Health Bill (Seventh sitting)

Sojan Joseph Excerpts

Committee stage
Thursday 25th June 2026 Public Bill Committees

[Gregory Stafford]

My hon. Friend is absolutely right. The danger in this process—especially the multiple instances of chasing within a period of weeks, which sometimes happens—is that pressure is put on patients. Again, I know anecdotally from patients who have been speaking to me that those who are most compliant—if I can put it like that—and do not want to make a fuss are generally older and vulnerable people, who feel that they are perhaps causing an inconvenience to the system. They see people with, in their view, more serious conditions or a greater need. We need to be very careful about creating perverse incentives, financial or otherwise, to try to take some of those people off the list. As I say, the significant jump that we have seen deserves more scrutiny and inquiry, and that is why I am very supportive of my hon. Friend’s amendment.

We need to understand whether patients are being removed because they no longer require treatment, as the hon. Member for Bury St Edmunds and Stowmarket said—which is, of course, entirely appropriate—or just to improve targets, present an improved picture of waiting lists, and unlock the financial benefits tied to performance metrics. There is a troubling echo here. We saw similar practices in the 2000s when patients were removed or reclassified in ways that reduced waiting list numbers without genuinely improving access to care; it damaged confidence in the system then and it risks doing so now. What concerns me most is that we may be repeating that pattern. If the Government find they cannot meet their waiting list targets, there is a real danger that the pressure to do so will translate into decisions that, intentionally or not, compromise patient safety and fairness.

[Sojan Joseph (Ashford) (Lab)]

We are in 2026. Social media and the media scrutinise everything that we do. Will the hon. Member confirm if there has been any report in the media that somebody, anywhere in the country, has had their condition made worse, or died, or did not get treatment?

[Gregory Stafford]

There have been a number of reports of situations where people have not received care and have died because of that, so I do not see the hon. Member’s point. I think that, with amendment 52, my hon. Friend the Member for Sleaford and North Hykeham is trying to ensure that when the statistics are published, we can scrutinise the reasons behind them. The hon. Member for Ashford may be entirely right; let us imagine that is the case, and there is no gamifying or pressure going on. Why not allow the public to see that? Why not put to bed the HSJ stories that say there is something fishy going on? He should welcome that level of transparency and scrutiny to back up his argument if he is correct.

Health Bill (Sixth sitting)

Sojan Joseph Excerpts

Committee stage
Thursday 25th June 2026 Public Bill Committees

[Sojan Joseph (Ashford) (Lab)]

New clause 2 clearly states that everybody should have a legal right to an appointment with their GP “within seven days”, while the current provision is that patients are entitled to see a GP or other professional within 24 hours or two days for urgent care. Would creating this legal burden on GP practices not reduce their ability to prioritise, meaning that the people who need urgent treatment will be delayed further?

[Helen Morgan]

We do not consider the right to achieve a cancer diagnosis and treatment to be burdensome on the secondary care providers of those treatments; we consider that important enough to enshrine that right within the NHS constitution, and this would be a similar level of right. I would not imagine that a GP would be worrying about somebody taking them to court, but it would confer upon the Secretary of State the duty to ensure that primary care is adequately resourced in order to be able to meet that commitment.

Health Bill (Fifth sitting)

Sojan Joseph Excerpts

Committee stage
Tuesday 23rd June 2026 Public Bill Committees

[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.

[Sojan Joseph (Ashford) (Lab)]

I strongly support the argument that clinical staff, even if they progress into a senior role, should carry out some sort of clinical practice. Does the hon. Lady agree that that is what went wrong over the past few years, especially when NHS England was created? Many senior clinicians who were moved into management posts had no contact with clinical areas. That is what this Government are trying to fix by abolishing NHS England.

[Dr Johnson]

I am talking predominantly about clinicians working in trusts who are trained and very experienced, but then move to work in the same trust but in a more managerial role that does not involve clinical care. I am not saying that every single person needs to be delivering clinical care—there may be exceptions, of course; people do have career changes—but I encourage the Government to reflect on the number of posts being created that take people away from the clinical arena, and on the effect that that has. When the Minister is presented with the number of nursing or midwifery-qualified staff working in a particular department, that may not reflect the number who are delivering clinical care and, by their own admission, the Government do not know which is which.

Amendment 33 would place a duty on the Secretary of State to ensure that the workforce is trained on the wider determinants of health, such as housing standards, air pollution and the use of harmful substances. In my many years as a paediatrician, I have yet to meet a nurse, doctor, surgeon, porter or care co-ordinator who does not know that damp and mould are bad for people’s health, and I have yet to meet a fellow employee who does not know that air pollution causes asthma, or that tobacco use increases the risk of chronic obstructive pulmonary disease, cancer and a whole host of other ailments.

Considering the many pressures on NHS workers, I do not believe that mandating a new programme on health determinants is a good use of time. I fear that it is rooted in the agenda of creating more and more mandatory training, and I would actually encourage the Minister to look at rationalising mandatory training to that which is absolutely necessary. Control of the curriculum for such staff is dealt with separately, so I object to amendment 33.

Health Bill (Fourth sitting)

Sojan Joseph Excerpts

Committee stage
Tuesday 23rd June 2026 Public Bill Committees

[Sojan Joseph (Ashford) (Lab)]

I rise to support clause 7 and amendment 33, tabled by my hon. Friend the Member for Worthing West. Having worked in the NHS for many years, I have seen that education and training, especially mandatory training, is absolutely necessary. Some may argue that health staff have too much training, particularly mandatory training, but this amendment specifically concerns training

“in the wider determinants of health such as housing standards, exposure to air pollution, occupational risk, and use of harmful substances like tobacco.”

We may have staff, especially those working in mental health, who have training in some of those areas, but staff in A&E, where patients first present, may not have that training, and may be missing that curiosity. We have heard many incidents involving families living in mouldy houses or people exposed to air pollution. It is important that staff have the curiosity to consider where a patient has come from when they turn up at A&E, or, when planning a discharge, where they are being discharged to.

In the last few years, we have seen many internationally trained healthcare workers join our health sector who may not be familiar with the social and housing situation in this country. Whether this is to be a part of their initial training as nurses or doctors, or through mandatory training at work, the amendment is important because it could help to prevent illnesses and identify them earlier through professional curiosity. I support amendment 33.

[Dr Johnson]

I declare an interest as a member of the NHS workforce and an NHS consultant paediatrician. In England, around one in every 17 working people is employed by the national health service. That is quite a shocking statistic. It is the largest employer in the country and, indeed, in Europe. It has grown significantly over time, in part because the needs of the population have changed. Life expectancy is longer, which is something to be cherished—that is a good thing—but it brings challenges to the health service, as people are more likely to be living with multiple chronic conditions rather than easily treatable ailments. They require more tests, medicines and clinical care. Demographic change requires a larger NHS workforce, particularly in secondary care.

The previous Conservative Government not only recognised the scale of that challenge but took swift action to increase staffing levels across the board, adding more than 42,000 doctors and 55,000 nurses, health visitors and midwives. Conservative Ministers also supported the pipeline responsible for producing the next generation of medical practitioners. They funded 1,500 additional medical school places and opened five new medical schools, including in Sunderland, Lancashire, Chelmsford and Canterbury, and one just outside my constituency in Lincoln. Emergency care became the fastest-growing specialty, with the number of emergency care doctors doubling. That is what support for the NHS workforce looks like.

Conservative investments in the workforce helped to improve survival rates for cancer, increase the number of GP appointments and deliver the fastest vaccine roll-out in Europe. Under existing legislation, the Secretary of State has a responsibility to ensure that there is an effective system for planning and delivering education and training to current and potential staff. Health Education England has been rolled into NHS England, so it is ultimately NHS England that has the duty to ensure sufficient and appropriately trained staff to meet NHS workforce needs. Now that NHS England is to be abolished, it is right that this duty is to be given to the Secretary of State through clause 7, although to some extent it is a statement of the obvious that that is part of his job.

The job of members of this Committee is to improve the Bill, not just wave it through, and that means recognising that the existing legislation had some inadequacies. Clause 7 states:

“The Secretary of State must exercise functions…with a view to ensuring”

several things about the workforce. It is not a cast-iron requirement; the Secretary of State must just think about it, but actually he should not just think about his job; he should get on with it. I have a bit of a bee in my bonnet about legislation that creates obligations that are easy to proclaim and that are virtuous but are difficult to measure. Such legislation makes legislators feel good about themselves because they are writing nice things into legislation, but they are not really robust. What does

“sufficient people with appropriate education”

mean? What is “sufficient”?

One reason concerns are particularly acute is the Government’s shambolic record on workforce planning. They came to power saying that they had a plan, but their workforce plan has still not been published, almost two years since they came into office. I heard the Minister say “imminently”, but I had a written answer last week, I think, saying “imminently”. I appreciate that “imminently” is probably better than “soon”, but what does it really mean, and how soon can we expect the plan to be published? Does she mean that it is coming this week or next? Can she guarantee that it will be published before the summer recess? Has the Prime Minister’s resignation yesterday put all this up in the air once again?

The Royal College of Radiologists has said that the shortfall in clinical radiologists has grown from 29% to 32% since 2024, and the Royal College of Nursing has released data showing that the growth in the nursing workforce slowed last year to its lowest level in eight years. Newly qualified midwives are finding themselves with no jobs to go to in the health service, despite the fact that there is a maternity staffing crisis in some areas. Will the Minister explain the reason for the delay? She said earlier in this sitting that it was not NHS England, but what is causing the delay?

We were told that stakeholders wanted more time to have conversations, test ideas and work together. One would think that after the many months of deliberation, Ministers would have put together an exceptional workforce plan, but the Royal College of Nursing, the British Medical Association, of which I am a member, Unite the union and several other organisations wrote to the Health Secretary earlier this month to urge for the plan, which they have but which has not been published, to be “paused”, because they are

“concerned that the current direction falls significantly short of the scale of workforce growth required to meet patient need and relies too heavily on assumptions about the current state of NHS services, productivity and technology that are not borne out of frontline experience.”

I recently tabled a question asking who had been given advanced sight of the workforce plan, and I received confirmation that the royal colleges and unions have been involved. As I mentioned, I am a member of the Royal College of Paediatrics and Child Health. We now have a situation where a workforce plan is being delayed, and it has been brought before other organisations for discussion rather than elected Members of this House. It is taking far too long. In the meantime, things are going backwards. It is simply not good enough. Ministers are now about to roll out a plan that has mortified seemingly everyone who has seen it, while expecting members of the Committee to rubber-stamp a rather flimsy legal duty.

In May, the Financial Times reported that plans drawn up under this Government would see recruitment cut back. The article reads:

“A workforce plan being finalised by health officials says the NHS in England will have to use technology to get by with hundreds of thousands fewer staff than envisaged under the previous Conservative government.”

Is that clinical staff? Are we going to have fewer doctors? It is not clear because we have not seen the plan and it has not been published. A draft of the plan seen by the newspaper said that the NHS

“does not need anything like the…numbers…set out in its 2023 workforce plan.’

Will the Minister confirm whether those press reports are accurate? She previously said that her plan

“will ensure that the NHS has the right people in the right places with the right skills for patients when they need them”.—[Official Report, 13 January 2026; Vol. 778, c. 737-738.]

Does that mean fewer people and more AI?

Health Bill (Second sitting)

Sojan Joseph Excerpts

Committee stage
Tuesday 16th June 2026 Public Bill Committees

[Joe Robertson (Isle of Wight East) (Con)]

Q Professor Croisdale-Appleby, the local healthwatch on the Isle of Wight has proven invaluable in amplifying patient voice, gathering patient experience and helping those who are democratically elected—MPs and councillors—to hold health leaders to account. My concern about that function being folded into the ICB is that the ICB has often been on the sharp end of critical analysis by Healthwatch, and so the ICB will end up marking its own homework. We will lose the critical voice that has, I am sure, led to better decision making. How can we possibly resolve that fundamental issue, if Healthwatch is folded into ICBs?

Professor Croisdale-Appleby: You make a pivotal and focused point. The independence is vital, not just because of the quality of what Healthwatch produces, but because of the confidence that it gives people that they are speaking to an independent organisation. In the background, some communities distrust being critical about the care that they receive in case it rebounds on them. If the same organisation is responsible for marking its own homework, as you put it, that problem will be much greater than it has been in the past. In terms of what to do about it, I think that you stick to some basic principles. If we are moving forward positively, we have got to be locally driven. We must reach out to communities. They will not reach into us; we have to reach out to those communities and the individuals within them.

I mentioned the value of qualitative evidence. It is not always easy for big institutions to go through all the work of evaluating qualitative work. It is easy to look at quantitative statistics, but the patient voice must be highly visible and central to policymaking. That was the basic idea behind the Bill: it would be about the patient and the patient voice, putting the patient right at the centre of the multiple discourses. As my colleagues have said, we should be totally transparent about priorities, impact and holding people to account. If all five of those principles are followed, it will work. If they are not followed, it will not.

[Sojan Joseph (Ashford) (Lab)]

Q Sarah, you mentioned that the patient should be the centre of all this. I do not think that anybody disagrees—including any politicians—that making these changes is in the best interest of the patients. However, many changes have happened over the decades, but data for the last 10 years shows that patient safety incidents and complaints are steadily going up, so those changes have not made any impact on patient care, safety or experience. We need to do something here.

After each incident, there is a recommendation or an action plan, but clinical staff or patients do not have much involvement with those and do not see any difference. Healthwatch helpfully finds the issues, but it may not actually go back and see what changes are made following its recommendations. The CQC physically goes into clinical areas to see the difference, and has the power to take action against those responsible, so is it not a good change that more accountability will sit with the providers, and the CQC—or local authorities and ICBs—can take action against them?

Professor Croisdale-Appleby: Forgive me; you asked several questions. Which would you like me to start with?

[Sojan Joseph]

I asked whether it is not a good change to streamline these bodies so that fewer of them have powers to take action like the CQC?

Professor Croisdale-Appleby: There is always a danger, if I may say so, in the use of the word “streamline”. We have to think what is lost in the streamlining process. I do not want to repeat what I have said and waste your time, but one thing that is important is whether there is a golden thread running through seeking out and listening to patients’ views, putting those together in a coherent form, making recommendations for improvement—that is what we do all the time at Healthwatch—and then holding people accountable for that. I remember Penny Dash saying that one of the points of the Bill is to bring this closer to those who commission and those who deliver. I am not sure that it necessarily takes it closer to that simply by embedding it—as a colleague asked earlier—within the formal structure. There is a danger in that that the patient voice is often a spiky voice. As a former chair of hospitals and so on, I know that patients do not always say things that are convenient. That point about independence is vital. If I may, sir, I take slight issue with your term “streamlining” and would try to take that apart into the different components that might comprise it.

Sarah Tilsed: I cannot comment too much on the CQC, but on the point about a rise in complaints but nothing seems to be happening, we are finding that patients do not want to complain any more because they are finding that they are getting a worse service of care. That might be a slightly separate issue, but considering that there are so many complaints and that patients are not wanting to complain because they are scared, I do not think that streamlining is the right way. We need an independent voice that will focus solely on the patient voice, which I think we are completely losing at the moment.

[Gregory Stafford]

Q On the streamlining point, you have articulated very clearly why you think it is inappropriate, as have members of this Committee, and most of the evidence we have received suggests that it is not appropriate. What do you think is the reasoning behind the Government’s real push for this, when the evidence against it is so clearly strong? Is it simply that they want to save money, in your opinion, or is there an alternative motive?

Professor Croisdale-Appleby: If we talk about money— I will be quantitative here—Healthwatch England currently costs £3 million per year and the network receives £25 million per year. To people like me, £3 million and £25 million is a lot of money, but in the greater scheme of things it is not a significant amount, particularly when you think what is being produced for it.

I cannot speak appropriately, in my role as chair of Healthwatch, about Government policy. It is not my job to do that; it is the Government’s job. If you want to ask me a question on a purely personal basis so I can step outside of that role, I will be happy to answer, but I always have to draw a very distinct line on anything that I say. Everything so far has been said in my formal position as chair of Healthwatch as opposed to any personal views, because I certainly do not want to comment on Government policy.

--- Later in debate ---

[Helen Morgan]

Q My other question is about digital exclusion. This is particularly for Dr Imam, because we associate older people with being digitally excluded, although I know it is not exclusively older people who are digitally excluded: how would you envisage the digital record interacting with something more analogue for people who cannot use the NHS app for whatever reason?

Dr Imam: That is a really important question; it is something that needs to be thought about very carefully when it comes to the implementation. From my previous NHS England experience, where we have had digital innovations implemented in the older age group, or among those who are perhaps traditionally digitally excluded, that has included partnerships to enable people to have the option of someone coming around, and there has been a thought process regarding people who perhaps cannot engage with technology as easily. That could involve people from the voluntary, community and social enterprise sector—for example, we had Age UK in the previous panel. There are lots of good examples of that type of work to ensure that people are not disadvantaged.

Dr Byrne: There is an opportunity here in the context of digital exclusion. In a digital-first NHS, it is really helpful to think continually about what the analogue version of the system is in the event of further cyber incidents and outages of the system. We need to continually build and maintain a resilient system for the times when digital-first is not available. It is an important opportunity to do so if we think about that question of exclusion.

[Sojan Joseph]

Q I was listening to Dr Byrne’s concerns about confidentiality and trust. I want to declare that I have worked in the NHS in the mental health sector for many years. I worked in one of the biggest mental health trusts, Kent and Medway mental health NHS trust. We use an electronic patient record called Rio. As Dr Cocker said, before anyone is given access to the record, they have to have training on information governance and data protection, and access is given based on their role. That system creates an audit trail, so patients can request to see how many people have accessed their information in the last month or two—there are facilities on the system to check that. Is staff training and raising awareness among patients important for creating trust and confidentiality?

Dr Byrne: Those things are very important, yes. There are some technical solutions. Again, the SPR is an opportunity to look at that across the system, because systems vary greatly in the sophistication of their audit function, for example. Even when there is an audit function, if someone has legitimate access through their role as a doctor or a nurse, it can be difficult to know whether their access in any particular case is legitimate. These are not common occurrences, but it is extremely distressing for patients if their confidentiality is breached for any reason.

It is not simply a matter of technical controls. We need to look at how we build stronger, more effective deterrents across the system by having effective sanctions when incidents do occur. I am keen to look at that and delighted that the Department of Health and Social Care and NHS England are, I think, very interested in having that conversation with me. At the moment, it certainly seems that there is a variable response across the system to inappropriate access.

Looking ahead to the SPR, we need to look at that make improvements, so that the public can have faith that, given the harm that it can cause them, it will be taken very seriously if anyone does access their records inappropriately. There are technical, cultural and system aspects to think about here. The SPR is definitely an opportunity to do that, and I am very keen to work with other stakeholders on that.

[Peter Prinsley]

Q I am an ENT surgeon. What do you think about giving the patient ownership of the single patient record as well as discretion over whether the information in that record is revealed to the clinical team?

Dr Byrne: It is an interesting idea, but I am not sure. I heard your question earlier about data controllership specifically in this regard. You will not necessarily like my answer. There are two ways of answering the question; perhaps straightforwardly, legally, but also clinically. I will start with the legal answer, which in some ways is easier. Data controllership in data protection law is a very technical term; it is determined by who is making the decisions about processing the means of the data. An organisation running and controlling an electronic patient record would be the data controller. Obviously, this is ultimately a question for the regulator and the Information Commissioner’s Office to determine, but that would be the legal position, nevertheless.

Clinically, we have to come back to thinking about what a patient record is for. Primarily, it is to provide good care in the context of the clinician-patient relationship. If you prioritise the needs of either side of that relationship, I think it is problematic; the needs of one must not outweigh the needs of the other.

The clinical record is there to enable clinicians to record what someone is presenting with, the difficulties they are having, what investigations are appropriate, the findings and what the plan is. It needs to be there for that tool to work. To take you on a slight thought experiment, if it was entirely held within a patient’s control—however loosely we use that term, legally or otherwise—and we could all amend, correct, change or add our diagnoses, findings and treatments, that might be clinically problematic. That may not be the answer you want, but it is the straight answer, if I am honest, from both a clinical and legal perspective.

Health Bill (First sitting)

Sojan Joseph Excerpts

Tuesday 16th June 2026 Public Bill Committees

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

I am a member of the Royal College of Paediatrics and Child Health, a member of the British Medical Association and an NHS consultant paediatrician.

[Sojan Joseph (Ashford) (Lab)]

I used to work in a mental health trust for many years, and I am still its employee—I am on an extended career break from the trust.

[Helen Morgan (North Shropshire) (LD)]

I am a vice-president of the Local Government Association.

--- Later in debate ---

[Gregory Stafford]

Q Would you agree with that, Mr Lant?

Jacob Lant: Yes. I kind of think, as the debate goes on, that—with the changes to Healthwatch in particular—you could achieve so much without legislation. You could beef up the internal functions for listening to a patient and engaging with them without legislation—there is no requirement for that. You could invest more resource in that, and you could do the same with Healthwatch. You could think about the resourcing of the structures and the support they receive, so you could make that whole system better without legislating to get rid of it. As Sarah said, the NHS changes are a distraction at a time when we should be moving on with focusing on patient care.

[Sojan Joseph]

Q Mr Lant, I am trying to understand a bit more about the patient experience and improvement in care that Healthwatch brings. My understanding is that when a patient raises a complaint with the local provider, it usually gets investigated by a local service manager or a matron, but when somebody is not confident about raising a complaint with the local provider, they go to Healthwatch, and that complaint usually filters down for the same local service manager or matron to investigate it—we have seen that happening. Patient experience is not being improved without local accountability or local change. Can you explain why you are concerned about abolishing Healthwatch and bringing more accountability to local ICBs or local authorities, which may improve patient experience and patient care?

Jacob Lant: The issue is that the system—the NHS provider, the commissioner or whoever is picking up the individual complaint—will treat that as an individual incident to look into. Healthwatch may support the individual to raise that complaint or that individual piece of feedback, but the collective learning across that is more important, and it is pulling out the themes that are consistent across multiple bits of feedback, both positive and negative, that makes the difference. We see that evidence and insight from Healthwatch making a difference in local and national policy. It might not feel like that to the individual patient, but things like the creation of a single patient record exist in part because of a lot of campaigning by local healthwatch on the issue of people having to repeatedly tell clinicians about their experiences.

It also could be issues to do with not being able to find a dentist, for example; the system will treat that as an individual incident of helping someone who is trying to find a dentist or not, but Healthwatch could use that insight to petition and push for national change around the commissioning of a service like dentistry. A topic like administration of care, which Healthwatch, National Voices and the King’s Fund have all worked on together, is invisible from the way that the system perceives performance at the moment, but because we listen thematically to patient experience, we can push for a much greater focus on things like the basics of communication and keeping patients up to date on what is happening with their care, which really matter. Healthwatch is thematically looking at patient feedback differently from the way that system does, and that is something I fear may be lost.

[Liz Twist]

Q Ms Woolnough, you have talked about the abolition of NHS England, and, as I understand it, you are dealing with what the position is rather than taking a stand. Beyond the legislation, what are the key things that we should be looking at to get the transfer of functions to ICBs and DHSC right?

Sarah Woolnough: We have talked quite a lot about the culture in the NHS and whether these changes enable the sort of shift that lots of people talk about wanting. Let us be really serious about devolving power and earned autonomy, and about the balance between politicians rightly being held accountable for high-level metrics but with enough operational freedom to allow local systems—services close to people and patients—to get on and do the best for them?

We have a slight concern that, even though the Carltona principle should mean that the Secretary of State will enact powers in a way that does not slow things down, because of the broad sweep of powers given back to the Secretary of State, and the quite extensive powers of direction, politicians come under extreme pressure to intervene in certain cases or when there has been a scandal or patient safety issue, and that could lead to things clogging up.

Fundamentally, our worry has been—again, this goes beyond the legislation—how do you genuinely create a system where the culture is not as paternalistic as it has traditionally been, where you are empowering both staff and patients and citizens to have more say in their care, and where system leaders are not constantly looking up for permission, worried they may be held to account for quite a narrow set of metrics? Although managing money and constitutional standards is very important, if we are to deliver the 10-year plan aims and improved patient care, it is more than that. Our worry has been that the abolition of NHS England by the legislation will narrow things. We do not know, because it is broader than legislation, but how do we fundamentally shift the culture? I know that that is the Government’s intention, but it is about more than legislation. Where is the work to make that happen?

--- Later in debate ---

[Helen Morgan]

Q Do you think anything else should be on the face of the Bill to give us clarity so that that GP concern is mitigated?

Kay Keane: The patients need to understand exactly who has access to that record and exactly who is feeding into it. There is a huge amount of trust between a patient and a GP, and a patient and a healthcare professional in a general practice, and we do not want that trust to be diminished so that the patient stops telling us the things that are worrying them—the whole story. We want them to continue their trust, but if they think that information is spreading further and further across the system, we might lose some of it.

[Sojan Joseph]

Q I want to touch on the single patient record. I declare that I used to work in mental health services. In my experience, mental health patients often navigate between A&E, GPs and mental health services during weekends. Often the clinicians do not know what medication they are on, or what kind of contact patients had on the Friday or Saturday. Also, during the discharge process, getting medication from the GP can be delayed until the discharge notification gets to the GP. Yes, there are concerns about who will own this data, but do you not think that the single patient record will bring a huge benefit for patient safety and continuity of care?

Kay Keane: In the example you gave, the hospital should be giving seven days-worth of medication to the patient. That is clearly its responsibility. Within those seven days, the GP practice should get a discharge letter that says what has happened; if appropriate, we then take over the prescribing.

If the information comes and is good quality—if the data is good and timely—the things you mentioned do not happen; they happen when neither of those things are the case. In my experience, information that comes out of A&E is often difficult to understand. A&E might make a diagnosis that it works with, but by the time that gets to the ward it can be different, so the A&E information we act on could be very different from what the patient is discharged with. Timely and good-quality information is therefore really important, and that GP record then becomes the centre of the patient’s care.

Dr Dickson: You are talking about transfer of care between services and about a weekend being an important flashpoint, but I think that that transfer of care does not happen appropriately even during the week. It is getting better, with electronic systems, but it is still not necessarily working for the full benefit of patients, especially if they access multiple services. The value of the single patient record is to make that safe, but the question is, will it do that? Can it do that? Is it safe to do that? Will the patient’s data be protected? That is what we are we are worried about. I think that is what patients worry about. They perceive that we do that already, and when they come up against the healthcare service, they realise that it does not happen; they do not realise that it is not a personal thing to them, but a systemic problem. It is about getting patients to understand the systemic nature of the lack of data sharing at the moment.

[Joe Robertson]

Q If responsibility for managing and safeguarding the single patient record is to sit with general practice, if that is what the Government want, can you tell us, Kay Keane, as chair of the Institute of General Practice Management, what the implication would be for workload, and particularly workforce, in practice management?

Kay Keane: I think it is impossible, really, for me to understand that. It is a large part of our job already. As Dr Dickson said, we act as a small business. We do all the things that any other small business does, so being able to manage that record on top of that would take a huge amount of investment into general practice.

I would argue that maybe the investment into general practice should not be on data, but should be in the wider workforce. We are really good at looking after our data now. We care about it, we hold it close to the care of the patient and we share it only when appropriate, but in our view to then be the data controller of other information is too much and is unmanageable for a general practice to do.

Equally, our data is very personal to us, and we want to keep hold of that. We do not want our patients worrying about the stories that they tell us, so a model where we feed into something else and have responsibility for the bit that it is fed into sits more comfortably with the Institute of General Practice Management.

Dr Dickson: I do not have much to add to that. The devil is in the detail of where it sits and how we reassure patients that we are trusted with their data—that we are sharing what they have given us appropriately for their health, but not for spurious reasons. I think people’s understanding is that we share an awful lot more than we do, so there is a gap. People perceive that we are going to overshare, whereas actually this will allow us to come up to the level that we should be at.

Health Bill

Sojan Joseph Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[Sojan Joseph (Ashford) (Lab)]

We have already seen the difference that a Labour Government can make in improving our NHS. That is the result of the difficult choice that this Labour Government made to prioritise investment in the NHS and our other public services, but I know from my 22 years working in our health service that investment on its own is not enough. That is why I am pleased that this Bill will reverse the legislation passed during the Conservative and Liberal Democrat coalition, which made NHS overly rigid and too prescriptive, increasing bureaucracy and weakening accountability. The Bill is an important part of delivering a reformed NHS by implementing the elements of the plan that require legislation.

I particularly welcome the parts of the Bill that will amend the National Health Service Act to make provision for the establishment of a single patient record. Patients too often receive care that is not as co-ordinated as it could or should be, meaning that they must repeat their story each time they see a different medical professional. From my experience in mental health services, I know that mental health patients go to A&E, explain their story to the doctors there, explain the same story to a mental health worker, and then explain the same story the next day when they are admitted to a mental health ward. That is very challenging for professionals and patients. The single patient record can therefore be very useful.

We also have patients coming from other parts of the country. For example, a patient from Manchester could be admitted in Kent, where the doctors and medical professionals will, in some cases, be unable to access that patient’s records for many days. That delays the treatment, so it will be a big step to have a single patient record.

The other area I welcome is the abolishment of NHS England. During my time in the NHS, I saw layers and layers of management structures and scrutiny by different organisations, which caused lots of repetition, so I welcome the abolishment of NHS England. I would like to see that money go to the frontline, so that we can recruit many more nurses for hands-on patient care.

Finally, I would like to raise the issue that many other colleagues have raised: parity of esteem for mental health services. I would like to hear from the Minister that the single record system will be implemented not just in other parts of the health system, but in mental health services.

Meningitis Outbreak

Sojan Joseph Excerpts

Tuesday 17th March 2026 Commons Chamber

[Wes Streeting]

I thank the Liberal Democrat spokesperson for her response, and I strongly endorse what she said about the importance of vaccination. When it comes to determining which vaccines are available and to which cohort, we follow the advice of the JCVI, but if one good thing can come out of this awful situation, I hope it is general public awareness of the importance of taking up vaccinations where they are available. They remain one of the best public health tools available to us.

On the one hand, it is a very good thing that few people alive in this country today remember the dark days when this country did not have a national health service and did not have vaccination available for common treatments. It is wonderful that we now live in a country where the memories of some of those everyday conditions being widespread killers are distant, but there is also a real risk of a return to those Victorian conditions, because of the misinformation and irresponsible anti-science political positioning that we see in certain corners of even this House. I hope that politicians in particular will think carefully and responsibly about our shared duty to the public in helping people be protected.

On the specific concerns that the Liberal Democrat spokesperson raised, the public health risk to the wider population remains low, but we are actively contact tracing and offering antibiotic prophylaxis to those in close contact with cases. The antibiotics are one course, and they are effective in 90% of cases. I once again emphasise to those watching that if you or someone you know develops symptoms of meningitis or septicaemia, you should seek medical help urgently by calling 111 or 999, particularly if symptoms deteriorate. If you are one of those students at the University of Kent who may have left campus and would otherwise have been visiting one of those four sites, we are making arrangements for you to be able to see your GP and receive the antibiotics there.

[Sojan Joseph (Ashford) (Lab)]

I thank the Secretary of State for his statement. I pay tribute to all the health leaders in Kent and the school leaders for their calm and quick actions yesterday and over the weekend. I was able to get a briefing from UKHSA yesterday morning and also was able to visit my local hospital, the William Harvey, which has made immediate changes to accident and emergency to take care of those patients who are turning up. There is much speculation on social media and in local newspapers that vape sharing might be the reason behind this outbreak. I am not asking the Secretary of State to comment on that speculation, but can he reinforce the public health message? Can he offer advice to young people and parents in the Kent area on precautions they should be following at this time?

[Wes Streeting]

I thank my hon. Friend for his support for the local health system and for engaging so actively with my Department and the UKHSA team in response to this incident. He is absolutely right to press on public advice. It might be helpful to be clear that transmission requires close and prolonged contact, such as someone living in the same household or intimate contact such as kissing or the sharing of vapes or drinks. It is those sorts of things where the risk of spread exists. This disease is not like some of the other respiratory conditions that we have seen recently. It is important that people understand how it is spread, because they may find that reassuring. A range of symptoms can present, including a rash that does not fade when pressed with a glass, the sudden onset of high fever, a severe and worsening headache, stiff neck, vomiting and diarrhoea, joint and muscle pain, dislike of bright lights, very cold hands and feet, seizures, confusion or delirium, and extreme sleepiness or difficulty waking. Those symptoms can also apply to a wide range of other conditions. As ever, if in doubt, the best thing to do is to seek medical advice, whether that is calling 111, or in an emergency dialling 999, or seeing your GP. I urge everyone to share the public health information that is disseminating online, so that we can spread facts rather than misinformation.

Oral Answers to Questions

Sojan Joseph Excerpts

Tuesday 13th January 2026 Commons Chamber

[Stephen Kinnock]

We are in negotiation with the British Dental Association about the long-term contract reform that is so clearly needed, but I also draw the hon. Member’s attention to the announcement I made in December about a range of interim reforms, particularly on urgent work, where we are significantly increasing the fee rate for urgent dental activity. That will kick in from April and will make a real difference in access to urgent care.

[Sojan Joseph (Ashford) (Lab)]

T5. I thank the Secretary of State for his letter following the concerns I expressed about corridor care at the William Harvey hospital during Health and Social Care oral questions in October. He noted the decisive steps taken to reduce the pressure, including employing more doctors, freeing up beds and accelerating hospital discharges. However, after 14 years of under-investment, corridor care has become normalised in parts of the NHS. What steps are the Government taking to ensure that they meet their commitment and we see an end to corridor care at the William Harvey hospital?

[Wes Streeting]

I am grateful to my hon. Friend for his advocacy on this matter. I know that it has been taken seriously by NHS leaders nationally as well as locally, and they listen carefully to what he says on behalf of his constituents. I have reported to the House this morning on all the action we are taking to drive improvement. We are seeing improvement, but there is so much more to do. We are determined to consign corridor care to the history books, and not just in Ashford but right across the country.

Budget Resolutions

Sojan Joseph Excerpts

Tuesday 2nd December 2025 Commons Chamber

[Sojan Joseph (Ashford) (Lab)]

I congratulate the Chancellor on delivering a Budget that protects the national health service, reduces the national debt and eases the cost of living. I warmly welcome her decision to find money to reduce energy bills, freeze rail fares and freeze prescription charges. I also welcome her decision to help to lift 2,600 children out of poverty in my constituency.

It is pleasing to see the announcement in the Budget of millions of pounds of new investment to upgrade technology in healthcare. Providing funding for new digital technology to automate administrative tasks and allow swifter access to patient information will improve NHS productivity. Instead of spending time on admin, NHS staff will be able to focus more on caring for patients.

Since being elected to this House, I have pressed for more to be done to shift healthcare to the community and help to take the burden off hospitals, such as the William Harvey hospital in Ashford, so I welcome the announcement of neighbourhood health centres in the 10-year health plan. I am delighted that the Budget provides funding to ensure that the first of those will be rolled out across the country.

The Budget also provides support for young people taking the crucial first step into long-term employment through apprenticeship funding. That initiative builds on the Labour Government’s small businesses plan, which brought prioritised investment in apprenticeships and digital training by working with local colleges and providers. Ashford college in my constituency is doing excellent work in that area.

This Budget and its priorities stand in stark contrast with what is happening in my local area of Kent. While Labour chooses to invest in public services, rejecting the failed Tory policies of austerity, Reform-led Kent county council is continuing with reckless cuts and fantasy economics. The council, the leader of which said that it would be a “shop window” for how Reform would govern nationally, recently revealed that it had a £46 million overspend.

The Leader of the Opposition wants to turn the clock back. She has argued that the Chancellor should not have made the choices that she did in the Budget, including more than doubling the fiscal headroom. That choice has been welcomed by the financial markets and will provide greater financial resilience, but the Conservatives rejected it, arguing instead that we should return to the days of austerity and cut spending instead.

As someone who worked in the NHS, I saw the damage done by the Conservative Government’s approach to our health service and other public services. It also meant that pay for NHS workers, teachers and other public sector workers was frozen for years, which had a detrimental impact on staff morale, recruitment and retention.