Health Bill (Seventeenth sitting)

Debate between Peter Prinsley and Caroline Johnson

Committee stage
Thursday 16th July 2026 Public Bill Committees

[Dr Prinsley]

I am interested in what the hon. Member has to say about strike action. I was involved in trying to get the resident doctors’ strike stopped, but was unsuccessful for many months. I think she is talking about the principle of whether people involved in medical care should ever go on strike. If she were to apply the proposed measure to medical practitioners, would she introduce the same rule for nurses?

[Dr Johnson]

If the hon. Gentleman reads new clauses 81 and 82 together, he will see that one of them would require doctors not to go on strike, because they are involved in the clinical decision making across the piece, while the other would make provision for staff across the NHS to be on minimum service level provision. That is something that I maintained under the previous Government as well: I do not think that doctors should go on strike, in the same way that the police and the military do not go on strike.

Medical professionals are key to the functioning of a hospital in a way that means they should not go on strike. Other staff within the hospital provide an extremely valuable and important service, but often several individuals provide that service, so it might be possible to say, “We can have three here rather than five today and still deliver most of the service.” Fundamentally, I do not think that it is morally right for doctors to go on strike, because in effect they are saying to people, “We know you’ve been waiting for your knee replacement for a year and we know your knee hurts, but we’re not going to do your knee replacement today, because we’re going to go on strike for more cash.” I just do not think that that is right. [Interruption.] I will take an intervention from my hon. Friend the Member for Farnham and Bordon.

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[The Chair]

That is up to the hon. Lady.

[Dr Johnson]

I am very happy to take an intervention.

[Dr Prinsley]

This is, obviously, a very interesting discussion. I agree—I actually do—that medical practitioners should not go on strike, but the question is whether that should be the law. I would apply the same question to nurses, a point that the hon. Lady has not answered.

[Dr Johnson]

For generations, it has not needed to be the law: doctors did not go on strike, because they recognised what would happen to patients if they did. Now that we know that doctors will go on strike, the landscape has changed. Consultants—I should say that I am an NHS consultant—have just balloted to go on strike, which will be fundamentally unsafe. The Government have a duty to keep people safe; first and foremost, that is the Government’s job. Doctors going on strike is fundamentally unsafe and should not happen. I agree with the hon. Member for Bury St Edmunds and Stowmarket that morally it should not need to be the law, but I think the evidence suggests that it does.

New clause 82 would make it

“an offence for medical practitioners to undertake strike action”,

and would provide for the Secretary of State to repeal any necessary clauses of other employment regulations in order to do so. New clause 81 concerns the minimum service levels provided across the NHS. There are staff who provide an important and valuable service but whose jobs may not be clinical; for example, services may be able to run with slightly fewer porters if they want to go on strike.

I hope that no member of NHS staff would want to go on strike. I hope they would want to make sure that patients were getting care, and I hope they would recognise that, in a universal service, they are essentially causing harm to the patients around them, who are their friends, their neighbours, the people who live on their street and the people who would look after them. However, the evidence suggests that that is happening, so I am afraid that these new clauses are necessary. We need to put a minimum number of staff in place to support the doctors, and doctors should be at work to make sure that patients are safe.

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[Dr Johnson]

I beg to move, That the clause be read a Second time.

Advice and guidance services were an improvement. Previously, if a general practitioner wanted to refer someone to hospital, a consultant would triage the referral. Sometimes, the referral was not needed, so a message would be written to the GP saying, “I wonder if you’ve tried this” or “Could you give more information, please?” Improving that process was the advice and guidance service, which in many ways is beneficial.

I am, however, concerned by the suggestion earlier in the year that advice and guidance will become a compulsory feature, and that only after advice and guidance has been received will there be potential for referral. Instead of a GP being able to refer to a consultant and a consultant being able to accept that referral, advice and guidance will have to be sought first. That will cause a delay in patient pathways and flow. It may mean that the date on which the person is added to the waiting list for an appointment is a couple of days later. That may slow things down and improve the figures, but I cannot see any clinical benefit from mandating it.

There is also a concern that there would be what is called a diversion rate of at least 25% by March 2027 for at least 10 high-volume specialties. I am concerned about that. If someone gets to the point of being given a hospital appointment, that is because the clinician who saw them in primary care used their clinical judgment to decide that the patient needed that appointment, and the consultant triaging the referral used their clinical judgment to decide that the patient needed to be seen.

[Dr Prinsley]

I wonder whether the hon. Member’s experience mirrors mine. Many years ago, it seemed to be easy for general practitioners to ring me up. I often received telephone calls from general practitioners asking for advice about patients. As time went on, general practitioners became busier and busier and seemed to have less time to telephone consultants. When I started my consultant career, I spoke often to general practitioners, and by the time I got elected to Parliament and had to stop, I found that was a very unusual thing. Has her experience been similar?

[Dr Johnson]

I think we are all getting busier. As such, it is harder for clinicians in primary care to phone the consultant and speak to them, because both are busy and potentially seeing patients. I am not criticising the ability to have an advice and guidance service, because it is helpful. We do the same with specialists in tertiary centres, for example. One might send them a message asking a question. Advice and guidance is a good principle. My concern is that it would remove the ability for consultants to refer directly, introducing an unnecessary delay in the system. Are we questioning the judgment of clinicians? Why do we want to reduce the number of patients who get put on the list by a quarter?

I recognise, as I am sure the hon. Member for Bury St Edmunds and Stowmarket does, that sometimes referrals could be better directed. There is a mechanism already for doing that, but new clause 86 reflects the fact that general practitioners should still be able to refer patients using their clinical judgment to a consultant. That may be someone who the patient has chosen to see or who the GP believes is right for the patient’s condition.

[Dr Prinsley]

The other important fact is that more and more hospital referrals were not coming from general practitioners at all, but from other people working in the general practice such as nurses and physician associates, who are less confident in forming a clinical judgment.

[Dr Johnson]

If they are, they can use the advice and guidance service. The point is that when a general practitioner wants to refer his or her patient to a consultant on the basis of their clinical need, they should be able to. That is the purpose of the new clause.

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[Dr Johnson]

I beg to move, That the clause be read a Second time.

Under the Government’s preference-informed allocation scheme, when a doctor is applying for a foundation post, they are allocated randomly to a job. They get to express a preference, but there is no work they can do to make them more likely to get where they want to be; there are no certificates they can earn, there is no research they can do, and there are no exam results they can get that would improve their chances. That is fundamentally wrong.

The Government say that many people get their first choice, which is true. That is great for them, but it is not great for the people who do not get their choice and have no control over their future. We had a very good debate on this subject, attended by many people in this room, in January, and there was widespread agreement on both sides of the House that it was the wrong thing to do. The Minister said at the time that the Government would keep the system under review. Has the Minister reviewed the system? Does she believe that we should prioritise medical graduates with the most relevant qualifications, clinical experience and skills? Does she think that doctors should have the opportunity to have control over where in the country they work and what jobs they do? Should doctors be able to work harder, aim for better results or do additional activities in order to get themselves the job they want, or does she think it should all be done by a computer?

I would be interested to hear the Minister’s thoughts. The new clause makes clear our position that meritocracy should prevail and people should be rewarded for the work they do and the results they get, and that we should be hiring the best clinicians who apply for the jobs.

[Dr Prinsley]

I think the new clause refers specifically to the foundation programme—

[Dr Johnson]

Correct.

[Dr Prinsley]

Does it actually say that in the new clause?

Health Bill (Sixteenth sitting)

Debate between Peter Prinsley and Caroline Johnson

Committee stage
Thursday 16th July 2026 Public Bill Committees

[Dr Prinsley]

I am listening carefully to what the hon. Member, who is a medical colleague of mine, has to say. Although I think that a fracture liaison service is an excellent idea, there are many, many aspects of medical care that require careful attention, such as the management of people with hearing loss—my own field—or the assessment of people with chronic renal failure. Does the shadow Minister believe that all aspects of each individual disease category require some sort of primary legislation?

[Dr Johnson]

Not necessarily, no, but this one does, because the Government clearly made a promise before the election. The former Secretary of State was clear that it would be one of his first acts—that is what he said—and it has not happened, so in this case we need to hold the Government to account. It is our job to hold them to account on their promises, and I am afraid that they are failing on this one.

To sum up, the Government need to get their act together, because otherwise more and more vulnerable people will come to unnecessary and potentially fatal harm. I look forward to hearing the Minister’s plans to accelerate the delivery of the Government’s promise—and fast.

Health Bill (Fourteenth sitting)

Debate between Peter Prinsley and Caroline Johnson

Committee stage
Thursday 9th July 2026 Public Bill Committees

[Dr Johnson]

New clauses 12, 56 and 84 are about care in our accident and emergency departments and care in corridors. I do not want to rerun the debate on corridor care that we had in the Chamber last night, but corridor care does not provide safety, privacy and dignity, and it is unpleasant for the patient, their family and staff. If someone is in a corridor, how can they get changed, or use a commode or a bed pan? How can they be examined privately, and give information about their medical history without being overheard by a person walking down the corridor or the person in the bed next to them? Corridor care also has safety issues; for example, a patient may not be proximal to as much equipment, such as oxygen supplies and other equipment that might be required in the event of a collapse or arrest. It is not right and should not be the case that patients are cared for in corridors.

The hon. Member for Blaydon and Consett talked about the history, but I agree with my hon. Friend the Member for Isle of Wight East that the current situation and the future are what is important. A&E services are under pressure. Attendances went up by 2.5% last year, but in March 2025, 46,766 people waited more than 12 hours in A&E following a decision to admit before being moved to a more appropriate bed. That figure is up 8.8% on the previous year. The Government’s urgent and emergency care plan sought to improve that poor performance, but things have got worse. The latest NHS figures, from May 2026, show that more than 50,000 patients waited more than 12 hours following a decision to admit—17.1% higher than the May 2025 figure. The narrative that there was a problem but now things are getting better is not necessarily accurate. We keep being told that waiting lists are coming down, but they are higher than they were a month ago, and for those waiting for an admission or procedure, they are than they were a month ago and higher than they were a year ago.

[Dr Prinsley]

I wonder whether the hon. Member remembers that in 2010, when I believe there was an election—[Interruption.] Yes. The point I wish to make is that at the end of the previous Conservative Government, before Labour came back into office, waiting lists had reached an absolute record. Under the previous Labour Administration, waiting lists came down to almost nothing, but after 2010 they crept up and up, and by the time of the election in 2024 they had reached a record. I think she will recognise that Labour Governments have had strong records of reducing waiting lists, which is what we are doing now. We are only getting started, but it would be good to have some words of encouragement.

[Dr Johnson]

I am always happy to encourage the hon. Gentleman; I hope that in the impending reshuffle, he is given the opportunity to put his experience into practice. I have one word for him: pandemic. The pandemic made a huge difference to the numbers on waiting lists, and there is no current pandemic. It is possible to make arguments about whether the Government at the time—I was not in the Government at the time—were too harsh in their policies around elective care, whether patients would have come into hospitals for elective operations during covid or whether they would have preferred not to, and whether the waiting lists grew more than they may have done in other circumstances, but to try to say that the pandemic had no effect is going a stretch too far.

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[Dr Prinsley]

rose—

[Dr Johnson]

I will come to the hon. Gentleman in a minute, but I need to answer my right hon. Friend’s question first. My right hon. Friend has a much better memory than me—I was much younger then—so I am sure his statistics will be accurate.

[Dr Prinsley]

I think the principal reduction that the right hon. Member for Melton and Syston described was a result of the change of practice in the way that psychiatry was managed. During that period, we closed the asylums—large hospitals on the outskirts of almost every town and city. That was the result of a change in clinical practice—the idea that patients should be managed within the community. However, we continued to close acute beds, and it is the acute beds in the district general hospitals that are the problem we are talking about.

[Dr Johnson]

I think we are going back full circle to the hon. Gentleman’s intervention on my hon. Friend the Member for Farnham and Bordon, when he suggested that the problem was that beds had historically been closed. Now he is making the point that there were clinical reasons why that happened, not just managerial reasons. I think that is an important thing to note.

Moving on from capacity, we also need to look at the workforce. I would be grateful if the Minister could tell us how soon “imminent” is in terms of the workforce plan. There was also a point picked up earlier—I cannot remember who picked it up; it might have been the hon. Member for North Shropshire—about discharge from hospital and pharmacies. One of the challenges that I find as a clinician is that hospital pharmacies often close relatively early, which means that it is more difficult to discharge patients in the evening. That is something for the Minister to look at. There is also, of course, the importance of social care, and ensuring the provision of social care beds both to prevent admission and to get people out of hospital as quickly as is safely possible.

That is the background to this group of new clauses. New clause 12, in the name of the hon. Member for North Shropshire, would require a report on corridor care to be produced six months after the passage of the Act, and then every 12 months, containing data at the hospital, trust and ICB level on the number of individuals receiving care in an inappropriate place. That seems sensible data to collect, but I believe the Government may already to be collecting it; the Minister may be able to enlighten us on that. The report would also set out the steps taken in that year to reduce the number of patients in inappropriate care spaces, the plans for the coming year to reduce that number further—as I said, it is going up at the moment—and the funding allocated to that. There is some sense to that. Then the Secretary of State would have to give evidence in front of a panel, called the “corridor care tribunal”, which would include patients, affected families and impacted NHS staff, who would be selected by Healthwatch and NHS royal colleges.

I have just a couple of points on that. One is that Healthwatch will be abolished by the Bill, which would make that challenging—perhaps the new clause would need to be redrafted. Also, I am a member of the Royal College of Paediatrics and Child Health and an NHS consultant paediatrician and, as far as I am aware, the royal colleges are independent of the national health service. They are separate; they are connected in terms of training, standards and advice, but I believe that they are organisationally independent. I am sure that the Minister will correct me if I have got that wrong.

I wonder whether the hon. Member for North Shropshire has considered whether the Health and Social Care Committee, which is elected and politically balanced, might be the right body to scrutinise those Government plans. My hon. Friend the Member for Isle of Wight East, who is a member of the Select Committee, is not here now, but—

Health Bill (Fifth sitting)

Debate between Peter Prinsley and Caroline Johnson

Committee stage
Tuesday 23rd June 2026 Public Bill Committees

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

Before the lunch break I was saying that, in essence, clause 7 states what the Secretary of State’s job is. It moves the function of planning the workforce from NHS England to the Secretary of State, which is a reasonable thing to do. I talked about the previous Government’s record on opening new medical schools and how that has helped with the number of clinical staff.

We also talked about workforce planning. The Government are due to produce a workforce plan, but it is not clear when it is due to come out. It was due to come out at the end of last year, but it did not; it was then due to come out in the spring, but now it is the summer. Given the Prime Minister’s resignation, it is not at all clear when it will come out. Will the Minister let us know whether it will come out before the summer recess, this week or whenever?

I quoted some of the concerns of the Royal College of Nursing, the British Medical Association, of which I am a member, and others. Those concerns include the workforce plan. Those organisations have seen what we have not seen, so they have been asked to comment on something that we have yet to see. That brings me to new clause 44, which is in my name.

Before the general election, Labour promised that it would double the number of medical school places. The now Chancellor of the Exchequer promised to double the number of medical school training places, as did the now Secretary of State for Science, Innovation and Technology. Once the general election had passed and Labour was in government, the promise was reiterated. At oral questions in October 2024, the now former Health Secretary said:

“This Government are committed, as we were in opposition, to doubling the number of medical school places”.—[Official Report, 15 October 2024; Vol. 754, c. 683.]—

but there has not really been any progress.

During a debate this year on the junior doctors’ foundation programme, I asked the Minister for Care whether the Government’s intention was still to honour that pledge. He said:

“Yes, that is the Government’s intention.”—[Official Report, 22 April 2026; Vol. 784, c. 133WH.]—

only to later submit a written correction stating that the Government had never committed to doing so. Are they going to, or not? It is not clear.

Labour promised to double the number of medical school places, but now that pledge appears to have been airbrushed out of history. Can the Minister please explain why she and her colleagues deemed the workforce pledge essential before the election but not after it? Can she tell us whether it is Government policy? In essence, my new clause 44 asks Members on the Government Benches to vote for what they promised before the election and have promised since.

New clause 44 is very simple: it stipulates that the Secretary of State must double the number of medical school training places by 2031-32. That is what Labour promised, so it should be fairly easy for Labour Members to vote for it. I hope that the Committee will support the new clause, which only requires Ministers to do what their party promised before it came into government.

If the Government are not keen on committing to clear targets, they can at least commit to full scrutiny of their workforce plans. Of course, there is a risk that the House has been misled. Either the promise was made or it was not. The Minister for Care said that it was promised and then submitted a written correction to say that that was inaccurate and that it was never Government policy, but if it has been stated by the Secretary of State at the Dispatch Box, representing the Government, then it is Government policy. Can the Minister help to clarify that point? If the House has been misled by either her former boss or the Minister for Care, perhaps she can clear that up for us. Perhaps the vote will help.

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

Does the shadow Minister agree that if we doubled the number of medical students, we would simply not be able to accommodate those people as young doctors unless we also doubled the number of training places? After five or six years, those medical students become young doctors. If we are to correct any problem with the medical workforce, it is insufficient to simply state that we will double the number of medical students.

[Dr Johnson]

The hon. Gentleman is right. When all the new doctors that the Government have promised have been trained, they will need jobs and postgraduate medical training, and there are issues with that. Nevertheless, the Government asked the public to vote for them on the basis that they would double the number of medical school places. Many of the hon. Gentleman’s colleagues produced little videos to that effect, which can be viewed on Twitter. They toured the newsrooms saying, “Please vote for us, we’re going to double the number of medical school places.” They suggested that there would be a revolution in Government to make sure that there were enough doctors. This is important—more doctors would help.

All new clause 44 does is ask the Government to commit to doing what they have said that they will do—or to say that they will not. Either way, we have had the Secretary of State saying one thing and a Minister saying the opposite and then correcting it, so we need clarity. The public deserve that. The Minister herself said that they would double the number of medical school places so that we have the doctors that our NHS needs. If they do not double the number of medical school places, it follows that they will not have the number of doctors that the NHS needs. Presumably that is in their workforce plan, but it needs to be cleared up.

Amendment 50 would put a duty on the Secretary of State to publish independently audited forecasts of the NHS workforce every five years. The logic is straightforward: if the Government believe that their plans are sufficient, they can be compared to an impartial assessment of the workforce. The previous Government published a workforce plan in 2023, setting out how to tackle existing and future workforce challenges over several years. That included doubling the number of medical school places. Yet three years later, this Government are on course for a new plan that is reportedly far less ambitious—we will find out in a minute.

The workforce affects whether patients can be seen on time, maternity wards are safely staffed and elderly patients get the dignity they deserve. It is the difference between the NHS meeting the challenge of an ageing population or slipping into decline. If Labour Members are confident that the Minister’s workforce planning is robust, I expect that they will support my amendment, which requires an independently audited forecast. If they are not willing to support it, that suggests that they know this Government cannot be trusted to deliver the workforce that patients need.

Amendment 54 and new clause 45 were also tabled in my name. Amendment 54 would require the Secretary of State to look at the amount of clinical work that NHS managers undertake. As a clinician, I have increasingly noticed that highly qualified clinical practitioners come in, become the person on the ward who can be relied on, and then go off because they get promoted to a nine-to-five job that is easier and pays more, but does not deliver clinical care.

The chief medical officer, for example, still delivers clinical care, and the amendment probes the Government to consider how many nurses and clinicians in hospitals are delivering clinical care. I asked that in written questions, and the Government did not know the answer. It is materially important information, particularly when looking at the Dash report, which talks about an explosion in the number of people who are clinically trained but not providing clinical work—instead, they are creating guidelines and monitoring whether other clinicians are doing the work. If more of those people were engaged in clinical activity, that might improve the quality of both the guidelines and care, because more junior staff would have senior staff around to help them.

Health Bill (Fourth sitting)

Debate between Peter Prinsley and Caroline Johnson

Committee stage
Tuesday 23rd June 2026 Public Bill Committees

[Peter Prinsley]

I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 4 ordered to stand part of the Bill.

Clause 5

Patient involvement and choice

[Dr Johnson]

I beg to move amendment 59, in clause 5, page 4, leave out lines 2 to 4 and insert—

“(1) In exercising functions in relation to the health service, the Secretary of State must act with a view to enabling patients to make choices with respect to aspects of health services provided to them, including to make choices as to the provider of those services.

(2) For the purposes of subsection (1), the Secretary of State must ensure that patients who are referred for a service to be provided outside a hospital setting (‘out-of-hospital services’) are offered a choice of provider of that service from among the providers available in their integrated care board area and, where relevant, in neighbouring areas, in accordance with regulations made under section 14Z45B.

(3) Regulations under section 14Z45B must provide that, where an out-of-hospital service is to be provided to a patient, the integrated care board must—

(a) offer the patient a meaningful choice of at least two providers capable of providing the service, which may include NHS bodies and independent sector providers approved to provide that service under arrangements with the integrated care board;

(b) provide the patient with information to support an informed choice, including for each available provider—

(i) indicative waiting times;

(ii) the location at which the service would be provided;

(iii) the quality ratings or outcomes data applicable to that provider for that service where such data is available; and

(iv) whether any costs would be incurred by the patient in travelling to or receiving the service at that provider;

(c) not exclude from the list of available providers any provider approved solely on grounds of commercial interest or organisational type; and

(d) take all reasonable steps to give effect to the patient's choice within a clinically appropriate timeframe.

(4) For the purposes of this section, ‘out-of-hospital services’ means services—

(a) provided in community, primary care or ambulatory settings rather than in a hospital inpatient or outpatient department; and

(b) which the Secretary of State specifies by regulations as being within the scope of the choice obligation under subsection (2),

and may include diagnostic services, audiology and hearing aid care, podiatry, dietetics and nutrition, physiotherapy, ambulatory cardiac monitoring and such other services as the Secretary of State may specify.

(5) In specifying services under subsection (4)(b), the Secretary of State must have regard to—

(a) the potential for the expansion of choice to reduce waiting times for the relevant service;

(b) the availability of sufficient independent and NHS providers to make genuine choice meaningful; and

(c) the desirability of ensuring access to choice for patients in all parts of England, including in rural and deprived areas.

(6) The Secretary of State must publish, and lay before Parliament, within 12 months of the date on which this Act is passed, a statement setting out—

(a) the out-of-hospital services for which choice obligations under subsection (2) will initially apply;

(b) the timetable for extending the choice obligation to further services; and

(c) the support that will be made available to patients, in particular those with limited digital access or literacy, to exercise the choices to which they are entitled under this section.

(7) The Secretary of State must review and update the statement required by subsection (6) at intervals of not more than two years.”

This amendment strengthens the new patient choice duty inserted by Clause 5 from a general aspiration into a specific, enforceable right to choose between providers for out-of-hospital services.

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[Peter Prinsley]

Does the shadow Minister accept that, in order to encourage innovation within the health service, we need to do whatever we can to support clinical academics? It is within the academic departments of universities, where people are working in hospitals and teaching in medical schools, that we see the most fruitful innovations.

[Dr Johnson]

The hon. Gentleman is right, but there are pressures and challenges for clinical academics, which he will be aware of. I am sure the Minister, in summing up, will tell us what she is doing about those.

We need to support innovation in all parts of the health service, not just in university hospitals. One of my concerns is that there has been a drive towards a hub and spoke model. There are good reasons for that, and there have been some good outcomes for patient care, but in some cases it restricts innovation in the peripheral parts of the model; it can disincentivise innovation and make it more difficult. We need to consider how we support innovation in all areas of the NHS.

Health Bill (Second sitting)

Debate between Peter Prinsley and Caroline Johnson

Committee stage
Tuesday 16th June 2026 Public Bill Committees

[Peter Prinsley]

Q I would love to amend the figures in my bank account—I would like to be able to go into my Lloyds bank account and add a nought to the end of the balance figure—but I cannot, because the bank controls that. But I am the one who has access to the data.

Dr Byrne: I totally support that ambition. Patients and the public having more agency in their care, strengthening that relationship, and them being able to access their information through the NHS app is a great thing. That is hugely helpful, and there is real potential with the SPR to strengthen that. We have landed on agreement.

[Dr Johnson]

Q Do you have any thoughts on the separation of elements of the record such as safeguarding records and sexual health records? We have heard about carers being able to see parts of the record. Surely there are circumstances where we may want people to see parts of the record but not others, or people may wish to share some parts and not others. Are you aware of any provision being made for that?

Dr Byrne: At the moment, I think it is too early to say. Those are absolutely important questions that will have to be addressed in the design. At the moment, I am not sure how the programme intends to deal with those questions, but clinically, that needs to be thought about. There are complications that need to be thought about very carefully in terms of the record and the access. Sometimes that is clinically complicated, but I am not aware of what the plans are for that.

Junior Doctors’ Foundation Programme

Debate between Peter Prinsley and Caroline Johnson

Wednesday 22nd April 2026 Westminster Hall

[Peter Prinsley]

Some time ago, when I came here, I had working with me an intern, Dr Harry Dunn, who was a medical student at Cambridge University. He graduated last year. He came top, not only of the University of Cambridge medical student cohort, but of the whole of the University of Cambridge, so he was the top student of his year. He was offered a foundation post in Northern Ireland. He chose not to take it, and has now gone into consulting, having given up medicine. That is an extremely sad example of an unintended consequence of this crazy lottery.

[Dr Johnson]

I congratulate that person on his prowess in university. He is clearly an incredible person, and it is a shame that he has been lost to medicine. I am sure Northern Ireland is a great place to work, and it is disappointing that he did not want to go there, but he should have been able to apply for the jobs that he wanted in places where he wanted to work, and to compete fairly for them. That is a bit stressful and competitive—but getting into medical school is competitive.

You may not know this, Mrs Barker, but the hon. Member for Bury St Edmunds and Stowmarket and I grew up on the same street, in the same town, and went into similar-ish careers. We competed for medical school places and for our jobs. We are all here today having competed against others for election—that is the reality of life. To remove the competition, which is based on meritocracy, and replace it with a random allocation is more unfair and stressful than the alternative.

One of the issues raised about the old scheme was that it was difficult to recruit in some areas. The competition for the best jobs, or at least those perceived to be the best or most wanted jobs, means that some areas of the country and some specialties could find themselves with the people who did not succeed in getting the jobs they wanted. How do we manage that? It used to be managed with rotations. When people went to the interview for specialist jobs, they would be called in one at a time and told, “These are the rotations available. Which one do you want?” The best jobs—the most popular ones—would be mixed with the least popular, so that would mitigate the problem.

There is one issue that I want to raise briefly. Some medical schools in the UK, including Newcastle, have overseas campuses in Malta, Cyprus and Malaysia. Some British people have gone to those branches of UK medical schools and have found themselves completely excluded from places in the United Kingdom under the medical training changes that the Government have made in the past couple of months, which seems wrong. We talked about that when the Bill went through, and the Minister was keen to reassure us that all would be well, but we have found that British students have not been able to get jobs in the British training programme. Will the Minister look at prioritising at least those who went to medical school before the changes for British jobs?

The current system gives junior doctors—resident doctors, as they are called now—no agency, no control, no appeal and no alternative. It is clearly unfair. Could the Minister update the House on how he intends to fix the system?

Brain Tumour Survival Rates

Debate between Peter Prinsley and Caroline Johnson

Monday 9th February 2026 Commons Chamber

[Dr Johnson]

My right hon. Friend invites me to speak outside my area of expertise; I am afraid I do not know the answer to that.

[Peter Prinsley]

Will the shadow Minister take an intervention?

[Dr Johnson]

I will, particularly if the hon. Gentleman has an answer for my right hon. Friend.

[Peter Prinsley]

I cannot understand how there can be a relationship between head injury and brain tumour. Repeated injury causes some neurological conditions, particularly for footballers, whom we see getting early dementia, but I do not see a connection between head injury and brain tumour. Does the shadow Minister?

[Dr Johnson]

It is certainly something that I have read about. I am happy to be corrected by the hon. Gentleman if he feels that my resources are incorrect, but that was certainly one of the suggestions for how to prevent these tumours. I do not think that prevention will necessarily be the major way in which we improve the survival rate. I also do not think that it will be early diagnosis, but I would like to finish talking about that. Regular screening for people with genetic disorders can really help to identify tumours early, and the second thing that can help is access to diagnostic tests. The Conservative Government introduced community diagnostic centres across the country, which increased the number of scanners available to those who needed a scan to identify whether they had a brain tumour. This Government have said that they will double the number of scanners available. Can the Minister comment on whether they are on track with that?

We need the workforce plan, so that we have the people to perform and interpret the scans. I do not know whether the Minister has had any tips on whether the workforce plan is imminent, but can he give us a date for when it is likely to be published? It has been delayed, but it is important. We have the cancer plan, but so much of it is dependent on the workforce plan. Thirdly, opticians have a role to play. Since a South Tees project pioneered in 2015, opticians have been able, during regular eye tests, to identify people who have signs of brain tumours, and to refer them, when necessary. Encouraging people to get regular eye tests may contribute to early diagnosis.

The fourth thing that can help with early diagnosis is symptom awareness—among both the general public and healthcare professionals. I want to talk about HeadSmart, a 2011 programme about the types of symptoms that could help identify a brain tumour. It had quite significant cut-through with both healthcare professionals and the public. It halved the time for a scan, and for diagnosis of children with brain tumours. It also improved the cognition of survivors, but it did not significantly improve the survival rate. While early diagnosis helps a bit, it is very difficult—particularly in children, who are quite neuroplastic, so symptoms appear quite late. The location and type of tumour are more important in the treatment and prognosis, and there are many different types. That makes this area of medicine extremely complicated, so I think the answer is that we need better treatments.

Treatments currently include steroids, chemotherapy, radiotherapy and surgery, but there are many others with promise. Convection-enhanced delivery enables chemotherapy to be delivered across the blood-brain barrier more effectively. Many hon. Members have talked about freezing, and last month there was a debate on the topic of freezing brain tumour samples; does the Minister have an update following that debate? His colleague, the Under-Secretary of State for Health and Social Care, the hon. Member for West Lancashire (Ashley Dalton), said that she would look at the detail and report back, so I hope that he will have an update for us this evening. Gene therapy has also shown a lot of promise, and there has been talk this evening about the trial in which an adeno-associated virus is used as a vector to seek out the glioblastoma cells and use the patient’s immune system to kill the tumour cells. That trial has promise; if it works, it could lead to real improvements in treatment.

Research will be key. BioNTech’s 2023 partnership promised that there would be 10,000 patients in cancer vaccine trials by 2030, but new innovators face barriers. This is a global fight; work is going on right across the globe, and we need to make the UK’s environment one that stimulates and supports research, so that British people can have the earliest possible access to the newest treatments. At the moment, the wider economic picture for research is not great, and we have seen some researchers pull out of investments in the UK. Taxation, national insurance, employment rules and the speed of adoption by the NHS are all factors that I hope the Minister will try to improve.

The hon. Members for Edinburgh South West (Dr Arthur) and for Strangford (Jim Shannon) talked about the devolved Administrations. Could the Minister comment on how he and his team are working with those Administrations to encourage research right across the United Kingdom? I also wanted to talk about rural areas, because it is all very well encouraging trials in the UK or England, but so many of those trials are in the centre of London, or in the other big cities; it is much more difficult for people living in rural areas, such as my constituents in Sleaford and North Hykeham, to access them. Could the Minister please update the House on how he is making it easier for research to occur in rural spots?

The hon. Member for Witney summed it up perfectly when he said that ambition is important, but actions, not words, are the key. We need specific, measurable targets, not just warm words—this Government have been very good at warm words on health, but much poorer on delivery. For the sake of the one in two people who will get cancer, and all their friends and loved ones, I hope that on this occasion, there is more action, not just words.