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.

Suicide: Reducing the Stigma

Sojan Joseph Excerpts

Wednesday 19th November 2025 Westminster Hall

[Sojan Joseph (Ashford) (Lab)]

It is a pleasure to serve under your chairship, Mr Mundell. I congratulate the hon. Member for Richmond Park (Sarah Olney) on securing this important debate, and I pay tribute to her constituent, who is in the Gallery to support this campaign.

It is important to reflect on the progress that has been made in this country to remove some of the stigma around suicide, but more progress still has to be made. The more we discuss this issue in this House and in our constituencies, the greater the impact we can have in removing the stigma completely.

This Government inherited a mental health crisis—there are nearly 1.8 million people on NHS waiting lists for mental health treatment. At the same time, after decades of decline, suicide rates have increased since 2007. Worryingly, the suicide rate is now higher than at any time in the 21st century. In my local area of Kent, although the suicide rate has been coming down in recent years, it is still higher than the national average.

As is the case in the rest of the UK, suicide rates in Kent are significantly higher among men than among women. Across the country, 100 men die by suicide each week and men account for approximately three quarters of all suicide deaths in the UK. This trend has been consistent since the mid-1990s. While men are more likely than women to die by suicide in all age groups, that difference is most pronounced among middle-aged men—suicide is the biggest killer of men aged under 50. I welcome initiatives such as Movember, Andy’s Man Club, the Campaign Against Living Miserably and other similar schemes for the work that they do to help men. I particularly welcome the fact that today the Government published the first ever men’s health strategy, as part of which they will be working with the Premier League’s Together Against Suicide initiative. I would be grateful if the Minister could say a bit more about that, and about what will be done to remove the stigma around men’s mental health.

Suicide rates among young people are the lowest of all age groups, but over the past decade there has been a concerning 22% increase. A rise in the number of young people feeling disconnected and isolated after the pandemic lockdowns and an escalation in online bullying are reported to be contributing factors.

Another sector in which the silent tragedy of suicide is all too prevalent is the farming and agriculture industry, in which an average of three people die by suicide every week. Mental Health First Aid England reports that, between 2021 and 2023, suicide deaths among farmers increased year on year.

[Edward Morello (West Dorset) (LD)]

The hon. Gentleman is talking about young people and farming. Those two issues overlap in rural areas such as mine. Our child and adolescent mental health services are centralised in Dorchester, so someone living in the extremities of Lyme Regis, Beaminster or the surrounding villages could be looking at a 30-mile round trip to access them. Given that our part of the country is famous for its unreliable bus network, that is pretty difficult for a lot of young people and for those living in isolated communities. Does the hon. Gentleman agree that improving access to things like CAMHS is vital if we are to protect young people in rural communities?

[Sojan Joseph]

As someone who worked in mental health services for 22 years, I absolutely agree. We need access to mental health services, and not just for young people; everyone is important. Getting help early is key to preventing suicide among young people.

The situation is worse among men working in the farming industry. The likelihood that a male farm worker will die by suicide is three times higher than the national average for men. Earlier this year, a Farm Safety Foundation report revealed that over 90% of farmers said that poor mental health is the biggest hidden problem in the industry.

What is contributing to that poor mental health and the increased risk of suicide among those working in the agricultural sector? It is driven by a combination of isolation—many work alone in remote areas—and financial pressure from market volatility, debt and rising costs. Long working hours, often exceeding 60 hours per week, lead to exhaustion and poor mental health. There is also a strong stigma around seeking help, which means that many farmers suffer in silence.

The connection between suicide and mental illness is well documented, but reducing the stigma of suicide should not be viewed solely as a mental health issue. Many individuals who die by suicide have never engaged with mental health services or displayed obvious symptoms, and not all have a diagnosed condition. People at risk often face a complex mix of personal, relational, community and societal factors. As the suicide prevention strategy highlights, common risk factors include physical illness, financial hardship, gambling, substance misuse, social isolation, loneliness and domestic abuse. Although mental health support is important, the strategy stresses that reducing stigma extends far beyond that. Focusing only on mental health risks overlooking those in acute distress who do not meet the diagnostic criteria. It also places the burden on mental health services, when in reality reducing the stigma of suicide requires a collective effort from local authorities, employers, schools, the justice system and society at large.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

One of my constituents, Steve, founded the Jordan Legacy after he lost his son to suicide. Its work involves outreach to schools, universities, employers and community groups. I echo the point that the hon. Gentleman is making. Does he, like me, think that there should be more support for the fantastic work of such charities and organisations?

[Sojan Joseph]

I absolutely agree. Charities do a brilliant job. Youth groups in our communities used to be very good places for young people to go, and I would love to see them coming back into our communities.

Effective prevention means prioritising early intervention in schools, universities, workplaces and community settings, which are also important. Every suicide is a tragic event that has a devastating impact on the family and loved ones, and this impact can be felt across the community. That is why we must break the silence and dismantle the stigma around suicide. Every conversation matters. When people feel safe to speak, they are far more likely to seek help, and that can make all the difference.

--- Later in debate ---

[Stephen Kinnock]

Absolutely—we believe the sky is the limit. As I mentioned to my hon. Friend the Member for Caerphilly, we are clear that we see this as the first step. Clearly, premier league clubs are high profile, so hopefully people will look at the partnership, learn from it and say, “Yes, that is something that we can do.” Fingers crossed that it takes off.

As part of the men’s health strategy launch, we also announced the suicide prevention support pathfinders programme for middle-aged men. The programme will invest up to £3.6 million over three years in areas of England where middle-aged men face the greatest risk of suicide. It will support new ways of embedding effective, tailored support for middle-aged men and create clearer, more joined-up pathways into existing local suicide prevention systems. For over a decade, middle-aged men have faced the highest suicide rates of any age group. They account for around a quarter of all deaths by suicide in England. That is a shocking statistic, and it is why middle-aged men are identified as a priority group in the suicide prevention strategy for England.

It is important that we do not simplify the picture. The national confidential inquiry into suicide and safety in mental health found that of men aged 40 to 54 who died by suicide, 67% had been in contact with health and partner agencies in the three months before they took their own life, and 43% had been in contact with primary care services in the three months before they died. That tells us something vital: a significant proportion of men do reach out, presenting an opportunity to make the most of every interaction with men who may be at risk of suicide. Our responsibility as a Government is to ensure that when men take that step, the services they encounter are accessible, joined up and genuinely equipped to meet their needs. That is what the pathfinders programme will do.

By improving engagement with healthcare and improving access to the right support, we can begin to dismantle the stigma that continues to cost too many men their lives. In April this year, NHS England published its “Staying safe from suicide” guidance, which strengthens the approach to suicide prevention across mental health settings. It promotes a holistic, person-centred approach, rather than using stratification tools to determine risk. The guidance directly aligns with the aim of our suicide prevention strategy and reflects our commitment to continually improving mental health services, particularly by identifying risk assessment as an area where we must go further.

The implementation of the guidance has been supported by a new NHS England e-learning module, which launched in September, to help ensure that staff across services are confident and equipped to apply the guidance in practice. The NHS medium-term planning framework, published last month, states that in 2026-27, integrated care boards must

“ensure that mental health practitioners across all providers”

undertake the e-learning

“and deliver care in line with the Staying safe from suicide guidance.”

The Minister with responsibility for women’s health and mental health, who sits in the other place, wrote directly to crucial stakeholders across the sector—including the chief coroner, the Charity Commission, the Professional Standards Authority for Health and Social Care, and the British Psychological Society—to promote the guidance and the e-learning module, and I am pleased to say that the response has been overwhelmingly positive. By way of example, the Charity Commission circulated information about the e-learning to around 5,000 charities involved in suicide prevention or mental health support—an encouraging demonstration of the sector’s commitment to improving safety and support for those at risk.

More widely, we are improving mental health services so that people are met with the right support. We recognise that expanding and equipping the workforce will take time, but I am pleased to say that we have hired almost 7,000 extra mental health workers since July 2024. Mental health remains a core priority for the NHS. That is why we are investing £688 million to transform services, including £26 million to support people in mental health crisis.

As part of the 10-year health plan’s commitment to transforming how the whole health and care system works, we are introducing neighbourhood mental health care for adults, which will bring community, crisis and in-patient care together in a single, seamless offer. Six neighbourhood mental health centres are already operating 24 hours a day, seven days a week, offering open-access support to anyone who needs it. Co-delivered with primary care, the voluntary and faith sectors, and local specialist services, the centres make it easier for people to seek help in their own communities, without judgment or barriers.

[Sojan Joseph]

Will the Minister give way?

[Stephen Kinnock]

I am very tight on time, but I will give way briefly before wrapping up.

[Sojan Joseph]

A recent study shows that many people are reaching out to artificial intelligence chatbots to seek mental health support. The Government are putting so many new initiatives in place; does the Minister agree that we need to publicise them more, so that people do not seek incorrect information from AI chatbots?

[Stephen Kinnock]

I absolutely agree. This is a human challenge, and humans need to take it on. That is what we will do. There is nothing more human that going to a premier league football match, so I hope that that will be a good way of raising awareness, just as my hon. Friend says.

As we reflect on the lives lost and the families forever changed, we reaffirm our commitment to tackling stigma, improving support and ensuring that everyone feels able to speak up, ask for help and be heard. I thank the hon. Member for Richmond Park again for raising this crucial issue.

Oral Answers to Questions

Sojan Joseph Excerpts

Tuesday 21st October 2025 Commons Chamber

[Stephen Kinnock]

I did not hear the hon. Gentleman welcome the fact that we provided £100 million—an unprecedented amount—in capital funding for hospices, and £26 million a year and £80 million over three years for children’s hospices. We recognise that hospices benefit from being rooted in their communities, with amazing charity and philanthropy support, but of course we know that the Government need to do their bit as well, and that is precisely what we were doing. I was very pleased to visit Noah’s Ark children’s hospice in Barnet last week and to speak to the chief executive, who warmly welcomed the stability and certainty that the three-year allocation has provided.

[Sojan Joseph (Ashford) (Lab)]

T6. After a decade of under-investment in our NHS under the Conservatives, I welcome the progress that has been made on reducing A&E waiting times under this Government, but there is no immediate fix. Just last month, a coffee shop at the William Harvey hospital in Ashford was converted into an emergency ward to treat A&E patients. Will the Secretary of State visit the hospital to see the continuing problems with corridor care, and will he update the House on what the Government are doing to ensure that the hospital can manage winter pressures and maintain safe, high-quality care?

[Wes Streeting]

I am grateful to my hon. Friend for bringing this matter to the House’s attention. It is appalling for coffee shops to be commandeered as spaces for the care of patients, and we will not accept it. I am happy to look at the case that my hon. Friend has mentioned. We will also be publishing figures on corridor care so that we can hold the system to account, and the public can hold us to account, to improve the situation that we inherited.

Mental Health Bill [Lords]

Sojan Joseph Excerpts

Report stage
Tuesday 14th October 2025 Commons Chamber

NHS England recently introduced six pilots for the transformation of community mental health services. Some of that work is being delivered by my local mental health trust—the Cumbria, Northumberland, Tyne and Wear NHS foundation trust—and I think it shows promise. As we consider these amendments to the Bill, I would be interested to see how the learning from those pilots can be taken forward to further improve community mental health services.

[Sojan Joseph (Ashford) (Lab)]

Similarly, a community service called Mental Health Together has been introduced in my area. Does my hon. Friend agree that the whole mental health system is so complex, with different practices in different parts of the country, and that not having continuity and a standard across the country is a big issue for mental health?

[Lewis Atkinson]

My hon. Friend is absolutely right and I thank him for his intervention. Part of the issue around poorly reported waiting times is that it is less easy to see that differential access than it would perhaps be in physical health services. Indeed, over the years when specialist teams have been set up—for example the early intervention and psychosis teams and assertive outreach teams, which I know my hon. Friend knows well given his professional background—they have been introduced with very good intentions and to target specific needs, but they sometimes make it more difficult for patients to get overall care rather than very specialist care for individual conditions.

I will not take any more time, Madam Deputy Speaker, but I will just say that the mantra of investment and reform applies to mental health services, as it should apply to all our health services. For us to make further progress in pursuing parity of esteem between mental health and physical health, we not only need to consider these amendments today and pass the Bill to modernise the legislation, but ensure the Government have sufficient political priority on producing and improving mental health services.

--- Later in debate ---

[Gregory Stafford]

My hon. Friend is absolutely right. Both he and I made those points in Committee. I am surprised that the Minister does not see the risks here. The safeguard that my hon. Friend talks about must be beyond any doubt. The amendment in his name provides exactly that clarity. It would prevent unrelated or loosely connected individuals from stepping into a role that rightfully belongs to those with both a legal duty and an emotional bond—the parents or guardians—and it would preserve the fundamental principle that parents should not find their role diminished by accident or administrative oversight.

As I was saying, this is not an abstract risk; it is a very real and foreseeable consequence of the unclear drafting. These amendments do not weaken the rights of patients. They strengthen the protections around them. They ensure that in modernising this law, quite rightly, we do not inadvertently undermine the oldest and most important protection of all: a parent’s duty to safeguard their child. We must ensure that the state can only curtail that right under the strictest judicial scrutiny, with evidence tested and the child’s welfare paramount. In doing so, we will make this legislation not only legally sound but, in my view, morally right.

New clause 31, tabled by my hon. Friend the Member for Hinckley and Bosworth (Dr Evans), would require local authorities and ICBs to supply a fully costed plan to ensure they are able to provide adequate community services for people with learning disabilities and autistic people. I support that entirely. As vice-chairman of the all-party parliamentary group for special educational needs and disabilities, and from speaking to groups in my constituency such as Last Wednesday and Growing Hope, I know that the process around SEND is complicated and not fit for purpose. Fortunately, we have a chance to help it slightly with this Bill, so I ask the Minister to support new clause 31.

[Sojan Joseph]

I would like to speak in support of new clause 37, tabled by my hon. Friend the Member for Thurrock (Jen Craft). On Second Reading, I warmly welcomed the changes that this legislation will introduce regarding autistic people or those who have a learning disability. As a result, it will no longer be possible for someone to be detained in a mental health hospital indefinitely simply because they have autism or a learning disability. In the current system, autistic people and those with a learning disability have experienced inappropriate care, over-medication and extended periods of detention because of a lack of facilities in the NHS and social care, so this change is welcome and long overdue.

The Government have confirmed that the changes will be implemented once the necessary community provision is in place. Establishing strong support in the community is essential for not only enabling safe discharge from hospital settings but preventing unnecessary admissions in the first place. I recognise that the Government are working on setting out what strong community services look like and what resources they require to implement them. From serving with the Minister in Committee, I have no doubt about his commitment to ensuring that this community provision is introduced in a timely manner, but I support the proposal of my hon. Friend the Member for Thurrock that there should be a road map in the legislation that will provide a clear framework outlining how those services will be introduced. After all, ending inappropriate detention requires robust community-based alternatives to ensure that people with autism or a learning disability who would have previously been detained do not fall through gaps in the system.

Having a road map developed in conjunction with autistic people, people with learning disabilities, their carers and healthcare professionals will help to identify and address any gaps in service provision and workforce capacity. I also believe that it will help to reduce the risk of people with autism or a learning disability needing police intervention or emergency hospital care because the support is inadequate. By putting in place a road map, new clause 37 would help to ensure that we end all the sooner the injustice of people with autism or a learning disability being detained.

[Ian Sollom (St Neots and Mid Cambridgeshire) (LD)]

I will speak to amendments 24 to 28 and 36 to 38 in my name, which address gaps in crisis provision and accountability for autistic people and people with learning disabilities.

On Second Reading, I told this House about Declan Morrison, my constituent who died aged just 26 after spending 10 days in a section 136 suite that was wholly inappropriate for his complex needs. I remind the House that section 136 suites are designed for 24-hour stays, or a maximum of 36 hours in extreme cases. The coroner who investigated Declan’s death found that

“there is a risk that future deaths could occur unless action is taken.”

The timeline of what happened in the run-up to Declan’s death shows a cascade of systemic failures. Declan’s family, Graeme, Sam and Kaitlyn, have asked me to ensure that Parliament learns from what happened. These amendments in my name reflect those lessons and the coroner’s recommendations.

In Committee, the Minister made several points about earlier versions of these amendments, which I have tried to address in these revised versions. In particular, on crisis accommodation, the Minister argued that existing duties on ICBs already cover crisis provision and that the amendment was too prescriptive, potentially restricting ICBs in designing provision, emphasising the importance of flexibility for ICBs to meet local needs. I understand the desire not to be overly prescriptive, but in Declan’s case, over 100 places were contacted and no suitable accommodation could be found anywhere in the country. Flexibility failed Declan.

The revised version of the amendment allows for regional solutions beyond the ICB, but I suspect that the Minister will still find it too prescriptive. However, the fundamental question remains: should there not be a duty to ensure that provision exists somewhere? The Cambridgeshire and Peterborough ICB established a crisis service after Declan’s death that operated at 98% capacity, demonstrating both need and viability, but it closed when funding was withdrawn, highlighting the challenge with voluntary provision.