Health Bill (Seventeenth sitting)

Sojan Joseph Excerpts

Committee stage
Thursday 16th July 2026 Public Bill Committees

[Helen Morgan]

I absolutely agree. My mother and grandmother both had polio, which nobody would expect to experience in this day and age. That same grandmother’s sister died of diphtheria, and her father had smallpox. That was all just over 100 years ago, so it was not too long ago that people were experiencing what we now consider to be antiquated and unthinkable diseases.

The vaccination programmes that have been brought in over the past century have undoubtedly been game-changing for public health, not least for people growing up with working-class backgrounds, as my family would have been. That is why it is so important to deal with the disinformation that allows unscientific and dangerous anti-vax views to be communicated convincingly to the wider community.

[Sojan Joseph (Ashford) (Lab)]

I agree with the hon. Member that people with power, especially those with political platforms, have used it to spread misinformation about vaccination. Some medical professionals working in our hospitals and the NHS—doctors and nurses—are also against vaccines. Can the hon. Member explain how we can tackle that issue?

[Helen Morgan]

It is really important not to blame people who have seen convincing information online or have been given convincing information by people who ought to know better—including at political party conferences. We need to battle the source of that information and ensure that accurate, factual information is available and communicated to everyone in an accessible way by people they trust. That is key to all this. As I have said before, ostracising or ridiculing people who have been given information in a very convincing way is not the way to resolve this problem. We need to tackle it in an understanding way by communicating the facts sympathetically and accessibly.

It is important to note that concerns about vaccinations are not exclusive to a single group of voters. There is significant vaccine hesitancy across some ethnic minority communities and in hard-to-reach places across the country. We must do more to support doctors, nurses and the NHS to fight fiction with facts, or the long-term health of the country will suffer. That is what new clause 77 seeks to do. There is some great local work being done, but there needs to be a joined-up strategy to combat all aspects of disinformation, because a nice social media video telling people to get their jab will not beat it.

Now that Reform UK has a greater presence in our local government, NHS leaders will have to handle more and more difficult conversations with anti-vax and conspiracy theorist councillors, and they deserve support to engage with those people effectively and constructively. The proposed strategy would provide just that. It would have to consider

“support for medical professionals to build trust and engage with persons who are anti-vaccine…investment in public messaging to combat medical disinformation, including engagement with trusted online influencers…outreach campaigns focused on communities that are sceptical about vaccinations…introducing criminal liability for those, including online influencers and politicians, who profit from medical disinformation, and…a new verification requirement for any social media account claiming to be a medical professional.”

We must do more systematically to protect the NHS and our nation’s health from the growing threats of medical misinformation. We urge the Government to give this issue the focus it needs, and we hope that they consider this new clause one way to do that.

Health Bill (Sixteenth sitting)

Sojan Joseph Excerpts

Committee stage
Thursday 16th July 2026 Public Bill Committees

[Karin Smyth]

Again, I am grateful to the hon. Member for Sleaford and North Hykeham for bringing this discussion before the Committee. This new clause would require the Secretary of State to make regulations about how the NHS uses private provision to support access to treatment and reduce lists. I understand the point that she is making, but I assure her that this is an unnecessary new clause.

ICBs already can and do use private healthcare providers to offer patients treatment in their area and boost capacity to reduce lists. Our approach is pragmatic, not ideological: in the 10-year health plan, the Government committed to continuing to use private sector capacity where it is available; that is not because we favour the private sector but because we are committed to using capacity wherever it is available. Our priority is treating patients in a timely manner, not favouring one form of provider over another. Under existing legislation, patients must be offered a choice of provider for their first outpatient appointment, where the duty of choice applies. If a person’s needs are not met by local services or waiting times are high, they can use that choice to see an appropriately qualified provider.

However, we must resist the temptation to apply a one-size-fits-all approach here. ICBs are responsible for the financial sustainability, planning and strategic commissioning of services for their local populations, so they are best placed to decide how private premises should be used to meet a population’s needs. For example, high waiting times, which we obviously inherited from the Conservatives, for a particular specialty may result not from a lack of capacity but from increased demand from GP referrals. The ICB must have the flexibility to improve how advice and guidance—referral support, for instance—is working for GPs, rather than being required to wastefully spend NHS funds on increasing capacity with the private sector.

[Sojan Joseph (Ashford) (Lab)]

If this is put on the statute book, will it not mean that the private sector can have more and more hospitals, when we should be using them only if the NHS does not have the capacity? The private sector should be the last resort rather than a first choice.

[Karin Smyth]

I am slightly confused, as I suspect other Committee members are, by the Opposition’s approach to the private sector, having had a discussion in relation to the previous new clause about not using the private sector and boosting work and employment opportunities in our country. They do have a slightly odd view with regard to this. As I said, our view is very pragmatic: it is to support the treatment of patients to get waiting lists down. That is what our constituents deserve. Where capacity can be used, we want to make sure that that choice is available.

Health Bill (Fifteenth sitting)

Sojan Joseph Excerpts

Committee stage
Thursday 9th July 2026 Public Bill Committees

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to see you in the Chair, Ms Lewell. I will speak first to new clause 84, tabled by the hon. Member for Sleaford and North Hykeham. I reconfirm the Government’s focus on reducing long waits by improving patient flow, increasing productivity and delivering better emergency care for patients. Last night in the Chamber, we had a good discussion about corridor care in particular; all our comments are on the record, so I will not delay the Committee by repeating everything, but I will take some time to answer the questions raised in Committee this morning.

We are clear that the Government will end corridor care in this Parliament. It is completely unacceptable. Longer waits for emergency care can be associated with poorer patient outcomes. That is why, through the urgent and emergency care plan in 2025-26, we are investing more than £450 million to expand urgent and emergency care capacity, including new same-day emergency care services, urgent treatment centres, additional mental health crisis provision and nearly 1,000 replacement ambulances. Alongside that, we are implementing new clinical standards and improving patient flow across hospitals, all to reduce the number of patients waiting more than 12 hours.

[Sojan Joseph (Ashford) (Lab)]

I was pleased to take part in the debate in the Chamber yesterday. I raised some examples from my local hospital, which is expanding its same-day emergency care because of the funding that we received from the Labour Government. We also have a safe haven for mental health patients who do not need to go into accident and emergency. Lots of work is happening in my local hospital area, which will make a big improvement to corridor care and wider emergency care pressures. Does the Minister agree that that is what we need to do, and that the Labour Government are doing it?

[Karin Smyth]

My hon. Friend has been a strong campaigner. His health community has a lot of problems, as he well knows, but he is always there first, challenging me about the challenges in his healthcare system. He ensures that the people of Ashford are duly represented. He is absolutely right that what will make a difference to patients is improvement on the ground. I do not minimise how far there is to go, but I think patients are already starting to feel that improvement.

In the debate last night, we heard about some great work that is happening. We heard from, among others, my hon. Friend the Member for Ashford; from my hon. Friend the Member for Rossendale and Darwen (Andy MacNae), who talked about the challenged system and the challenged hospital in Blackburn, and the real improvements there; from my hon. Friend the Member for Watford (Matt Turmaine); and from my hon. Friend the Member for Bury St Edmunds and Stowmarket, who talked about progress in West Suffolk. That is really encouraging to see.

Earlier in the debate, statistics in the public domain were raised by, I think, the hon. Member for North Shropshire and others on deaths due to long waits and so on. That is a completely unacceptable situation, but I want to put it on the record that those statistics are not Government statistics. We had a bit of a debate about that. My hon. Friend the Member for Bury St Edmunds and Stowmarket highlighted how one can attribute cause of death to certain provisions. It is a really important measure. We do not want anyone waiting, full stop, but the statistics are not verified as Government statistics. I want to be clear about that.

On new clause 84, I assure the Committee that trusts are already held to account on the number of patients waiting 12 hours from arrival in A&E to admission, discharge or transfer. The medium-term planning framework published in October 2025 sets out the expectation that trusts will reduce the percentage of patients waiting 12 hours or more, year on year until 2028-29, as part of our overall ambitions to return to meeting the NHS constitutional standards.

The Government already produce comprehensive data on urgent emergency care performance, including on waiting times and on 12-hour waits. Those data provide transparency, support the oversight of the NHS’s performance and enable independent analysis of patient outcomes. We have been very keen to ensure that those statistics are published.

Another issue raised this morning was bed numbers. We had a bit of a historical throwback to the 1990s; I will not detain the Committee further by doing that again. My hon. Friend the Member for Bury St Edmunds and Stowmarket talked about changes in clinical practice, mental health beds and so on. I could talk for many hours about that. As a junior manager coming into the health services, one of my first tasks was to define what a bed is. That is not an easy thing to do. Most people think they know what a bed is but, as we discussed earlier, a trolley without wheels could be a bed. Counting beds and defining what they are and what they are used for is a complicated business in the health service. I know you will tell me not to deviate from the new clause, Ms Lewell, but this is important. Practice changes, and it is important that we make the most effective and efficient use of NHS resources. That means making changes to bed numbers, where they are and how we count them.

In June 2026, an average of 13,618 adult patients in acute hospitals per day were waiting for delayed discharge. We have improved data collection, so we have a better sense of the scale of the problem and, crucially, where it is; it is different in different places. We are seeking to improve that data. I gently remind the Committee that the NHS England website produces an awful lot of really good data so that Members of Parliament and our constituents are able to keep track. As my hon. Friend the Member for Bury St Edmunds and Stowmarket made clear, we need to keep up with best clinical practice, as well as the best use of resources. We are very happy to share that information and keep it transparent.

New clauses 12 and 56 were tabled by the hon. Member for North Shropshire, who is right to raise the unacceptable waits for care that some patients experience in A&E after the decision has been made to admit them. That includes patients being treated and cared for in corridors at times because of hospitals’ lack of capacity to admit them. As we discussed last night, the Government are clear that corridor care is not an acceptable standard of care and must not be normalised. We inherited an NHS under severe pressure with long waits and increasing numbers of patients receiving care in non-designated clinical areas. It is unacceptable, but I am afraid it was allowed to happen under the Conservatives. We are committed to eradicating corridor care, and we have a plan to do so.

To improve transparency, we have already established a clear national definition of corridor care. Again, the Conservatives could have done so in the past 14 years but chose not to. We have introduced daily reporting arrangements and strengthened the data quality processes. We are working hand in hand with stakeholders, including the royal college. In addition, we have published national guidance to support safe care where such situations cannot be avoided.

We are working hard to tackle the causes of corridor care; we are not just reporting on the consequences. That is why we want to improve patient flow. We have had good discussions about patient flow, both pre-admission and post-discharge, involving social care and primary and community care to support people who need care homes. We do not want people—particularly frail, elderly people—turning up at hospitals if it is better for them clinically to be treated where they are. We are improving patient flow, strengthening the discharge arrangement and investing £215.5 million in new and expanded urgent care services across England. We are also providing targeted support to the trusts facing the greatest challenges in relation to corridor care so that improvements can be delivered where they are needed most.

I gently remind the hon. Member for North Shropshire—and the hon. Member for Sleaford and North Hykeham, as a clinician, will be clear on this information about admissions—that when a patient presents at A&E, a clinician decides whether to admit them to the hospital, provide treatment, transfer their care to another location or discharge them. Under the current reporting rules, the clock starts running on a patient’s arrival in A&E and stops when one of those actions is taken. As a result, no decision is made to admit to A&E itself. Instead, if someone requires admission, it should be to somewhere elsewhere in the hospital.

Although I fully recognise the concerns that underpin these new clauses, I do not believe that further statutory requirements are the right approach. In the debate last night, we outlined in full the Government’s absolute commitment to addressing the issues and improving the situation for all our constituents. I hope that I have suitably reassured hon. Members that these new clauses are not required, and that they will not press them.

--- Later in debate ---

[Dr Chambers]

Yes, I sat on the Tobacco and Vapes Bill Committee for six weeks, going through the legislation line by line. One of the most interesting things about that Bill is not only that it will improve public health and life expectancy, but that it is probably one of the single most impactful pieces of legislation in terms of improving inequality and especially socioeconomic health outcomes. So many of the disparities in life expectancy between wealthy people and those living in relative poverty are due to levels of smoking—it is not just smoking, but that is a significant factor. It is good of the hon. Gentleman to highlight that.

During the coalition, the Tories recognised that the approach I described would send a powerful message that public health is the responsibility of all Government Departments. When it was scrapped, the then shadow Health Secretary, the right hon. Member for Makerfield (Andy Burnham), said that we could tackle Britain’s looming obesity crisis only if all Government Departments pulled together. We completely agree with that statement.

New clause 79 tries to address some of the issues that occurred back then, including by placing requirements on ministerial attendance and giving the Liaison Committee oversight to drive accountability. I am sure the Minister will agree that greater cross-Government working is needed. What are the Department’s plans to support that? If we want to tackle the various public health crises facing our country, we cannot do so without proper cross-Government working.

In my professional life, I was made an honorary lecturer at Bristol University veterinary school in the area of One Health, recognising that animal health, human health and environmental health are completely interlinked. It is difficult to improve one without looking at the factors that improve the others, and we need that kind of approach throughout all Government Departments.

[Sojan Joseph]

It is good to see you in the Chair, Ms Lewell. I strongly believe that public health is very important to our health system because it focuses on prevention, so that people do not end up in A&E or in hospital beds. Unfortunately, over the last 10 or 15 years we have seen the opposite. If we are serious about improving the nation’s health, prevention must sit at the heart of every decision we make.

Public health professionals bring a vital perspective—one that looks beyond treating illness to understanding and tackling its root causes. They consider the wider determinants of health, from housing and education to inequality and the environment, and they help us design services that keep people well, rather than responding only when they become unwell. We need to identify our priorities, ensure resources are allocated appropriately and develop a long-term strategy.

New clause 79 proposes to create a new committee. As somebody who worked in the NHS for many years, I have seen that there is no shortage of committees, senior leaders, management or meetings in our healthcare system. In fact, there are too many. What is missing are people to work on the frontline; that is what we saw over the 14 years under the Conservatives—and the Lib Dems were part of that.

One reason why I became active in politics was that I saw the frontline struggling. I worked as a nurse on the frontline in mental health services, and what we saw was money being diverted to create more senior leadership, more groups, more meetings and more management, while we were missing the people who actually did the work on the frontline. The new clause asks us to create a new committee, but we have enough committees and managers. In fact, through the Bill, we are trying to modernise the system by getting rid of some of those managers—that is the most important thing I can identify in the Bill. However, lots of the new clauses I have seen today and in the last Committee sitting have proposed creating more committees and directors. We are missing a point here. The Committee has an opportunity to reform our health system. If Members speak to a nurse or doctor who works in a hospital in our system, they will say, “We need more nurses, healthcare assistants and doctors, not more managers or directors.”

Not only in this new clause, but in many of the new clauses we are talking about, we need to think about embedding the public health voice within integrated care boards. Stronger integrated care boards will enable us to act early, reduce health inequalities and deliver care closer to home.

[Natasha Irons (Croydon East) (Lab)]

My hon. Friend is making powerful comments. I was struck by his argument that we need to focus more on what we do in communities. In Croydon East, a community diagnostic centre has opened, which is important because people in my community have a healthy life expectancy 10 years lower than that of people living a mile down the road. Does my hon. Friend agree that we should be focusing on those real, tangible interventions at the heart of the communities that need help the most? That is what this Government are trying to do.

[Sojan Joseph]

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

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

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

[Sojan Joseph]

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

[Edward Argar (Melton and Syston) (Con)]

The hon. Gentleman will probably be aware of the King’s Fund report from late last year, which covers the years 2010 to 2025. It highlighted that the growth rate was only 5% for managers during those 15 years, but 94% for children’s nurses and 55% for doctors, and other groups had similar increases. We are seeing investment and workforce increases in the right areas.

It is right that we acknowledge, as I suspect the hon. Gentleman will, that the one group where we have not seen that same growth is community health visitors and community health workers. Alongside the massive investment and increase in doctors in the past 15 years, that group, and the role it plays, deserves focus from whichever party is in government.

[Sojan Joseph]

I agree. We need more band 5 nurses or healthcare assistants who can check blood pressure or blood sugar in patients’ homes. When someone rings their GP surgery, they should be able to meet a nurse or a healthcare worker to carry out some basic checks, rather than being delayed from seeing somebody until, a few weeks, months or a year later, they end up in A&E. That is where the focus should be.

I do not support the new clauses, and I urge the Committee to think about some of the other new clauses that propose creating more directors or committees. We need to focus on making our health system more productive.

--- Later in debate ---

[Gregory Stafford]

I certainly agree with the hon. Gentleman’s penultimate point: we need to support home-grown clinical academics and the life sciences industry in this country. As he has drawn me down that line, I declare that my wife works in the life sciences industry in the UK. I entirely agree with him on that point. However, if he is saying that a corollary is that we should not do pharmaceutical trade deals with other countries, I do not agree, because UK patients need the best medicines no matter where they come from. If that was not what he was saying and I am putting words into his mouth, I apologise, but that is how it sounded to me. I agree that we should support the home-grown, but obviously we need access to medicines from around the world.

That brings me to my concerns about new clause 76. I understand why the hon. Member for Winchester supports it, but the way it is written means that, for the lifetime of the Act, any trade deal with America would have to follow those strictures. Although I accept that he does not like the current deal or the incumbent in the White House, it seems odd that we are singling out in statute, and putting a stricture on, one country over every other. I still probably would not have voted for it, but the new clause might have been more acceptable had it referred to any trade deal with any country, or even a group of countries—I know he is a big fan of one particular group of countries. That might have made it difficult. It would be dangerous essentially for the Bill to put a stricture on a trade deal with one specific country—especially one that is probably our strongest ally. I think that sits very badly.

[Sojan Joseph]

Does the hon. Gentleman agree that the existing constitutional arrangements already provide mechanisms, ministerial accountability and parliamentary scrutiny? Singling out one country is a politicising measure, and it will have long-term consequences for our relationship.

[Gregory Stafford]

Yes, I agree entirely with the hon. Gentleman. It would be a very slippery slope to write that into legislation. I understand the motivation—as I often do—behind Liberal Democrat new clause 76, but I do not think its drafting is appropriate in this context, and I cannot support it.

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[Dr Johnson]

This group of new clauses is about carers and how we look after them. They do so much work for so many people across the country by looking after their loved ones. Many of them are not necessarily in good health themselves, and some are even children. These new clauses have a positive intention: to try to improve carers’ lives and make sure that they are recognised.

I congratulate the hon. Member for Winchester on his success in keeping open his respite care centre. Perhaps he could share his notes with me, because the Reform county council in Lincolnshire is currently trying to close Swallow Lodge, a respite care centre that provides for people of working age who have severe disabilities. The council wants to close it, and the people there are devastated by that suggestion. We had a public meeting, which many people came to, and they had not been consulted at that point. I think that an assumption was made that they are not able to communicate, but many of them are able to do so with support. However, that communication had not happened.

It has caused fear for people. They are worried about where they will go instead and whether it will be suitable. What about the people they made friendships with at the centre? Many of them have elderly parents—in their 80s, in some cases. It is also economically short-sighted, because people may end up going into full-time care, which will ultimately cost the council more.

The council has now been persuaded to do a full consultation, which will happen over the next few months. If the hon. Member can share anything with me that was successful for him that could help me keep Swallow Lodge open against the Reform county council’s changes, I would be very grateful.

[Sojan Joseph]

As the chair of the APPG on adult social care, I pay tribute to unpaid carers for the enormous contribution they make to their families, their communities and wider society. I often have meetings with them, and as part of my job before I became an MP—I worked in the NHS—I had a lot of contact with carers. I have seen so many vulnerable patients benefit from the enormous amount of work that carers do. In some services, such as the mental health service, there is already provision for identifying carers, carers’ assessments and support for carers. Carers provide extraordinary support, often at great personal sacrifice.

Although the intention here is to make the wellbeing of carers a statutory duty, we need to be careful that we do not put any statutory responsibility for that on the NHS and create more administrative burden for it. I would appreciate it if the Minister would respond to that point, and if the Government would consider something to support carers, while not putting any more administrative burden on the NHS, where we are focusing on providing more support on the frontline.

New clauses 16 and 17 would impose new obligations on integrated care boards to promote carers’ wellbeing and to identify and record unpaid carers whenever they come into contact with NHS services. I want to make it clear that we should not create any more administrative burdens for NHS frontline services. Although identifying and supporting carers is important, the requirement would add to the administrative burden on NHS organisations at a time when they should be focusing on delivering frontline care.

We should be cautious about creating new statutory duties that divert resources and staff time away from patients. The proposal for a national respite care scheme is similarly well intentioned, but it risks imposing a centralised, one-size-fits-all model across a system that already makes local authorities and health boards responsible for assessing local needs and delivering support. Again, although we need more support for carers, we should be careful that we are not duplicating any of the services that are already available. Some charities also do a brilliant job of supporting carers. The provisions in these new clauses should be looked into, but we need to be cautious that we do not create more burdens for our existing systems.

[Joe Robertson]

I am grateful to the hon. Member for Winchester for introducing these new clauses and for the debate that that is allowing us to have. Unpaid carers are too often a silent and fundamentally unappreciated part of society, which the system could not cope without. They are family members who are thrown into the role of looking after their loved ones, which they did not expect to have to do. Most of them have no formal qualifications, but through love and family ties, they provide unpaid support, which in many cases has a negative effect on the financial wellbeing of the household and involves a huge amount of emotional toil.

The crisis in social care has lasted for decades under different Governments, who have struggled to tackle it, and it is putting increasing pressure on family carers. Many do not see themselves as a carer—they see themselves as a husband, wife, daughter, son or friend—but they provide millions of hours of care and support, year in and year out. My former role was at a national nursing charity that seeks to support the families of those living with dementia. I saw for myself how much wraparound care can achieve in relieving pressure and unnecessary suffering, not just for the person living with dementia—it does not have to be dementia, but that is what I have experience of—long-term frailty or conditions that require support, but for their family and carer. Very often, the biggest care need for the person living with dementia is the biggest need their family carer has; if we can sort the family carer’s biggest need, they can go on and do so much more for the person they love.

I thank the hon. Member for Winchester for allowing us to have this debate. I urge the Government, if they do not adopt these new clauses, to do all they can to relieve the pressure on unpaid carers up and down the country and to provide support for them.

--- Later in debate ---

[Sojan Joseph]

I pay tribute to all the parents and schoolteachers who engaged with me last summer, following the White Paper and the SEND consultation. It has been a huge problem in Kent. Kent county council has been under Conservative administration for the last 25 years. In recent years, it was in special measures because of its SEND provision. Parents really struggled. My inbox is filled with these issues. We know that 98% of SEND provision tribunals rule in the parents’ favour. There has been a long wait. Does the Minister agree that, whether we accept the new clause or not, we need to look into how the NHS and local authorities can work together to make it easier for children, families and schools to get proper provision in place?

[Karin Smyth]

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

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

NHS Corridor Care

Sojan Joseph Excerpts

Wednesday 8th July 2026 Commons Chamber

[Sojan Joseph (Ashford) (Lab)]

We must continue to highlight corridor care, as it puts a spotlight on the pressures facing the NHS. One of the first visits I made after being elected to this House was to William Harvey hospital in my constituency. During my visit I was shown around an A&E department where 19 patients were being treated in corridors, even in the summer months, when emergency departments are typically under less pressure. That was deeply concerning, and demonstrated how under the previous Conservative Government corridor care became increasingly normalised. I have previously spoken in the House about the incident at William Harvey hospital last September, when a coffee shop had to be converted into an emergency ward to accommodate A&E patients because it ran out of corridor. That was not an isolated incident, but part of a wider pattern caused by years of under-investment and rising demand. NHS staff continue to provide outstanding care in difficult circumstances, often without the capacity, workforce or facilities that they need.

One lesson we must learn from the failures of the previous Conservative Government is that health infrastructure must keep pace with population growth. I recognise the need to build more homes to address the housing crisis that this Government inherited, but we must ensure sufficient capacity in GP surgeries, community health services and urgent care facilities. While schools and shops often come as part of a new housing development, healthcare infrastructure has too often been an afterthought. We need sufficient primary care capacity to prevent avoidable hospital visits and admissions that make corridor care more likely. Will the Minister set out what steps the Government are taking to ensure that, as new homes are built, health infrastructure planning and investment keep pace?

I welcome the Government’s commitment to end corridor care by the end of this Parliament. We should never accept a situation in which hospital corridors become makeshift wards. No patient should receive treatment without privacy and dignity, and no member of staff should have to provide care in an environment that falls below the standards they strive to uphold. Our constituents rightly expect to be treated in safe, appropriate and dignified settings.

I was pleased by the announcement a few months ago that East Kent hospitals NHS trust, which covers William Harvey hospital, will be part of the new intensive recovery programme. I am hopeful that such targeted support will help to tackle the significant challenges facing the trust, reducing waiting times, improving patient flow, and ensuring that people across east Kent receive the timely, high-quality care they deserve. I hope the programme will help to ease the pressures that have contributed to corridor care, and that the Minister will update the House on the new intensive recovery programmes.

I also welcome the forthcoming opening of an upgraded same-day emergency care unit at William Harvey hospital, which I recently had the opportunity to visit. Funded through the trust’s use of part of a £29 million investment from the Labour Government, the unit will increase capacity and help to relieve pressure across the hospital, enabling more patients to receive timely assessment and treatment. I also welcome the recent announcement by the local ICB about the single neighbourhood provider. GP services in my constituency are proactively reaching out to frail patients, which will help to avoid them going to A&E.

This Government have made important progress through additional investment, workforce expansion, improved discharge arrangements and targeted support for struggling trusts. Those steps should be welcomed, but there is more to do. If the Government are to fulfil their commitment to end corridor care, they must continue to pursue reform with urgency and determination—

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. I call Amanda Martin.

Health Bill (Twelfth sitting)

Sojan Joseph Excerpts

Committee stage
Tuesday 7th July 2026 Public Bill Committees

[Dr Johnson]

My hon. Friend is absolutely right. That answer was quite shocking, really. The pause before it and the reaction was remarkable. The purpose of HSSIB is to investigate without fear or favour, and to enable people to come forward in a safe way, but if it was folded into the CQC, as the regulator, and the problem was the regulator, how would it investigate itself? How would it make recommendations to itself? What if it thinks the board that it works for is incompetent? Is it going to tell its boss that it is incompetent? How does that work? No one seemed to know the answer.

It also seems that Ministers have not thought about how the HSSIB unit will be vulnerable to political pressure. Under the Bill as drafted, the Government are planning to direct the “vast majority”—according to the impact assessment—of the investigations, and the quality board is going to have some influence over the recommendations, again under the direction of the Secretary of State.

The Liberal Democrats have tabled amendment 5, which would require the appointment of a committee. That idea is well intentioned, and we recognise the same problems and the same flaws in the Government’s approach, but I do not think it is enough to solve the problem. Even if the law says that the oversight of the investigative units will remain operationally independent, I just do not see how that is possible. I can see that the hon. Member for North Shropshire is trying to help by creating something better than what the Government have produced, but I do not think it is enough.

We have also tabled some amendments, including new clause 42, which would ensure that there is some operational independence in the choice of investigation by requiring the Secretary of State to adequately fund and resource patient safety investigations, including some of those initiated by this unit within the CQC.

Amendment 55 is a probing amendment. We noticed that much of the legislation has been lifted and shifted from the previous Act, but some things are missing, including national security grounds. We want to understand why that ground has not been included in the Bill. Very occasionally, health events have national security connotations—the Salisbury chemical weapons attack, for example. In such circumstances, restrictions on investigatory capabilities could be necessary. I do not know—I was just interested in why the Government have chosen deliberately to remove that particular clause.

Amendment 56 would allow

“the Commission to recoup charges in excess of the costs incurred in providing assistance.”

The HSSIB programme is world-leading. People look at it from across the globe, and some have asked for training or information on it, for which we have been able not just to recoup costs but actually charge. I do not understand why the Government have removed that provision, because it is an opportunity for them to get extra money without taking it off people in taxes. Do the Government want HSSIB to lose its international standing, or do they want British taxpayers to subsidise training for foreign health services? It is not clear. I would be grateful if the Minister explained that.

We need to come back to what the hon. Member for Bury St Edmunds and Stowmarket said at the beginning: what is the purpose? The purpose is patient safety.

[Sojan Joseph (Ashford) (Lab)]

The point about patient safety is absolutely important, as every Bill Committee member would agree. The number of patient safety incidents has been going up for the last 10 years. Between 2015 and 2022, there was a 62% increase in patient safety incidents in this country, and since the creation of HSSIB, the number of incidents has again gone up. Does the hon. Member agree that the CQC, which has access to all patient records and all documentation in any healthcare settings in real time, would be able to monitor the improvement and progress that each provider is making following the learning from each incident? That would be important and helpful, as the HSSIB has limited ability to look into documentation and clinical notes.

[Dr Johnson]

I thank the hon. Gentleman for that intervention, but I think this comes to part of the problem. When producing a list of faults—of things that are wrong with the service—and saying, “We need to improve the culture; it needs to be better”, we need to ask, “Okay, but how? What will be the deliverable, measurable way of doing that? How will we go about improving things?” For example, let us say that there is a problem with patients with aortic dissection, so how will we prevent that? The benefit of HSSIB is that it produces a plan, the plan is implemented and patients are safer. Part of this is about the delivery plan.

As for the other part, the hon. Member talked about monitoring progress, but that is not the job of HSSIB. If a mistake or an event happens, it is investigated by HSSIB—HSSIB produces a set of investigations based on understanding how and why it happened, because of the safe space—and then those recommendations are put forward to the Government. The Government then, ideally, implement those changes. The Minister is there to ensure that those are implemented. It will be her job to ensure, having decided which recommendations are to be implemented, that that is done fully and properly. It is a separate function. The CQC is a regulator, HSSIB is an investigator, and the Minister is there to ensure that things are delivered properly.

Going back to patient safety, at the end of my interview, I essentially told the panel, “I cannot tell you that anything is 100% safe”. The assurances that can be provided are that the staff and equipment are available, that training is available for people to do the job, and that processes are in place to identify shortcomings and learn from them, so that they are not repeated. That is key: to find the learning and spread it more widely. As the hon. Gentleman said, implementation is a challenge. It is possible to implement this on an individual basis or to implement a lesson in a unit that has had an error or mistake. Spreading it more widely, so that this is heard in every unit across the country, is more challenging. Fundamentally, I do not think I have heard anything from any of the Ministers, and I do not think it is in the Dash report either, to explain why the Government believe that rolling HSSIB into the CQC with all the problems that it might cause—the risk of it suing itself over whether the safe space is available or not—makes patients any safer.

Health Bill (Eleventh sitting)

Sojan Joseph Excerpts

Committee stage
Thursday 2nd July 2026 Public Bill Committees

[Gregory Stafford]

As we move towards a single patient record, we have to ensure that technological progress does not come at the expense of those who are least digitally connected. As others have said, I am particularly concerned about older patients and many disabled people, who often rely most on NHS services but can face the greatest barriers when healthcare systems—and all systems—become increasingly digital. For some elderly patients in my Farnham and Bordon constituency, navigating online platforms is challenging, and others may not have regular access to the internet at all. Unfortunately, my constituency has one of the worst full-fibre broadband roll-outs in the country, and it has extraordinarily poor mobile phone reception in the central rural parts of the constituency, despite my best efforts with BT Openreach and others.

Disabled people may also face accessibility barriers that these systems do not always anticipate in their design. Modernisation should never mean creating a two-tier NHS—one for those who are digitally confident and another for those who are not. The people at risk of being left behind are often those with the most complex healthcare needs and the greatest reliance on the continuity of care. A proper assessment of digital exclusion is therefore not just a bureaucratic exercise, as some may describe it; it is an essential safeguard. We need to understand how the single patient record will affect elderly patients, disabled people, carers, those with learning disabilities and those who may struggle to engage with digital services.

[Sojan Joseph (Ashford) (Lab)]

My understanding is that the single patient record is just a single place where all of a patient’s medical records will be kept. It will not necessarily change the ways in which they access healthcare services, such as A&E, the GP or a dentist. Those ways of accessing healthcare will stay the same, whether we have a single patient record or not.

[Gregory Stafford]

For me, the key thing is that we must have equity of access to the single patient record. If somebody wishes to see their own medical record, they should be able to do so, whether they are digitally savvy or not. As far as I can tell, that is the intention behind the Liberal Democrat amendment.

However, the hon. Gentleman raises an interesting point. We are seeing this already, but the more we go down the digital route—because it is more efficient and straightforward, and takes out the unnecessary bureaucracy of having a human interaction to book an appointment or whatever—the more likely it is that this will become the portal for all interactions. I am not saying that that is the Government’s intention, but he raises a point, perhaps inadvertently, that we need to think about.

To conclude on amendment 70, before we proceed any further, the Government should be able to demonstrate that no patient will receive a worse service, face greater barriers to care or lose access to information simply because they are older, disabled or less digitally connected than others—that goes to the heart of fairness and equity of access in our NHS. I am absolutely certain that the Minister does not wish that to happen, but it would be interesting to hear how she will ensure that it does not happen.

Amendment 49, in the name of my hon. Friend the Member for Sleaford and North Hykeham, would prevent the Secretary of State from making regulations to establish the single patient record unless a public awareness plan had first been published and laid before Parliament, and a minimum three-month public information campaign had been conducted before the system went live. That seems eminently sensible, and I hope it is something that would be not just welcomed by Ministers, but on their agenda already.

Patients clearly have a right to know what information is being held, who will have access to it, how it will be used, what safeguards are in place and what rights they have in relation to their own data before the system goes live. A three-month campaign to give them that opportunity would be appropriate, because the things that I have outlined are not technical details that need to be buried in some Government website or hidden in the small print of a privacy notice; they are fundamental questions that deserve proper public engagement.

I am especially supportive of amendment 49 because of the impact on older people, disabled people and those who are less digitally engaged. I do not think that most of my constituents spend their time reading NHS policy documents online—my notes say “most”, but I think none of them do, unless they are involved in the health world themselves—and they should not wake up one morning to discover that a major change to the management of their health information has already been implemented without their knowledge.

A public information campaign is not a bureaucratic hurdle; it is a democratic necessity. If Ministers are confident that the single patient record will improve care, strengthen efficiency and protect privacy, they should be eager to make that case to the public and should therefore welcome the scrutiny, transparency and informed debate that a three-month public information would bring.

--- Later in debate ---

[Dr Johnson]

I beg to move amendment 48, in clause 47, page 36, line 1, at end insert—

“(4A) Regulations may not be laid under this section unless the Secretary of State has published a plan setting out the measures to be taken to prevent clinicians and other persons involved in the provision of health care or social care from accessing patient information made available through the system otherwise than for the purposes of the care of the patient concerned (an ‘inappropriate access prevention plan’).

(4B) The inappropriate access prevention plan must include—

(a) a description of the technical controls to be applied to restrict access to patient information to those with a legitimate care relationship with the patient;

(b) the system of audit logging to be applied to record each instance of access to patient information, including the identity of the person accessing the information and the time and circumstances of access;

(c) the sanctions applicable to persons who access patient information without lawful authority or without a legitimate care relationship with the patient;

(d) the arrangements for detecting and investigating suspected cases of inappropriate access; and

(e) the role of the Care Quality Commission, the Information Commissioner and any other regulatory body in enforcing compliance with access controls.

(4C) The Secretary of State must lay the inappropriate access prevention plan before both Houses of Parliament.”

This amendment prevents the Secretary of State from making regulations to establish the single patient record unless a plan to prevent inappropriate access by clinicians and other care workers has first been published and laid before Parliament.

Amendment 48 would prevent the Secretary of State from

“making regulations to establish the single patient record unless a plan to prevent inappropriate access by clinicians and other care workers has first been published and laid before Parliament.”

This is about trust. It is about people being able to trust that the records that will now be more widely available will remain confidential and be looked at only by those who need to look at them.

We have seen that people can be uniquely nosey when it comes to accessing medical records. For example, 48 staff members at the University Hospitals of Liverpool Group were found to have looked at the records of those involved in the Southport attack without any medical basis to do so. Almost a dozen staff members were sacked from the Nottingham University Hospitals trust because they had looked at the records of the victims in Nottingham. It is important that we address this, because it is happening already and needs to be tackled.

Paul Arnold, the chief executive of the Information Commissioner’s Office, said that trust is being “jeopardised”. The amendment seeks to ensure that proper thought goes into making sure that people cannot access records they should not be able to look at—for example, those of the Prime Minister or members of the Royal family—before the single patient record is live and can be used. We have Public Department 1 for HMRC; is there an intention to have something similar to close off records to reduce their accessibility where the public may be particularly nosey, either because of the person’s job or because of an event such as a terrorist attack, where we have seen people look at records when they should not have? There were reports that staff at The London Clinic, a private clinic, had been trying to sell records of the Princess of Wales online, so there are examples where this has happened before.

In addition, it is important that people know what the penalties are for deliberately misusing these records. My final question for the Minister is this. If a record has been viewed and there is a data log of it having been viewed, how long will that data log last for? Will it last for six months or a year, or will I be able to look back in 10 years’ time and see who accessed my records today? It is a case of understanding the Minister’s intentions and pushing the Government to ensure that these records are truly private to those who need to see them, not accessible to anyone who just happens to be curious.

[Sojan Joseph]

I declare that I am a registered nurse. I have worked in the NHS for many years, and I have used patient records throughout my career. The Nursing and Midwifery Council code requires nurses, midwives and nursing associates to respect patient confidentiality, share information appropriately and ensure that patients are informed about how their information is used. That is the existing system, and every nurse, midwife and nursing associate has to follow the code of practice. A similar code is there for the General Medical Council for doctors, and all other registered professionals follow those codes.

On top of that, information governance in the NHS ensures that patient data is handled legally, securely and ethically, providing a framework for data protection and confidentiality. We have numerous different digital systems in the health system currently. Before anyone gets access to those digital systems and patient records, they all have to go through information governance and data protection training. They are then given access to patient records. That is the existing system.

The shadow Minister, the hon. Member for Sleaford and North Hykeham, has just mentioned the Nottingham incident, which is a good example. It is a clear example of where those who accessed the records were able to be identified. There is a clear audit trail, and I have my own experience of taking people through disciplinary proceedings for accessing patients’ notes when it was not relevant to those staff. The existing patient data systems do have provisions to safeguard and monitor who is accessing patient records.

[Dr Johnson]

I understand what the hon. Gentleman is saying, which is that there are processes in place already and that the fact that someone got sacked for looking at the records is a sign that the systems work to an extent. However, does the fact that they could look at them at all suggest that the systems are not working well enough? Because it is a computerised system, there are methods for identifying whether someone is likely to need to look at that record. By knowing the profession of the person looking at it, and the department they are in, the computer can help to limit the number of people who look at those records when they should not.

[Sojan Joseph]

I agree that we are never going to have 100% proof. There will always be people accessing records. What I am talking about is the existing system, which does have provisions. What we need to strengthen is the training and the audit trail. All staff who do the training are aware that they are not supposed to check patients’ records unless it is relevant to them. Those who access records inappropriately should be identified and action should be taken.

Just because we are moving to a single patient record system, it does not mean that everybody is going to access everything they want. People working in the healthcare system are given access based on their role. Not everybody is able to access everything. Systems are in place, and we need to strengthen those systems and the training. We should not be scaremongering by saying that, because we are moving to a single patient record, everybody will be able to see their records.

[Edward Argar]

The hon. Member for Ashford made his point very clearly about what happens when something goes wrong and someone behaves inappropriately—the shadow Minister, my hon. Friend the Member for Sleaford and North Hykeham, has highlighted some very concerning recent incidents—and was right to highlight the ability to follow an audit trail and take action. He is also right to highlight the importance of training.

However, taking action once inappropriate access is known, and then following the audit trail, deals essentially with the consequences rather than preventing it from happening in the first place. That is why amendment 48, and particularly proposed new section 250E(4B)(a) of the National Health Service Act 2006, is important. It describes the technical controls. That goes beyond the audit process and what happens after something has gone wrong. It is about what can be done to build safeguards into the system to make it much harder for anyone to circumvent their obligations, and to build those technical safeguards into the overall design of the single patient record. That is a reasonable ask, because such incidents, while hopefully rare, as the hon. Member for Ashford alluded to, do happen and understandably cause concern.

The challenge is that there is potentially a lot more information in one place, rather than being held in different pots, trusts or GP surgeries. For those inclined to break their legal obligations and behave outside the rules, the potential opportunity to access a wider range of information is more significant. The design of the record needs to have those technical safeguards strengthened and built in.

--- Later in debate ---

[Joe Robertson]

That was a long intervention, but it was helpful. I disagree with the hon. Gentleman, because the legislation is not seeking to require technology companies or the providers of electronic record-keeping systems to be able to talk to each other. It is trying to create the concept of a single patient record, which is good, but it does not mandate a way to achieve that. I do not particularly want to name companies, but a big provider that is already in the health space and that provides electronic record-keeping systems might say, “We can already provide a single patient record. It is for other providers to adapt and feed into our record-keeping system,” and there is nothing in the Bill that says one technology company must adapt to another.

The technological issue is completely unaddressed. I am not even saying that it should be addressed in the Bill, because there are all sorts of issues around competition law and state support for particular companies. It is not a criticism per se of the way in which the Bill drafted, but this is an opportune moment to make the point that absolutely none of the clause will be delivered until a major issue that the Government have not yet addressed is dealt with. That issue is the interoperability of different electronic record-keeping systems provided by the private sector. They are all in competition with each other to get a bigger share of the market; unless and until that is addressed, the Government are not going to realise any of this. I do not want that to be the case. I want the single patient record to be realised, broadly speaking.

[Sojan Joseph]

I wish to speak in support of clause 47. I spoke on Second Reading about my strong support for the introduction of a single patient record. I am not a tech expert like my hon. Friend the Member for Lichfield—

[Dave Robertson]

I don’t know about that!

[Sojan Joseph]

It really surprised me to hear my hon. Friend talk about his experience of 450 systems in the computer system in his local hospital. I was shocked, because as a clinician who previously worked in the NHS, I wanted a system that made patient records readily available so that we could care for patients.

My understanding is that the clause amends the National Health Service Act 2006 to enable the Secretary of State to make regulations to establish a system to make patient information readily available to patients and to those involved in providing health or social care in England. Under the current system, care and treatment across different parts of the NHS are not as co-ordinated as they could and should be. All too often, that means that patients have to repeat their medical history every time they see a different medical professional. The shadow Minister, the hon. Member for Sleaford and North Hykeham, talked about how that can sometimes be useful for getting the diagnosis right, but it can be very traumatising for someone to have to explain the same story again in such a short period of time.

Speaking in the Chamber, I previously gave the example of a mental health patient going to A&E on a Friday. They tell their story to the professionals there and they tell the same story later when a mental health professional comes to see them. When they are admitted into a mental health hospital, they have to explain the same story when going into the ward, and then again to the nurses. Having to repeat their story again and again is traumatising for most patients.

[Dr Johnson]

My point was that this can sometimes be beneficial. If a clinician sees a young lady who has collapsed at school, she might have fainted or had a fit. There are a lot of different potential causes, such as cardiac syncope, and lots of different potential diagnoses. A lot of the detail in making the diagnosis is in the history. The patient will probably already have been asked their story when they arrived at A&E, but it is still important for a senior clinician to ask for it again.

My caution was against presuming that we can, in all cases, prevent repeated asking of questions. There would clearly be a benefit when there are particularly sensitive pieces of information, about which we need not ask two, three or four times, but we cannot stop all cases in which a patient is asked for the same story.

[Sojan Joseph]

Absolutely; a single patient record will not stop professionals from asking the necessary questions of patients at any time. Each ward round, the doctors ask the patients how they are feeling. They will have that conversation; that will not stop. We are talking about repeatedly having to tell the story.

The point was highlighted when the Committee heard from Jacob Lant, the chief executive officer of National Voices, a coalition of health and social care charities. In his 15 years of patient and public engagement, the most consistent theme is patients’ frustration at constantly having to retell their story, and the fact that medical notes are not available across different healthcare settings. Not only is that frustrating for patients, but it can also be deeply distressing. Kath Abrahams, the chief executive of Tommy’s, told the Committee that

“Women report constantly having to retell their story—highly sensitive or traumatic experiences of loss—and that repetition can happen across the early pregnancy unit and maternity services.”––[Official Report, Health Public Bill Committee, 16 June 2026; c. 66, Q108.]

As medical professionals, we are taught the importance of empathy and understanding, but if the absence of a unified patient record system is aggravating traumatic experiences for patients, we need to address that. The absence of a national unified report can also compromise patient safety and lead to clinicians making decisions based on partial or incomplete information, significantly increasing the risk of error.

We heard evidence of that from the chair of Healthwatch England, who highlighted the risk posed to patients with multiple comorbidities. He said:

“Without a single patient record, we can find that a consultant or a GP has access to only one part of that multiple comorbidity…That can lead to all sorts of unforeseen errors.”

That can result in poor health outcomes, increased hospital admissions and reduced patient trust, which is why he went on to speak about

“the great advantage that we can get from a single patient record.”––[Official Report, Health Public Bill Committee, 16 June 2026; c. 49, Q79.]

Experienced mental health patients often move between A&E, GPs and mental health services and have to repeatedly go through that traumatic experience.

I have spoken in the House previously about my deep frustration that the digital records available to me in mental health services in Kent and Medway were incompatible with those used in other parts of the NHS, both locally and across the rest of England. I know that that frustration is shared, so in advance of the Committee’s consideration of clause 47 I spoke to some of my former colleagues, as well as other healthcare professionals in my constituency, to find out what systems are used to record patient information.

--- Later in debate ---

[Joe Robertson]

The hon. Gentleman is making the point that I have been trying to. He referred to a number of companies that each provide an electronic record-keeping system. The Bill does not mandate those companies to speak to each other and create a single patient record; there is no requirement on those private companies to do anything. As they are in competition with each other, their answer could be, “We can provide the single patient record—we are already doing it—if you just use more of our system and pay us more money.”

I am not suggesting that this is the hon. Gentleman’s responsibility, but does he have anything to say about the practicalities of a single patient record as a theory and the interoperability of electronic record keeping—a practical thing not dealt with in the Bill?

[Sojan Joseph]

My patient record is currently kept by different organisations or providers, which cannot see each other. If I speak to the GP about my blood sugar and then end up in A&E, they cannot see that record. If I go to the mental health service, they cannot see what medication I was taking. When I get discharged back to the GP, he will not get the information on my medication. That is the clinical aspect I am talking about, although I fully understand the hon. Gentleman’s concern. I hope the Minister will address some of those issues.

The responses I collected demonstrate how disparate and fragmented digital record systems are within just one local area. I do not think any of our constituents are aware that their data is kept in different places and that the services do not talk to each other. That is what the Bill is trying to address. All that information will be available for doctors, nurses and any other healthcare providers so that they can see patients’ history and medication and those patients will be more safe. Things will be more transparent. It will be easier for admission to discharge processes.

[Dr Johnson]

There is no detail in the Bill. As my hon. Friend the Member for Isle of Wight East said, there is nothing in the legislation requiring the computers in his local area to talk to the computers in my local area.

[Sojan Joseph]

I hope that would be the outcome of this legislation. I will give an example. My constituency is very close to Dover. Lots of travellers go through Ashford, my constituency. We often get patients from Scotland, Manchester or Liverpool, for whom doctors cannot start a treatment because they have to wait 24 hours to 48 hours to get the information from the hospital where the person comes from. I am not saying that the story is the same across the country, but that is what we are experiencing.

[Dr Johnson]

In the event that someone from Scotland comes into the hon. Gentleman’s hospital near Dover and a doctor wants to look at their healthcare record, does the hon. Gentleman envisage that the doctor will log on to their local system and see the records from Scotland, or that they will have access to the Scottish system to look at the records directly there?

[Sojan Joseph]

I do not know whether there will be the same system in Scotland, but my understanding is that in the north of England doctors will be able to see the same system. Again, we can hear more detail from the Minister.

A single patient report has the potential to transform patient experience and safety by ensuring continuity of care, by reducing unnecessary repetition, by enabling better informed clinical decisions and the smoother discharge of patients, and by creating a more efficient and joined up healthcare system.

[Gregory Stafford]

I thank all those who have spoken so far in this debate. I have never seen the hon. Member for Lichfield so animated—Data Dave is clearly alive and well.

As we have discussed, the clause creates the legal power for a single patient record in the UK. It is important to say, as others have, that the Bill does not create the system but gives the Secretary of State the power to create it later through regulation. That does not mean, however, that we should not have a debate about some of the issues that we have raised.

I should state at the start that I support better information sharing when that helps patients receive safer and better care, and I think that the single patient record could well do that. Anyone who has worked in healthcare, as I have, knows the frustration that results from the records not following patients between services. Clinicians can lose valuable time in searching for information, if they can get it at all. As others have said, patients are often asked to repeat the same details over and again—not, as my hon. Friend the Member for Isle of Wight East rightly said, because it gives a richer experience but simply because people do not have the information. Better joined up records have the potential to improve care.

We have, however, been here before. I was a lot younger—we all were—but back in 2002, the national programme for IT, under the last Labour Government, was a £10 billion unmitigated disaster, which the Public Accounts Committee described as

“one of the worst and most expensive contracting fiascos in the history of the public sector.”

I want to make sure that there are safeguards, from both a contracting and a data safety point of view, so that we do not go down that route again. As my hon. Friend the Member for Isle of Wight East clearly outlined, creating such a record is fiendishly complicated from both a technology and patient information point of view and from a data sharing and data protection point of view.

The record could contain some of the most sensitive information about people, so Parliament has the responsibility to make sure that the legal framework is right. We also know that the record will work only if the data in the single patient record is worth the electronic paper that it is electronically printed on. As I am sure the Minister knows from her time in the NHS, the information is getting better but continues to be patchy across the country. Different trusts and organisations record things in different ways. I take my hat off to those who work in clinical coding, as they do one of the most difficult jobs in a trust. Again, we need to make sure that the data is accurate. Someone mentioned AI earlier; I think AI could help with that, but we are still some way off.

I want to canter through my concerns about the breadth of the powers being given under the clause. The Bill allows the Secretary of State to make regulations establishing the system and to decide how it operates. Those regulations may require or authorise the sharing and processing of patient information, decide who can access the information and create enforcement powers and financial penalties. Some of those important questions are not answered in the Bill. Parliament is being asked to approve a broad framework before seeing some of the detail.

My second concern is that the Bill says little about patient choice. There is no clear statement about whether patients will have the right to opt in or out and no explanation of whether patients can restrict access to all or part of their records. There is no mention of whether someone could choose to limit access to particularly sensitive information, such as mental health records, sexual health information or information about substance dependence. There are major questions for public trust but those are left, I would say, entirely to future regulations. We need clarity about them now.

My third concern is the scope of the information that may be included. The definition of “patient information” is extraordinarily broad. It covers information about physical health, mental health, diagnosis, treatment and care, including social care. The definition of “patient” includes people receiving social care or having their care needs assessed. What we do not know from the Bill is exactly how that data will be presented. Will it use language that a patient can understand? Will it talk about having a heart attack, or will it use medical information that a medical professional will need to assess? Or will it include both, so that the patient knows that they have had a heart attack, for example, but the medic can see the precise detail on what sort of transient ischaemic attack it was. We need to understand what the data is recording and at what level of detail.

Health Bill (Tenth sitting)

Sojan Joseph Excerpts

Committee stage
Thursday 2nd July 2026 Public Bill Committees

[Dr Chambers]

The hon. Gentleman makes some very good points. Obviously, the whole point of this amendment is to equip people who are providing what is often the daily care for someone else with the information they need to provide that care. My family cared for my father at home for many years when he had dementia; he was on medication for other physical health issues as well, and he was not capable of administering his own medicine, or even of understanding what he was on half the time.

[Sojan Joseph (Ashford) (Lab)]

I am very sympathetic to this amendment, and to the argument that patients and carers should have enough information about what they are providing care for. In the current system, carers get a copy of the care plan, which states what the patient’s care needs are, as assessed by health professionals. Does the hon. Member agree that carers need to see only the care plan for the patient, rather than the patient’s whole record?

[Dr Chambers]

I agree that there is no need for carers to see irrelevant or extremely historical information in the single patient record. Currently, however, there are a lot of carers who, for various reasons, such as not having legal power of attorney, cannot access the information that they need.

We also sometimes find that the people who are carers, who are potentially the spouse of the patient and are themselves elderly—because a lot of people receiving care are elderly—do not understand the information that they are being given. There can be a situation where the person providing care does not fully understand why the patient is getting some medication, or the best way to treat them. We hear that quite a lot.

We understand that the Bill is not designed to set out all the specifics of what the single patient record will look like—that key point was made in the interventions by the hon. Members for Farnham and Bordon and for Ashford. However, although we do not know exactly what it will look like, as it is being created, drafted and thought through, we would love the Minister to confirm to us that carers will be able to see the appropriate parts of the single patient records of those they care for, so that they can oversee their medical care and flag any issues.

There are some specific advantages to having a single patient record when travelling between hospital trusts. For example, being able to quickly see what historical medication the patient has had, especially when it comes to antimicrobials, and the results of tests that were performed in other hospitals and healthcare settings, is absolutely vital to ensure that we do not allow antimicrobial resistance to increase at an unnecessary pace. Often, patients do not understand the type of antibiotic they are on, or remember the name of it, and that is a specific but big issue, because it can generate antimicrobial resistance. There are a few more issues that I could speak to, but I will sit down.

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.