Armed Forces Bill (First sitting)

Debate between Neil Shastri-Hurst and Rachel Taylor

Select Committee stage
Tuesday 24th March 2026 Public Bill Committees

[Dr Shastri-Hurst]

It continues to be a pleasure to serve under your chairmanship, Mr Efford. I will confine my remarks to amendment 10, concerning the continuity of NHS secondary care services for the dependants of members of the armed forces. The amendment addresses an issue that has very real consequences for the health and wellbeing of service families, and therefore for the broader integrity of the commitment we make to those who have served and do serve.

At the heart of this amendment lies a simple maxim: those who serve their country, and the families who support them, should not be placed at a disadvantage when accessing essential public services as a result of the demands placed upon them by service life. That principle is, of course, recognised in the armed forces covenant; the question is whether we are giving full and consistent effect to it in practice.

The difficulty arises from a defining feature of military service: members of the armed forces are required to move. They are often asked to move frequently, often at short notice, sometimes across significant distances within the United Kingdom, and sometimes further afield. Those moves are not discretionary; they are intrinsic to the operational readiness and effective functioning of our armed forces. And when service personnel move, invariably their families move with them.

That reality carries with it a number of challenges, but one of the most pressing, and one that is too often overlooked, is the disruption to ongoing medical treatment for their dependants. While primary care is generally able to accommodate patient movement with relative ease, the same cannot be said for secondary care. Hospital treatment, specialist pathways and waiting lists are typically organised on a regional or trust basis. When a family crosses those organisational boundaries, continuity is not guaranteed.

The consequence, in too many cases, is that dependants find themselves required to re-enter the system. A child undergoing specialist treatment, a spouse awaiting elective surgery or a family member under the care of a consultant may be told that because they have moved into a new area, they must obtain a new referral, join a new waiting list and effectively begin the process again from the start.

It is important to be clear about what that represents—not a clinical judgment or a decision taken in the interests of patient care, but an administrative consequence of the way services are structured and commissioned across different parts of the NHS. It is in effect a failure of co-ordination. For the individuals concerned, however, it has a much more significant impact. It can mean delayed diagnoses, prolonged pain, deterioration in conditions that require timely intervention, and significant anxiety for families already managing the pressures of service life. It can also undermine confidence in the system and create a perception, justified or otherwise, that service families are being treated less favourably.

The amendment seeks to address that problem in a proportionate manner. It does not attempt to redesign the structure of the NHS—that would be a fool’s errand—nor does it impose a rigid requirement on how services should be delivered.

[Rachel Taylor]

The hon. Gentleman is making a powerful argument; we can all relate to the specific problems that anyone faces when they move house, and that is far more likely for service personnel. However, requiring patients to retain waiting list positions regardless of clinical urgency surely risks distorting NHS prioritisation principles, which are based on clinical need in order to ensure fairness and safety. Could he address that point?

[Dr Shastri-Hurst]

The hon. Member makes a valid point. Of course there will need to be a degree of clinical judgment, but the premise that somebody has to start at the bottom of the system by virtue of the fact that they are a dependant of service personnel is inherently unfair, and one that needs to be addressed in the Bill.

--- Later in debate ---

[Dr Shastri-Hurst]

My right hon. Friend is absolutely right: this is about not only streamlining the process, but giving more heft to those who wield the power to ensure that we get improved patient outcomes at the end of it. That is what we should all be seeking.

Ultimately, the question before us is very straightforward: are we content to allow a situation to persist in which service families can lose their place in the healthcare system simply because they are required to move in the course of service, or do we consider it reasonable to take targeted steps to prevent that outcome? In my view, the answer is clear. Where treatment has begun, it should continue. Where a place on a waiting list has been earned, it should be respected. Administrative boundaries should not dictate clinical outcomes. They certainly should not impose additional burdens on those who have little choice but to cross them.

The amendment provides a measured and practical mechanism to achieve that objective. It respects the structure of the NHS, acknowledges the reality of devolution and focuses squarely on the removal of a specific and identifiable disadvantage. In doing so, it gives tangible effect to the principles of the covenant. It recognises that our obligations to service families are not merely symbolic; they require a practical expression in the design and operation of public services.

[Rachel Taylor]

Although the amendments are well-intentioned, they are somewhat problematic because they target health, education, adoption and fostering, which are all devolved to the respective Governments. They risk recklessly breaching our devolution conventions, including the Sewel convention. The purpose of the Bill is not to strain relationships with the devolved Governments; instead, it seeks to empower them to design the right solutions for each nation.

The covenant duty is intentionally flexible and is supported by guidance and existing frameworks. It allows each Government to design their response. I believe that this Government should seek to work collaboratively with the devolved Governments on supporting our armed forces, rather than prescribing duties to them in legislation.

Furthermore, our NHS already works effectively with the covenant duty to support continuity. The amendments would risk governance and clinical risks. Instead, the Government are focusing on initiatives that aim to promote awareness of the armed forces community.

The Ministry of Defence already provides comprehensive guidance for service families through the adoption and fostering defence instruction notice, which embeds the MOD’s role firmly within existing civilian-led systems. These long-standing frameworks already ensure continuity for families when they move. In combination with the strengthened covenant duty, they will provide a far more practical and effective approach than is proposed in the amendment.