology test, scans or, crucially, the operating records. Consultations were delayed as I stared at creaking computers, with numerous software programmes, each individually protected by ever-changing and forgettable passwords, that slowly booted up. That obviously needs to change.

I would link the NHS number to an unique single patient record. I would give ownership of the record to the patient, and let the patient be the custodian and the gatekeeper. That is the truly revolutionary idea. If someone could easily look at their medical record, with appropriate physician safeguards, they could monitor everything—blood pressure, heart rate—and perhaps there would be an incentive for them to look after their health a little better.

Let us imagine for a moment the power of anonymised medical data for a population of 70 million people. The NHS is perhaps the largest complete set of health data on a whole population in the world. That is a huge resource for informing health policy and medical research. By tracking the health outcomes of millions of our fellow citizens, we can sort out all kinds of diseases, such as heart disease, cancer and mental health disorders. I can think of no greater innovation, or more helpful measure to improve the health care of this nation, than a single patient record.

[Martin Wrigley]

All the features that the hon. Member is asking for are available to people within the Greater Manchester area. Exactly those things are there and work today, even down to the remote monitoring he mentions.

[Peter Prinsley]

I am grateful for that intervention, and I am aware that in various bits of the country such systems do exist. I would like to see a single patient record that is genuinely single, so that when my hon. Friend the Member for Stroud (Dr Opher), who is sitting next to me, writes something in the record, I can see it, and when I write in my record, he can see it, and no letters are passing back and forth between us. That is why I am sure that legislating for the mandatory single record is what we must do, and as a surgeon who has worked for 40 years in the NHS, I will do everything I can to help.

NHS Federated Data Platform

Martin Wrigley Excerpts

Thursday 16th April 2026 Westminster Hall

[Martin Wrigley (Newton Abbot) (LD)]

I beg to move,

That this House has considered the NHS Federated Data Platform.

We are at a key time for the NHS as it changes from analogue to digital, and data is key to achieving better health results for all our constituents, as well as to the future of the NHS. AI analysis of scans can spot patterns of disease before the human eye, and modern communications can be much more effective than sending letters, which often arrive late. We are, however, at a junction where we can correct a series of mistakes made in the direction of travel in this process. I ask the Government to mind the gap between expectation and reality. We can and need to change.

In November 2023, a contract for services approaching £500 million was signed for the federated data platform. The Government’s contracts tracker describes a data platform owned and controlled by the NHS

“to unlock the power of NHS data to understand patterns, solve problems, plan services for local populations and ultimately transform the health and care of the people they serve.”

Sadly, the FDP developed by Palantir is far from that description.

The NHS is an inherently distributed organisation, with trusts in charge of their own IT. Although NHS England has been working on a unified data dictionary and standards, imposing a single central IT solution has yet to work. Indeed, a single central system can become a single point of failure. Such a critical element of national infrastructure must be under full control, fully owned and trusted.

Although I understand the appeal of a slick salesman who persuades that they can solve all the problems in the NHS, build that one system to bind them all, and use AI like magic to provide all the answers, sadly, it is not reality. Is Palantir’s FDP a product that the NHS can own and trust, or have we bought the emperor’s new clothes that, after huge investment, leave us with nothing? I will outline why this solution is wrong in three significant points: the contract is wrong, the solution is wrong and the supplier is wrong and simply not delivering on its promises.

[Kim Johnson (Liverpool Riverside) (Lab)]

I thank the hon. Member for securing this important debate at this critical point. Does he agree that the opaque procurement of the Palantir contract, one of Mandelson’s dodgy deals, is deeply concerning? Does he agree that the full details of Mandelson and the Prime Minister’s visit to the Palantir headquarters in 2025 must be made public?

[Martin Wrigley]

I agree with the hon. Lady entirely. The secret meeting in 2019 between Boris Johnson and Dominic Cummings and Peter Thiel—the founder and chair of Palantir—that started this whole thing, for which there are no minutes, must be clarified as well.

I ask the Minister to consider using the contract renewal point to stop the chaotic expansion of the Palantir platform monopoly, to work to a staged exit with a retender for British companies to build a replacement for Palantir, and to deliver a better, long-term solution providing British sovereign capabilities in line with principles outlined by the Science and Research Minister and the Prime Minister.

The current contract delivers a subscription service that leaves no deliverables after the subscription—no software, no improvements and no intellectual property after spending more than £330 million. All the specially written software and intellectual property rights belong to the supplier, says the contract. All the rights to any know-how are explicitly retained by the supplier and not passed across on termination of the contract. The contract delivers no software—not one line—just a subscribed service; a permanent lock-in; a single point of failure.

Why are we building a leased service wrapped in glossy marketing promises, rather than a product that the NHS can own and trust? We are paying the supplier to hire Accenture, PwC, NHS experts and consultants to create a solution that we do not own—the supplier does. It uses external AI platforms from OpenAI and Anthropic and brings questionable value itself. Prior to it buying an opportunity to provide its system to help manage the data from the covid vaccine programme, the supplier had no expertise in health.

The three-year contract asks for 13 core capabilities to be delivered. According to the National Audit Office and the supplier, after nearly three years, it has partially delivered on three or four of those capabilities. Hon. Members may have received letters from the supplier, which has also taken to sponsoring newsletters that we see every day.

When in front of the Science, Innovation and Technology Committee, the only benefit offered by the supplier and by NHS England was an improvement in managing staff rotas to deliver a higher operation throughput, which these days can be done by a relatively simple app. That is beneficial, but it perhaps relates more to the Government’s improvements in staffing and pay than to any magic from Palantir. It claims to have achieved waiting list reductions by removing people who do not respond to messages, but there is no external scrutiny or validation of results. This is a dreadful contract, and it is not in the national interest.

[Andrew George (St Ives) (LD)]

My hon. Friend is making an excellent case. I know that, in a moment, he will come on to the point that this contract is coming to an end. I am sure that it is being reviewed by the Government—the Minister will respond on that issue—but we are encouraging them to bring the contract to a close, for the reasons that my hon. Friend is properly explaining. He will perhaps also agree that we should go through a transition period to ensure that the conditions he has described are addressed, so that the Government can benefit from the software that has been developed.

[Martin Wrigley]

I think my hon. Friend has been reading my speech in advance. I absolutely agree with him.

I see that the outgoing NHS England chief data and analytics officer, Ming Tang, has publicly joined Palantir’s fightback, saying that the system is delivering—but having introduced Palantir and lobbied to deploy it, she would say that, wouldn’t she? Given Palantir’s habit of lobbying civil servants and the revolving door from Government, I wait to see where she will end up.

I ask the Minister to review the contract, particularly in the light of the Government’s policies on investing in UK tech, value for money, technical lock-in, key performance indicators and strategic supplier status, which suppliers should have. I ask the Minister to reject extending the existing contract, which locks in the NHS forever and delivers nothing tangible.

[Susan Murray (Mid Dunbartonshire) (LD)]

My hon. Friend is making some important points. Just yesterday, I highlighted the Scottish Government’s decision to buy Chinese buses, which come with a serious security risk. It would be wrong of me not to do the same when the UK Government take the same risks. We have some of the finest minds in the world here in the UK, but too frequently, we lose them to foreign firms that are out of our control. Does my hon. Friend agree that we should be developing Britain’s skills base here, and that whether it be buses or AI, we should be putting British jobs and British security first?

[Martin Wrigley]

I absolutely agree with my hon. Friend, as do the Prime Minister and the Science and Research Minister.

Turning to the solution, the solution is wrong. There have been many attempts to unify the NHS by using a single IT system; each one has failed. In reality, we must think of the NHS as thousands of independent organisations. NHS England has been guiding organisations towards a combined data dictionary for more than 10 years, combining definitions of what data means, how it is recorded and the way it is used. After three years, about half of the 200-odd NHS trusts across 42 integrated care boards are quoted as live on the FDP, and only a quarter of them report benefits from using it.

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

My hon. Friend’s expertise in this area is impressive. I recently spent a shift with the South Western ambulance service and saw how critical it was for that service to be able to access both GP and hospital data—we had a lady who had had a heart attack, and we did not know who she was. Does my hon. Friend agree that the priority should be for the different elements of the NHS to talk to each other, rather than be scraped by a third party such as Palantir?

[Martin Wrigley]

I do agree. Palantir will not enable GPs, paramedics or anybody else to see hospital data. They will have to go through Palantir to see that data, and they will not be able to access patient records from the hospital to the GP or vice versa.

Like any data warehouse, Palantir requires connecting software that reaches into each of the NHS’s internal systems and gathers data. That data gathering is being done NHS trust by NHS trust, as there are differences inside each one. That is embedding the use of Palantir-owned code inside every NHS trust by creating custom connecting software to connect and translate data.

In Devon, the local ICB has celebrated as a major success the adoption of the same electronic patient record across Devon’s four main hospitals. It has just gone live in Torbay trust, which serves most of my Newton Abbot constituency. In an organisation as diverse as the NHS, with such distributed responsibility, we can either impose one massive system to rule them all or build interoperability. Interoperability would allow GPs to see hospital records and vice versa. Palantir is not doing that.

Interoperability is how massive systems, such as the internet or mobile phone networks, work. They do not rely on one single system or supplier. In that way, a modular system, a bit like Lego, can be constructed that, overall, is immune to changes elsewhere in the wider environment, providing only the specific data required to deliver improvements in services. That form of system builds long-term capability and delivers without requiring a locked-in, expensive subscription. It can also be built by a UK tech consortium in parallel with phasing out Palantir, which would build UK sovereign solutions, tech skills and competencies.

Meanwhile, NHS England’s October 2025 medium-term planning framework mandates all NHS providers of acute, community and mental health services to sign up to the FDP, and it demands that any existing local data analysis systems are removed. That results in further lock-in.

[Sir Julian Smith (Skipton and Ripon) (Con)]

One of the issues that the hon. Gentleman has not discussed in his excellent speech is governance. The commissioner of the contract is the NHS, and it is also the main oversight body. He has put forward a black-and-white solution—end or maintain the contract—but is there not a case for a more robust governance structure? That could involve giving more powers to the National Data Guardian or setting up a bespoke oversight body for this contract.

[Martin Wrigley]

If the right hon. Gentleman looks at the contract, he will see that it is subscription only: deliveries under supplier software—none; deliveries under third-party software—none. Any programming written under the contract is owned by Palantir. The contract has to be adapted for any next phase so that Palantir can be moved out.

Palantir is not only the wrong technical solution; NHS users report that it is awful to use. An open letter to NHS England said:

“we already have similar tools in use that presently exceed the capability and application of what the FDP is currently trying to develop or roll out”.

An NHS worker said:

“We’re being forced to use a convoluted system that makes even the simplest tasks feel like pulling teeth. It’s demoralising, and honestly, it’s a waste of everyone’s time and public money”.

An NHS data analyst said:

“Not only could similar functionality have been delivered at a fraction of the cost, but the existing tools are already better integrated, more intuitive, and more conducive to collaboration”.

In early 2025, Greater Manchester ICB reported that the FDP

“does not currently have any system-level products that offer the same or better functionality, compared to the custom-built system already in use for NHS GM”.

An NHS developer concerned about Palantir wrote to me to say:

“There are any number of reassuringly boring companies that could deliver this contract, many of them based in the UK, and then we could just get on with the exciting work of using technology to improve care for our patients”—

quite right too.

We must halt this path of chaos before the costs build any higher. I ask the Minister to use the change from NHS England to allow a change of direction towards a distributed, interoperable UK sovereign solution. Will the Minister cancel the expansion of the FDP to community and mental health service providers?

Palantir is the wrong supplier. Its name comes from a magical seeing stone in “The Lord of the Rings”. It is how the evil lord Sauron corrupted the good wizard Saruman—I think we should have known at the beginning. Funded initially by the CIA as a defence contractor, Palantir’s vision is to become the default operating system for data-driven decisions in high-stakes institutions.

Palantir’s chair, Peter Thiel, wrote:

“I no longer believe that freedom and democracy are compatible.”

He has warned about the coming of the Antichrist in the form of an oppressive world government. Palantir’s stated aim is to have domination over most Government Departments across the US and allies, including healthcare Departments. Louis Mosley of Palantir UK recommended that the UK Government develop a “common operating system”, combining healthcare and central Government data. That is just mad.

Palantir is a company that builds lock-in into its architecture as a clear business tactic. Palantir’s Foundry system was installed for £1 to manage covid vaccination programmes, after high-pressure lobbying and persuasion. It bought the advantage for future contracts by providing the system for free. The company had no healthcare experience prior to the pandemic, and demonstrates a lack of data security by design. However, the main issue is trust. The future of the NHS depends on intelligent use of data with patients’ trust. Gaining the public’s trust for research that involves AI will be hard enough anyway, without a company like Palantir controlling it all.

Palantir and its NHS England advocates claim big benefits for the NHS. The BMJ this week published analysis of the initial Palantir trial at Chelsea and Westminster hospital that shows the benefits to be exaggerated and untrue. The National Audit Office has yet to assess the value of the deliveries to date and cannot confirm the numbers in Palantir’s claims. Even if we accept that Palantir has delivered some benefits, they are hardly worth £330 million or the National Infrastructure and Service Transformation Authority’s estimated whole-life cost of over £1 billion.

In addition, Palantir’s history with the Government is not good. After secret meetings and intensive lobbying in 2020, Palantir won a £27 million border control contract—without competitive tender, just like the Ministry of Defence contracts. The border system was subsequently terminated as it had no users and no value.

We need to replace Palantir, the chaotic, all-seeing, single-point-of-failure, data-hungry AI solution. We need a well-architectured, security-by-design, resilient and nationally significant bedrock FDP in the NHS for years to come that must be powered by UK technology. That will build UK skills and business, pay dividends for years to come and build trust from the UK public. The British Medical Association says that

“an FDP has the potential to transform how care is delivered, but only if it is done right—via a UK-owned FDP that has the full confidence and support of the profession and patients.”

I ask the Minister to take action now to stop the expansion of the Palantir solution, to review the dreadful subscription contract with Palantir, and to rebuild the FDP project to deliver a sound, sovereign system to make our NHS thrive in the world of data-driven health.

[Several hon. Members rose—]

--- Later in debate ---

[Martin Wrigley]

I thank the Minister for his comments. However, I do not think he has been accurately informed about the status of the contract. I have the unredacted contract with me, which says nothing about software delivery. The whole thing is based on subscription, and the intellectual property of all specially written software, which is defined to include the data collection software, belongs to Palantir. None of this belongs to NHS. That is in this contract—I can show it to the Minister, if he likes. I thank him for his agreement to work towards a better future for our constituents, and we all agree that what we need is a trustable route forward in working with data that will make the NHS a real force in the 21st century.

Question put and agreed to.

Resolved,

That this House has considered the NHS Federated Data Platform.

NHS 10-Year Plan

Martin Wrigley Excerpts

Thursday 3rd July 2025 Commons Chamber

[Wes Streeting]

Given my hon. Friend’s expertise, I am delighted that he has welcomed the plan so enthusiastically. I wholeheartedly agree with what he said. I give him 10 out of 10 for his product placement of the 10-year plan and, in particular, his remarks on the design of the front cover, which I will pass on to the team.

[Martin Wrigley (Newton Abbot) (LD)]

Having secured a Westminster Hall debate on the issue, I am delighted to hear the Secretary of State reconfirm that the Carr-Hill formula will be revised and changed. I am also delighted with the ambition of the new plan, and I think it is very good in an awful lot of ways. Will the Secretary of State remember that GP surgeries are businesses? To correctly plan, they need confirmation and positive indications of where their funding will go over a multi-year period. If that is always in the front of his head, then all will go well. I have scanned the plan and read about the new choice charter, the Care Quality Commission and the National Quality Board. However, I am concerned that the ICBs are becoming more powerful and unaccountable to local neighbourhoods. The regulators are good and will keep them systemically accountable, but we are missing Healthwatch. I am disturbed that Healthwatch has been cancelled as the patient advocate, giving the patient’s voice in local areas. Will the Secretary of State reassure us that there will be some way of getting individual advocacy, as well as regulation?

[Wes Streeting]

I welcome the hon. Gentleman’s support for the plan. Success has many masters, and I thank him for putting the Carr-Hill formula on the parliamentary agenda through his debate. I can reassure him about a few things. First, what the Chancellor has done in the spending review gives us the advantage of medium-term certainty, so the NHS will now be in the business of medium-term planning with the system, which enables it to make better use of the money that is allocated. Secondly, we are ending Healthwatch—I express my thanks to the people who have worked in Healthwatch for many years—but we are giving power directly to the patients. Alongside that, we are looking at what we can do to strengthen democratic accountability from elected representatives, to ensure that the patient voice and interests are protected.

GP Funding: South-west England

Martin Wrigley Excerpts

Wednesday 25th June 2025 Westminster Hall

[Martin Wrigley (Newton Abbot) (LD)]

I beg to move,

That this House has considered GP funding in the South West.

It is a pleasure to serve under your chairship, Dame Siobhain. GPs are the front door of the NHS. They diagnose and treat illness, prevent disease and provide vital mental health support. As Lord Darzi once observed, general practice displays “the best financial discipline” in the NHS family while constantly innovating to keep patients out of hospital. However, GP funding is complex, obscure and insufficient. The bottom line is that the amount of money GPs receive is insufficient to deliver the obligations they carry. That is a view held by every single one of the 28 practice managers I met in and around my district, who tell me the situation is unfunded, unsustainable and unsafe.

GP funding is broadly based on two elements: a so-called global sum for core service costs, and additional quality and outcomes framework payments. The global sum starts with a payment per patient per year of £121.79—that is less than we might pay for our dog to go to the vet for an annual check-up, or about a third of the cost of servicing a Renault Megane. It is no wonder that practice managers spend their evenings juggling spreadsheets simply to keep the lights on.

It gets worse. That paltry sum is then modified by something known as the Carr-Hill formula. Carr-Hill was designed for a different era. It weighs patient numbers and postcodes but underrates deprivation, multimorbidity and today’s population health priorities. The consequences are stark and deliver what is known as the inverse care law. In my constituency, the Buckland surgery looks after some 4,000 patients on its list but is effectively funded for 3,200.

[Will Stone (Swindon North) (Lab)]

The hon. Member talks about the number of patients that GP practices have on their books. We have an ambitious plan for building more houses. Does he agree that we need to consider not just existing GP practices but funding the infrastructure for future practices, so that we have adequate services for people? There are places in Swindon that will be expected to take on thousands more patients, and the infrastructure is simply not there right now.

[Martin Wrigley]

The hon. Member is absolutely right: we have to consider these things. I have spent many hours persuading my local hospital trusts and the integrated care board to talk to the local authorities and work in the cycles of the local plan, so that they get their requirements into that plan. All too often they say, “A new housing development has just been built. We need a new GP practice with it,” and that is too late. The cycles do not add up. The system is broken, and we need to change that.

The Buckland surgery is underfunded by some 800 patients every year. It is part of the Templer primary care network, in which 2,500 patients are effectively treated for nothing. This means that the Buckland practice faces an annual shortfall of approximately £84,000—money that would cover another GP. If we then look at the changing number of patients per GP, in 2019 each GP was supporting 1,800 patients, compared with around 2,400 today.

[Sir Ashley Fox (Bridgwater) (Con)]

My constituents tell me of their difficulty in getting an appointment with their GP. Does the hon. Member share my view that GP practices should get a bigger share of NHS funding, which would enable them to improve the health of our constituents? And does he share my concern that much of the extra money allocated by the Government risks being swallowed by increased national insurance contributions, inflation and pay awards?

[Martin Wrigley]

Practice managers tell me that that has already happened and they are less funded now than they were last year.

On the changing numbers, each GP was supporting 1,800 patients in 2019 and is supporting 2,400 today, but safe care is often estimated to be closer to 1,400 per GP. So we are overloading GPs with patients. Practices make heroic use of pharmacists, physios and nurse practitioners, but the arithmetic does not add up. Meanwhile, the other part of their funding, the quality and outcomes framework scheme, has faced changes that have negatively impacted primary care. This meant that, nationally, £298 million was redistributed from the QOF into the global sum—we can see how bizarre this funding set-up gets; the names are just weird—and into cardiovascular disease prevention funding. Another £100 million of funding was repurposed but does not put extra capacity into the system. Rather than providing new money to support GPs, this felt to practice managers that the Government had been rearranging the deckchairs.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on securing this debate. He is right to address this issue—I spoke to him just before his introduction. We have great difficulty across all this United Kingdom of Great Britain and Northern Ireland when it comes to securing GPs for practices. In recent years, I have been trying to ensure, with the health service, that action can be taken regarding the student loans of young medical students, if they give a commitment to remain in a GP practice for a set period of, say, five years. That would enable more GPs to stay in the system. Does he feel that that is something the Minister and the Government should take on board?

[Martin Wrigley]

All those things help, along with things like bringing back nurses’ bursaries. On rearranging the deckchairs, it is no wonder that practice managers described this year’s settlement as unfunded, unsustainable and unsafe.

[Steve Yemm (Mansfield) (Lab)]

Does the hon. Member agree that the increase of over 7% in GP contract funding for 2025-26, which the Government put in place, represents the biggest investment in GPs for more than 10 years? We always want to get more money for GPs and the Government are committed to that, but does he think that the largest increase in 10 years should make at least some difference for his constituents in Newton Abbot as well as mine in Mansfield?

[Martin Wrigley]

I thank the hon. Gentleman for that intervention, but sadly, I must disagree. That is not what practice managers are telling me. Their costs have gone up so much that all of the increase has been swallowed up, and they are not sure they can keep the lights on. They are really struggling. I have partners in GP practices who are paying themselves less than the minimum wage, which is not sustainable.

Patient demand has also increased post pandemic, and continued cuts have seen the removal of many services and social care that have supported what GPs do. On top of the cuts to Sure Start and a 40% drop in health visitors since 2015, carers already stretched thin face the prospect of losing personal independence payment support, which will inevitably rebound on general practice—the first line of defence. That is not to mention long covid and pandemic backlogs. All of those drive more people to want to see their GP. The cost of living crisis is compounding multimorbidity, where the most vulnerable in society with chronic illnesses are further pressured.

And then, we get the new requirement to run the appointment schedule from 8 am to 6 pm, filling every single slot. From October, practices must hold digital front doors, open all day, for non-urgent requests. With 100% booked appointments, there is no spare capacity for the person who falls in the care home or for the child who needs attention after school. Partners in the Albany surgery in Newton Abbot warn me that an unlimited invitation will flood a service that simply cannot be limitless. This is unsafe—unfunded, unsustainable and unsafe.

Talented doctors are leaving. The partnership model, still the cheapest and most community-rooted option, is no longer attractive when partners shoulder unlimited liability for premises, pensions and payroll, yet cannot guarantee safe staffing levels. The Royal College of GPs reports a 25% fall in GP partners over the past decade. The chair, Professor Kamila Hawthorne, put it bluntly:

“It makes no sense that trained GPs cannot find sustainable posts while patients wait weeks for appointments.”

[Ian Roome (North Devon) (LD)]

I thank my hon. Friend for securing the debate. Patients in Lynton, one of the remotest communities in North Devon, will soon have access to a GP, but that only happened because of a spirited campaign by local patients. Does he agree that if we are relying on an active community to highlight gaps in provision, it will always be the marginalised communities who find it hard to see a GP?

[Martin Wrigley]

My hon. Friend is absolutely right. I commend him on obtaining a ministerial visit to his hospital in North Devon. North Devon district hospital is fantastic and we need to ensure that it gets the investment it needs—just so long as we can get some south Devon patients there as well.

In Teignmouth, the previous four practices have merged into one, mostly due to not being able to find new partners. In Newton Abbot, one practice was on the verge of handing back its patient list due to not being able to replace retiring partners. We have not even talked about specific issues facing some of these surgeries, such as the unbreakable lease on a building that is not fit for use as a GP surgery, where the only possible course of action they could see was to declare themselves bankrupt. As doctors, that ends their careers.

And yet, these practices are doing amazing things. The Kingsteignton medical practice, partnering with the charity Kingscare, has created a model that is delivering for patients. Just think what could be done with a better funding model. Buckland surgery would like to link with the local school to tackle adverse childhood experiences before they turn into permanent ill health, providing better family support—much as it has already done with its links to a number of local support services through the Buckland hub.

Prior to the election, the now Health Secretary often quoted that a GP visit cost £40, whereas an A&E visit cost £400. I am not sure I agree with the absolute numbers, but the principle is fine: it is 10 times more expensive to put somebody through A&E than it is to put them through a GP. If we talk to Devon integrated care board on GP resilience and prevention, the evidence is crystal clear: prevention saves money. And yet, as Torbay and South Devon NHS foundation trust remains in NHS operational framework 4—we might perhaps equate it to “unsatisfactory” if it was a school—because of historical deficits, it is tasked with huge efficiency savings and is understandably risk-averse. Community services that once propped up primary and secondary care—the stroke recovery group, Devon Carers hospital service, the Torbay and Devon dementia adviser service—have vanished as funding evaporates. Closing gaps in prevention only widens cracks elsewhere. It is not getting better.

To sum up, the funding formula is broken. It delivers the inverse care law that the availability of good healthcare tends to be inversely proportional to the need for it within a population. We need to fix it. I am asking the Government today to: end the Carr-Hill formula, and make deprivation, rurality and workload properly weighted; invest in core general practice, not just peripheral schemes, so that partnerships remain viable; protect prevention budgets in the next spending round, as it is cheaper to keep people well than to rescue them later; support premises and digital infrastructure so that online access enhances rather than overwhelms safe care; and publish a workforce plan that retains experienced GPs, accelerates training and makes partnership an attractive career again.

[Several hon. Members rose—]

--- Later in debate ---

[Martin Wrigley]

I am not quite sure what to say now that the Minister has actually said that my prime ask will be delivered. That is fantastic, and shows the emphasis of these debates.

I thank colleagues from across the House for their contributions. We all agree on the importance of GPs and the need to fix their funding. It is vital to recognise the many good things that GPs and GP practices have been doing in what have been difficult circumstances for a good number of years.

It has been delightful to hear that MPs have been interacting with their local GP practices to understand the problems with the funding formula. Delighted as I am to hear the Minister announce changes to the Carr-Hill formula, GP funding is still complex. I tried to show how complex it is by focusing on just on two of its elements, but we have heard from other hon. Members that the extra funds are even more complex. The fact that the 7% increase is eaten up by the 6% increase in wages, NICs and so on shows that it is not simple.

I thank the Minister for being here—

[Stephen Kinnock]

Will the hon. Gentleman give way?

[Martin Wrigley]

I have never been interrupted by a Minister before—I would be delighted.

[Stephen Kinnock]

I do not even know whether an intervention is allowed here, Dame Siobhain—this is a revolutionary step—but the hon. Gentleman raised some concerns about the quality and outcomes framework, and I wanted to say that we have retired 32 out of the 76 quality and outcomes framework indicators, reflecting the fact that we agree with him: it was way too complex and there were too many indicators. By retiring those, we freed up £298 million, £100 million of which will go into the global sum, maximising the flexibility for practices to do what is right for their patients. The remaining £198 million will be repurposed to target cardiovascular disease prevention.

--- Later in debate ---

[Martin Wrigley]

I thank the Minister for the intervention. I am not quite sure what the protocol is; I do not think that that has ever happened. This is a most fantastic debate.

Capital investment in GP practices and buildings is welcome, but we have heard from across the Chamber that we need more. The problems with ICBs and the difficulties with trusts that are in NHS oversight framework segment 4 still impact GPs and how their funding works.

I will push my luck, because the Minister has been very generous with his time and very patient with us all: will he meet me and some practice managers to talk about the complexities of managing the practices with such a level of complication in funding, and to see whether the Government can identify further ways of making it easier to run these businesses, so that they can get on with delivering what they are there to deliver: healthcare for the greatest number of people with the maximum possible benefit? That would be helpful. I thank all hon. Members for their contributions.

[Dame Siobhain McDonagh (in the Chair)]

I respectfully say to Members that, while I do not have the power to stop interventions from people who turn up 45 minutes, an hour, or an hour and three quarters into a debate, speaking on a personal level—I am not the most formal of Chairs—I think it very impolite to make an intervention when you have not had the opportunity to hear from other Members. I do not have the power to enforce that, but if I could, I would.

Question put and agreed to.

Resolved,

That this House has considered GP funding in the south-west.

NHS Funding: South-west

Martin Wrigley Excerpts

Wednesday 11th June 2025 Westminster Hall

[Martin Wrigley (Newton Abbot) (LD)]

It is a pleasure to serve under your chairship, Dr Huq, and I congratulate my hon. Friend the Member for Torbay (Steve Darling) on securing the debate.

GP funding is in crisis. I have met representatives of individual practices in my Newton Abbot constituency, as well as the 28 practice managers from around the district. They all have a funding crisis. The recent GP settlement was described to me as unsafe, unsustainable and unfunded.

GP funding is complex, but in essence it has two parts: the global sum and the quality outcomes framework. The global sum is meant to cover basic costs, including salaries, facilities, and so on, and the QOF extra services, but it does not cover any of it. Practice managers across south Devon have told me that the global sum is £121.79 per patient per year. That works out as less than paying to take a dog to the vet for an annual check-up, or about a third of the cost of servicing a modest car, such as a Renault Megane. That sum is also then modified by the Carr-Hill formula, which, perversely, can reduce the sum in areas of deprivation. The Royal College of General Practitioners wrote in an open letter to Government last year that this formula is no longer fit for purpose and has contributed to the widening health inequalities across the country.

Practices in the areas of greatest deprivation have patients with more complex needs, yet they do not receive proportional funding to address those needs. For example, Buckland surgery in my constituency has 4,000 patients, but the Carr-Hill formula reduces the funding to the equivalent for 3,200 patients. Practice managers are juggling numbers to make things work. Some surgeries are short of a full-time GP; just imagine the impact that has on patients. No wonder it is difficult to get an appointment. That is unsafe. The Government have said that from October GPs must offer an open access service; that means that all available slots are booked, so emergency appointments cannot be seen. That is not sustainable.

Hospitals

Martin Wrigley Excerpts

Wednesday 23rd April 2025 Commons Chamber

[Stephen Kinnock]

I thank the hon. Lady for that intervention. Baroness Casey is working at pace to get the commission up and running, and that will be launched this month. On her point about Think Ahead, the fundamental challenge we had with that programme was its relatively high unit costs. We are aiming to ensure that we deliver value for money for the taxpayer—I am sure that the hon. Lady shares that objective. We have to ensure that we deliver a programme for mental health social care work that delivers not only the best possible outcomes for our communities, but the best possible value for taxpayer money.

A lot has been done in the nine months since the election, but there is a huge amount more to do, and this Government are getting on with the job. Alongside the work I have described, the Government are putting record levels of investment into healthcare, with capital spending rising to £13.6 billion over this year and the next. That includes £1.5 billion for new surgical hubs, diagnostic scanners and beds across the NHS estate, as well as new radiotherapy machines to improve cancer treatment; over £1 billion to tackle RAAC and make inroads into the backlog of critical maintenance, repairs and upgrades across the NHS estate; and over £2 billion to be invested in NHS technology and digital. We are also taking the pressure off our hospitals through care in the community, and I am sure the whole House will welcome the fact that we have recruited 1,500 extra GPs on to the frontline.

[Martin Wrigley (Newton Abbot) (LD)]

Coming back to community hospitals, I came to this House to try to save Teignmouth community hospital, which has been under threat of closure because Torbay, its parent hospital, has such a massive maintenance backlog that it cannot afford to maintain both itself and Teignmouth hospital, so it is shutting down community hospitals. In Devon, we have just three principal hospitals: North Devon, which we understand is under pressure, Torbay, which is under pressure, and Exeter. We need the community hospitals. Will the Minister stop Teignmouth hospital from being shut, so that we can maintain it until it can be rebuilt?

[Stephen Kinnock]

These decisions are the responsibility of ICBs, and the ICB is having to balance a range of pressures, as the hon. Member points out, created largely by the neglect and incompetence of the previous Government. It is now a question of ICBs having to cut their cloth to make the finances work with the limited resources they have. I am afraid that is symptomatic of the mess we found when we took over on 4 July.

Terminally Ill Adults (End of Life) Bill (Money)

Martin Wrigley Excerpts

Money resolution
Wednesday 22nd January 2025 Commons Chamber

[Martin Wrigley (Newton Abbot) (LD)]

Will the hon. Lady give way?

[Antonia Bance]

I will not—I have only a little time.

It is not just the health system that will take on new costs. Our civil courts are groaning under the strain of years of Tory underfunding, although my right hon. Friend the Justice Secretary is doing a brilliant job of putting our court system back to rights. However, this Bill will impose new unfunded and unknown costs on our courts. It blithely assumes that judges and courts will be available, yet the waiting time for a family court case at the moment is 10 months. That just will not work for the Bill. How much will the extra spending on courts cost?

Oral Answers to Questions

Martin Wrigley Excerpts

Tuesday 19th November 2024 Commons Chamber

[Andrew Gwynne]

We will confirm the 2025-26 local authority public health grant allocations in due course. Local government plays a critical role in delivering the Government’s health mission and driving action on the prevention of ill health. We are committed to working in partnership with local government to tackle the wider determinants of ill health.

[Martin Wrigley (Newton Abbot) (LD)]

T9. I have been shocked this week by all the major GP groups in my constituency detailing their financial situations. They are all close to the edge and are considering the options of bankruptcy, redundancies or handing in their contracts. What urgent respite can the Secretary of State give them?

[Wes Streeting]

I am in no doubt about the state that general practice was left in by our Conservative predecessors. That is why, in making decisions about funding allocations for the year ahead, we are taking into account all the pressures that general practice is under, as we clean up the mess left by the Conservatives.

Access to Primary Healthcare

Martin Wrigley Excerpts

Wednesday 16th October 2024 Commons Chamber

[Martin Wrigley (Newton Abbot) (LD)]

I congratulate my hon. and gallant Friend the Member for North Devon (Ian Roome) on his maiden speech. I start by thanking my long-suffering family, especially my children Zoe, Sam and Emily, who have been truly supportive throughout everything to get me to this place. Let me express my thanks to the amazing team in the constituency who worked so hard to get me here as well.

It is an honour to have been elected to represent my constituency of Newton Abbot, an area that I have called home for some 25 years. I tend to find that people in Westminster either ask, “Where is Newton Abbot?” or they say that they know it well through personal experience. We are on the south coast of Devon between Exeter and Torbay, between the sea and the gateway to Dartmoor with the Rivers Teign and Exe. The constituency name reflects our largest market town, but it could add Dawlish, Teignmouth, Kingsteignton, let alone the many villages from Starcross, Kenton, Bishopsteignton, Abbotskerswell, Ogwell, Denbury, Ipplepen, Broadhempston and many more.

I have been wondering what to tell hon. Members about my constituency. Perhaps the creative and innovative people, including Newton Abbot’s own Ollie Watkins, the members of Muse, or Peter Cross, usually seen at England rugby fixtures with his resplendent cross of St George hat and coat. Or the history of Brunel’s engineering of the coastal railway, today’s mining of ball clay or, previously, the granite used to rebuild London bridge, the British Museum and others, quarried from Dartmoor and transported via the Templer Way—a tramway itself created from granite—all shipped via the port of Teignmouth. Or the story of Dawlish violets, Jane Austen’s visits, Keats’ poem or how Dawlish became the home of black swans. Perhaps the protected shores of the Exe estuary and Dawlish Warren, home to many thousands of wildfowl and wading birds each winter. Suffice it to say, the area is steeped in history, fame and natural beauty. Members will find much more than Devon cream teas and scones—with cream and jam the right way up, of course.

Growing up in a Royal Navy family, we moved around an awful lot. Moving to Dawlish was a natural choice, but I suspect it was also my parent’s influence that caused me to set my sights on this place. In the 1950s, they met in Downing Street when my mother worked in Churchill’s office. My father told us stories of racing to the parking place outside No. 10 in his old MG.

Speaking of previous politicians, I pay tribute to my predecessor, Anne Marie Morris, and her dedication to the constituency. Her maiden speech told of the waves gently breaking over the trains on the Dawlish seawall. The 2014 storm, however, showed us that the force of the sea and the increased storms due to climate change were both serious and urgent. Since then, Network Rail has constructed a new seawall, rebuilt the station and more. However, it was the catastrophic cliff collapse near Teignmouth that caused the longest interruption of rail services, cutting London off from the south-west peninsular. We are still waiting for funds to be confirmed for that work. Climate change is a real and present threat to us on the coast, and we cannot stop it with just flood defences and mitigations. We must do everything we can to reduce the use of fossil fuels and carbon dioxide emissions.

Turning to healthcare, Devon has both an ageing population and fewer hospital beds per head of population than the national average. Local hospitals are falling into disrepair and are often overlooked in the model of care. It was during my first week in this place that I heard from the local NHS trust that it was cancelling the planned new Teignmouth health and wellbeing centre that would have replaced the crumbling hospital. Due to increased costs and a recent cap placed on its capital budget, bizarrely because of revenue overspend, the project was cancelled. The new centre was to have become the home to local GPs and local NHS services. I did write to my pen pal, the Secretary of State, but have yet to hear back.

In the meantime, I am working with the GPs to help them secure a new home and avoid putting primary care for 18,000 patients in jeopardy. Teignmouth hospital is still under the threat of closure, despite housing many NHS and voluntary sector services. Meeting recently with Volunteering in Health at the hospital with my right hon. Friend the Member for Kingston and Surbiton (Ed Davey), we saw how its model of wraparound care had been copied internationally and that Singapore was now rolling it out as global best practice.

As an engineer and a Liberal, I know that we do not need to accept broken systems. We can fix them, and by empowering people we can build a brighter and better future. I will do everything I can in this place to fix systems and help my constituents, and help to protect the beautiful constituency, the environment and its biodiversity as long as I am here.