Heart Disease and Stroke: Premature Deaths

Stuart Andrew Excerpts

Thursday 2nd July 2026 Westminster Hall

[Stuart Andrew (Daventry) (Con)]

It is a pleasure to serve under your chairship, Dame Siobhain.

I congratulate the hon. Member for South Ribble (Mr Foster) on securing this important debate and talking about his personal circumstances. It is always a very moving moment when colleagues talk about things that are so very personal to them. I also pay tribute to the wife of my right hon. Friend the Member for Rayleigh and Wickford (Mr Francois) for the work that she and her team do. It was fascinating to listen to my right hon. Friend. There may have been a bit more detail than I would have wanted to hear, but it told us a lot about the importance of that treatment.

I share an ambulance region with the hon. Member for North West Leicestershire (Amanda Hack), so I know exactly what she is talking about and how important it is. I thank her for her work with the APPG, and particularly for highlighting the issue for young people. It is important to remember that heart disease and stroke affect all age groups.

I thank the hon. Member for Strangford (Jim Shannon) for his work on the APPG and for his kind words. I visited his constituency when I was a Minister. If only I could have as much love as he gets from his constituents—he is hugely respected.

I feel like we will all have to club together to get a bat-phone for the hon. Member for Southport (Patrick Hurley). He made some incredible points, particularly about smoking. I confess that I gave up smoking in February. It was hard, but I know how important it is.

I declare an interest. I, too, want to pay tribute to the British Heart Foundation, which was the first charity I worked for in my charity career. I saw at first hand the incredible work it does, particularly on research. I thank it and all the other charities and organisations that are active in this space.

As we have heard so often today, heart disease and stroke continue to take people from their families far too soon. The hon. Member for Strangford spoke so powerfully about the 350 people in his area who are no longer around the table. Behind every statistic is a life cut short and a family left grieving, in too many cases in the knowledge that earlier action might have changed the outcome. A person’s chances of surviving heart disease or stroke should not depend on their postcode, income, sex, ethnicity or ability to navigate the health service. If we are serious about reducing premature deaths, the focus must be on prevention, earlier diagnosis, timely treatment, reducing inequality and proper support after the patient leaves hospital.

We must begin with prevention, because high blood pressure and high cholesterol can exist without obvious symptoms. People may feel perfectly well while living with a condition that substantially increases their risk of heart attack or stroke. By the time somebody becomes seriously unwell, an opportunity to intervene may have already been lost.

Prevention cannot simply mean advising people to live healthier lives. It means identifying those at risk, ensuring that NHS health checks reach the communities that need them most, and making full use of GPs, primary care teams and community pharmacies. Those services need the workforce, the time and the technology to identify risk and manage it properly. Detecting and treating high blood pressure and raised cholesterol must be regarded as core NHS work. The Government inform us that the NHS health check programme prevents about 500 heart attacks and strokes each year, which really is welcome, but the question is whether it reaches those at the greatest risk, including people in deprived areas.

We must also recognise the close relationship between cardiovascular disease and kidney disease. Kidney disease affects an estimated 7 million people in the UK. About 60% of kidney patients are diagnosed only in the later stages, when their cardiovascular risk is highest. About 20,000 kidney patients die from cardiovascular disease each year. Early testing for people with diabetes, high blood pressure and cardiovascular disease can identify kidney damage before it progresses. Indeed, Kidney Research UK suggests that less than one in five patients with chronic kidney disease receive SGLT2 inhibitors, despite their potential to reduce major cardiovascular events. Will kidney disease therefore be explicitly included in the modern service framework? What action will the Government take to improve early diagnosis and equitable access to proven treatment?

Early diagnosis is just as important for heart valve disease. In the UK, 1.5 million people live with that condition. Again, however, symptoms such as breathlessness, fatigue and dizziness are too often mistaken for the ordinary effects of ageing. That can mean that diagnosis comes only after the disease has become severe, and after irreversible heart damage has begun. Listening to the heart with a stethoscope remains a simple and low-cost first step. Where heart valve disease is suspected, patients need timely access and a clear route to specialist services. Will heart valve disease be explicitly included in the framework? And will the Government consider a single point of access for referrals to specialist valve services?

We must also confront the inequalities experienced by women. Cardiovascular disease kills more than 80,000 women in the UK each year, yet women are less likely than men to have their risk factors assessed, slower to receive a diagnosis, less likely to be referred to a cardiologist and also less likely to receive cardiovascular medicines or interventions. Women’s symptoms may simply be dismissed or attributed to stress, hormones or ageing, and women have been consistently under-represented when it comes to cardiovascular research.

The Government’s renewed women’s health strategy recognises some of those problems, and the commitment that publicly funded research should properly consider sex-based differences is really welcome. However, such recognition must translate into practice. Will the framework include measurable action to reduce sex-based inequalities in prevention, diagnosis, referrals, treatment and outcomes? And will women’s specific cardiovascular risk factors, including pregnancy history, gestational diabetes, menopause and autoimmune disease, be considered more consistently in NHS health checks and other assessments?

As we have heard, every minute matters for stroke patients. The speed of recognition, ambulance response, brain scanning and access to thrombolysis and thrombectomy can profoundly affect a person’s chances of survival and recovery. However, 24-hour coverage has still not been achieved, as my right hon. Friend the Member for Rayleigh and Wickford mentioned. The Government say that progress is being made, but patients need to know when every part of England will have reliable access to this life-changing treatment. Will the Minister set a firm date for that full 24/7 coverage, and will she explain how progress will be maintained while NHS England’s responsibilities are being transferred?

[Mr Francois]

For many years, stroke units have had access to thrombolysis—or “the shot”, as it is known in the trade. However, that is a very rough way of doing it, and it can have side effects and impede a patient’s recovery. Mechanical thrombectomy is a far more accurate way of solving a stroke problem, and with far less risk of subsequent side effects. That is why we are so keen to see its use grow, and I second my right hon. Friend’s request to the Minister.

[Stuart Andrew]

My right hon. Friend is so right. When he was describing its importance, I was thinking about one of my very dear friends who suffered quite a debilitating stroke. I thought, “If only that had been available for him, how different his life might be now.” I thank my right hon. Friend for raising that.

Care should not end when a patient leaves the acute ward. Someone who has survived a stroke might need to relearn how to walk, speak, eat and carry out other basic daily tasks. Rehabilitation and continuing community support are essential if people are to regain their independence and reduce the risk of another stroke. The same is true after a heart attack. Cardiac rehabilitation, medication reviews and support to manage risk factors can prevent further illness and save lives, yet access to rehabilitation remains uneven and too many patients experience a cliff edge between hospital and community care.

The Government have committed to reducing premature deaths from heart disease and stroke by 25% within a decade. That is a serious ambition, and, where they are taking practical actions to achieve it, they will absolutely have our full support, but it is important that that ambition is matched by a credible plan. In a letter dated 28 May, the Minister said that the framework we are expecting would be published in the spring. That deadline has now passed, so, like others, I again ask when that will be published. Will it contain clear milestones against which that 25% commitment can be judged? Will the Minister commit to regular, transparent reporting to Parliament so that Members can see whether earlier diagnosis, access to treatment and premature mortality rates are genuinely improving?

There is much on which Members across this House should agree. We all want fewer families to lose someone they love before their time; we all want patients to receive help before a manageable risk becomes a medical emergency; and we all want NHS staff to have the tools and capacity to provide the care their patients need. Reducing premature deaths from heart disease and stroke is achievable, but only through earlier identification of risk, faster diagnosis, timely treatment and rehabilitation that is available wherever a patient lives. Targets matter, but patients will judge success by whether they receive the right care in time, and that must be the measure of genuine success. They and their families deserve nothing less.

National Maternity and Neonatal Investigation

Stuart Andrew Excerpts

Tuesday 30th June 2026 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

I thank the Secretary of State for advance sight of his statement, and I thank Baroness Amos and her team for their compassionate work. As I said last week, I pay tribute to the women and families who gave evidence and to the babies at the heart of the inquiry. Many revisited the most painful moments of their lives after years of fighting to be heard. Their courage places a responsibility on us all.

Last week, the House confronted Donna Ockenden’s devastating findings in Nottingham. Today we face the wider national picture. Successive investigations expose the same failures: women dismissed, deterioration missed, staff silenced, inequalities unchallenged and leaders failing to learn. The problem is no longer a lack of evidence; it is a failure to act. Donna Ockenden said this morning that, sadly, so much in this report is stuff that we already knew. She also raised concerns about waiting until December, and I welcome the fact that the Secretary of State has just announced some of the work. She also said that no commissioner alone can fix a system needing action from every level from the Secretary of State right down to every ward. Donna Ockenden commands enormous respect and we should all listen to her, because she is right.

When will the Leeds and Sussex reviews produce their reports, and how will Ministers act on concerns before they conclude, so that families in those areas can see the change that they need as soon as possible? Families should not have to keep proving the scale of harm. Their testimony must now lead to action. The Birth Trauma Association says that the report has overlooked serious injury to women and brain injury to babies, so will the action plan address those harms, and how will families shape and scrutinise it?

We welcome the work beginning immediately on triage, discrimination, staffing and urgent estate risks. This is so important, and we must get on with that work, but families cannot wait until the end of the year for the wider plan. Those expecting babies now need reassurance about what will change and when. So many must be anxious, and we need to do all that we can to reassure them. The new triage standards will be published this week. By when must every trust meet them? Will the Secretary of State commit to update the House, by oral or written statement, on trust-by-trust progress? Will the estates funding include accommodation for parents close to neonatal units so that families are not separated from their critically ill babies?

We do not oppose a statutory maternity and neonatal commissioner, but Ministers must be clear about the role’s purpose, powers and accountability, because just one person cannot bring the change that is needed; local leaders have a responsibility too. When will the commissioner be appointed, and what will they be able to compel trusts, regulators and national bodies to do? How will local leaders be held accountable when care remains unsafe?

The additional midwifery posts are welcome, but temporary roles are not a sustainable workforce plan. Donna Ockenden has warned of rota gaps and of staff leaving obstetrics and midwifery. The 10-year workforce plan has been promised, delayed and pushed back repeatedly. When will it finally be published, and will it provide the permanent workforce that these recommendations require? With women having babies later and pregnancies becoming more complex, how will those at higher risk receive early specialist care?

I agree with the Secretary of State that the culture has to change. Listening to women is a clinical duty, not a courtesy; as I said last week, it is at the core of our safety issues. When concerns are dismissed, warning signs are missed, and mothers and babies are put at risk. That duty must apply equally in respect of every woman. A woman’s safety must not depend on her ethnicity, first language, disability, income or ability to fight through the system. As I said last week, both to the House and to the Secretary of State privately, I want us to work together constructively. Where the Government act with the urgency that the report demands, they will have our full support. We all have a duty, and ours is to support these changes.

Women and families will not judge today by new structures, promises or another report. They will judge it by what happens when a woman says that something is wrong. Is she heard? Are warning signs acted on? Is senior help available when needed? Are maternity units safely staffed? Can staff speak without fear? Do families receive honesty and compassion when harm occurs? Are fewer mothers and babies coming to harm? When decisions are taken, will they be fully explained?

The evidence has been gathered. Families have told their stories. The system has been warned. Now it must change.

[James Murray]

I thank the shadow Secretary of State not only for his questions, but for his tone and approach. When I gave the statement about Donna Ockenden’s report last week, we all agreed that the responsibility to deliver real change is shared by everyone in this House, so I appreciate his approach.

The right hon. Gentleman asked about the investigations in Leeds and Sussex, to which Donna Ockenden will be turning her attention over the rest of this year. It might be helpful for the House to understand that in developing a comprehensive action plan through the national taskforce, a framework will be devised so that any recommendations from future reviews can be incorporated into that plan and its implementation. That will ensure that we do not have a situation in which the plan is developed and future reviews come to conclusions or recommendations without a clear way for those to be integrated into the action plan. I hope that that gives him some reassurance over the process.

The right hon. Gentleman spoke about recognising families who have been harmed, as well as babies who survived and have grown up into children and adults while living with the harm of failings in maternity care. I am very conscious of them, not least because of the people I have met who sometimes feel forgotten or feel that their children are forgotten when we have these conversations. They live with the impact of brain injuries or other issues that arise during birth. They must not be forgotten, and I will ensure that they are included in the process.

The right hon. Gentleman asked about the roll-out of the new national triage standards, which will be published this week. The NHS England chief executive is meeting with NHS system leaders today to begin the process of ensuring that the triage standards, along with some of the other urgent measures that I have spoken about today, are rolled out. Although it is right to take time to get the comprehensive action plan in place by the end of the year, we do not want to waste time before we get on with the measures that we have decided should progress more quickly. NHS England leadership is progressing with those today.

The right hon. Gentleman asked about the funding for critical safety works in the maternity estate. Those critical safety measures are important, but the action plan will set out a more comprehensive approach not just for the physical infrastructure, but for the culture, which we have spoken about many times. We cannot invest money in culture in the same way as we can do so in physical infrastructure, but it is something that we need to address. We all agree on that. I sense that I had agreement from the House when I raised the importance of addressing cultural problems in maternity services.

The right hon. Gentleman asked about the responsibility being placed on the commissioner as just one person. I reassure him that my vision is for the commissioner to play a crucial role, but not on their own: they will co-chair the national taskforce with me, help to ensure that the national action plan is implemented, hold the system to account and, crucially, be a voice for women in the system. One way of the Government starting to address the issue of women being ignored in maternity services—an issue I have heard about so many times—is by ensuring that the commissioner is a voice for them when decisions are taken.

The temporary roles are an immediate step this year to ensure that newly qualified midwives have a way into making a contribution to NHS maternity services. Funding for those will be baselined in future years, and trusts will decide, trust by trust, how the funding is distributed among different roles. That will vary depending on needs in local areas.

The right hon. Gentleman also spoke about the importance of identifying women who are at higher risk because of different circumstances or problems they may face in giving birth. That is exactly what I hope the new triage standards will begin to address. If the triage standards can identify issues before they escalate and ensure that women get the right support more quickly, we will have an opportunity to avoid the extra, avoidable harm caused to women by delays in getting the right support.

The shadow Secretary of State closed his remarks by talking again about the need for a change in culture. He talked about the support from the Opposition, who will of course robustly challenge us where appropriate but support the aims that we are seeking to achieve. I thank him for that.

Nottingham Maternity and Neonatal Services

Stuart Andrew Excerpts

Wednesday 24th June 2026 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

I thank the Secretary of State for advance sight of his statement and Donna Ockenden and her team for the care and compassion with which they conducted the review. We had a meeting with her yesterday, and I have to say that it was probably one of the most difficult meetings that I have ever had. I pay tribute to the hon. Member for Sherwood Forest (Michelle Welsh). I can see how deeply personal and painful this is, and I admire her and all her colleagues from the region at what must be a very difficult moment.

Let me say from the outset that I want to be constructive in opposition when it comes to this issue. We need to work together; we have to see improvements. I begin with the women, babies, fathers, partners and families whose lives sit behind the review’s findings. To them, we owe a profound apology for failing them when a family should feel safest, most supported and most able to trust the care around them. For too many, that trust was broken; women were not listened to, families were not believed and warning signs were missed. Some suffered the deepest lost, others were left physically unsafe and others psychologically scarred. No statement can repair that pain, but it can mark the point at which testimony becomes responsibility, and responsibility becomes action.

The painful truth is not only that the failings occurred but that the themes are familiar: women not heard, families dismissed, poor communication, missed deterioration, weak governance and people unable to speak up. Maternity and neonatal safety has challenged Governments of both parties, but it would be wrong to let that history soften the urgency. Women and families are tired of telling their story, hearing promises and seeing the same themes return. The question is whether the system will move because of this review, and so I put three tests to the Secretary of State.

The first is the listening test. Women and families were not consistently listened to. Their concerns were too often dismissed or not acted upon. That is not a soft issue; it is a safety issue. How will the Government embed listening as a clinical discipline? How will trusts measure whether women feel heard? Will complaints and near misses be treated as information for improvement?

The second is the culture test. The review describes bullying, hierarchy and poor psychological safety affecting staff’s decisions and willingness to escalate. I pay tribute to those who were brave enough to do so. In maternity and neonatal care, minutes matter. If staff cannot challenge, safety is weakened. Staff cannot provide the care they want to if they are exhausted or unsupported, or if hierarchy matters more than candour. So I ask: how will boards be held accountable for that ward culture?

The third test is the delivery test. Harm rarely followed one error; it usually followed a chain of poor communication, weak risk assessment, delayed escalation, staff pressure, inadequate governance and missed learning. The response cannot be a single announcement. It must be accompanied by a delivery plan, so will the Secretary of State publish a national implementation plan with named accountability, delivery dates and regular updates to this House? That plan must address the workforce so that staff have the support and information they need to fulfil their roles to the ability they wish.

That plan must design services for today and the future, not rely on assumptions from the past. Women are having children older, pregnancies are more complex and more women are entering pregnancy with pre-existing conditions, previous loss, fertility treatment, mental health needs or circumstances shaping care. That means a need for practical, personalised care, informed choice and each woman being treated as a whole. The review also requires us to confront inequalities. The safety of a patient must not depend on confidence, class, ethnicity, language or an ability to fight through the system. The issue with our mortuaries is also really shocking. The horror stories that we have heard must never happen again. Is the Secretary of State working with colleagues in the Department of Justice to see what more needs to be done to overhaul this area?

Finally, we must recognise the psychological harm caused through silence, poor communication, lack of bereavement support and the battle for honesty. We know that our mortuaries need to have the highest standards. Compassion after harm is not a courtesy; it is a duty. Trust is rebuilt when women feel the difference in the room, when words change decisions, when staff speak without fear, when risk is escalated in time and when boards are judged by results. Where the Government act to improve safety, accountability, staffing and family voice, they will have our support so that we can see this through together. Where they do not, they will face our scrutiny. This review began with families who had to fight to be heard. The task now is to ensure that no family has to fight so hard again.

[James Murray]

I thank the shadow Secretary of State for not only the content but the tone of his response, and for the approach that he has taken. I firmly welcome this collaborative approach, because he rightly points out that this is an area that we should work across parties and across this whole House to address. His summary of the key issues that we must address through the work that we are doing—first and foremost, ensuring that women are listened to; the cultural changes we need to see; and the delivery test, recognising that this is a chain of failure—was very well made and in line with where I and the Department are coming at this issue from.

As I mentioned earlier, all the recommendations from today’s report, as well as the recommendations from the national report that Baroness Amos has been working on and from other inquiries and reviews of maternity service failures, will come to the national taskforce that I chair, precisely to deliver that delivery plan—that comprehensive plan of action. We will ensure that it is published by the end of this year, and the Government, working with the Opposition, will ensure that it is delivered across this country.

Puberty Blockers

Stuart Andrew Excerpts

Tuesday 23rd June 2026 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

This has been an important debate. It has been a difficult debate, but a necessary one none the less. There are some subjects in public life where the easiest course is silence, where every word is weighed, where motives are questioned and where hon. Members may be tempted to step back rather than step forward, but when the subject is the safety of children, silence is not an option.

Children and young people are at the centre of the debate. They are not slogans or political symbols to be used by either side of any argument; they are children, and often vulnerable children experiencing distress that can be profound, complex and deeply painful. They need kindness, patience and support from adults who listen and act responsibly. They need services that are timely, professional and compassionate. Compassion is measured not by how quickly we medicalise a child’s distress but by whether we protect the child’s future and respond to their present pain. That is the heart of the debate.

Sadly, those of us who are concerned about this trial are often labelled as transphobic. Personally, I find that offensive. Child safety matters to me, and so does equality for trans people, but we have to think about children. The Government ask the House to accept that the Pathways trial is the responsible way to build evidence. Ministers say that it is a carefully controlled study, that safeguards have been strengthened and that only a small number of children will be involved. But the question before us is not whether research matters—of course it does—but whether this particular trial involving children as young as 11 and 12 is the right and ethical way to proceed. We on the Conservative Benches do not believe that it is. My position is rooted in a simple principle: when evidence is uncertain, risks may be lifelong. When the patient is a child, the burden of proof must be exceptionally high. That is not ideology; that is good medicine.

The Cass review changed the debate because it brought clarity to a field that had been allowed to drift for too long. It found weak evidence, poor data, inadequate follow-up and a service model that too often failed to look at the whole child. It was the previous Government who treated those findings with the seriousness that they deserved. The routine prescription of puberty blockers on the NHS was ended because the evidence did not justify the practice. That was not a rejection of vulnerable young people; it was an act of safeguarding.

The Government now say that this trial is different. They say that it is not routine prescribing and that there will be monitoring, consent, assessment and withdrawal criteria. Yet process cannot answer the central moral question: can a child, at the start of puberty, truly understand the impact of interrupting that stage? Can an 11-year-old meaningfully consider questions of fertility, bone development, cognitive effects, sexual function and future regret? Can a parent, faced with a distressed child and a desperate sense of need for relief, rationally navigate the uncertainty without enormous pressure? Those are not abstract questions; they go to the integrity of consent itself.

In most areas of medicine, when the risks are serious and the benefits uncertain, we become more cautious, not less. We do not reassure ourselves merely because the cohort is small, or say that because only a limited number of children may be exposed, the ethical concern is reduced. For each child in the trial, the consequences are enormous and personal. For each family, the decision is life-altering. For each future adult, the question may one day be, “Did the people in authority protect me properly?”

The Secretary of State has said he feels “discomfort and unease”. I welcome that honesty, and I believe it to be heartfelt. Yet discomfort in this area should not be something that Ministers try to manage away; it should make them stop and think again. Unease is sometimes the proper response of conscience. The Government point to safeguards, but safeguards are not the same as certainty. Monitoring every three months may identify some problems, but it cannot guarantee that long-term harm will not emerge years later. Objective withdrawal criteria may be better than vague discretion, but they do not remove the risk of treating a child unnecessarily in the first place.

The Government have still not answered a fundamental question: why proceed now before the existing evidence has been fully examined? There are children and young people who were treated under previous services. There is data that may help us to understand outcomes. There is a Tavistock-related evidence base that should be completed and analysed before more children are exposed to puberty blockers in a new trial. Surely the first duty is to learn from what has already happened and therefore potentially identify wherever there may be gaps. That is not obstruction; it is responsibility.

The Government must not ignore the wider context. Many children who experience gender distress also have other needs: mental health difficulties, autism, trauma, family pressures, anxiety, depression, eating disorders or safeguarding concerns. Dr Cass was clear that services must look at the whole child and not just one aspect of identity. We should not accept a system that is slow to provide holistic support but prepared to move ahead with powerful medical intervention under the banner of research.

The House must be honest about the tone of this debate. There will be young people listening who will be feeling frightened by it. There will be parents listening who feel judged. There will be clinicians listening who are trying to do their best in a difficult and contested area. Let us be clear: our concern is not with the dignity of any child—their dignity is beyond question. Our concern is with the decisions made by adults in positions of power. Children deserve adults who can hold two truths at once: that their distress must be taken seriously, and that serious distress does not automatically justify experimental medical treatment.

[Vikki Slade]

I am slightly confused because we know that the young people in this trial will already have all those other things in place. The Minister has been clear about the talking therapies, for example, and about the time period. It takes two years in the gender system before anyone can access this trial. I am worried that it is slightly disingenuous to suggest that these children are going to be popped straight on to a trial without everything else being in place. Could the right hon. Gentleman just clarify that he understands that?

[Stuart Andrew]

I can assure the hon. Lady that I have given this an enormous amount of consideration. I understand what she is saying, but my argument is that we already have a set of data on children who have gone through some of these experiences, and that needs to be looked at. Having spoken to some of them, I do not want to see others experience it.

[Vikki Slade]

rose—

[Stuart Andrew]

I am going to continue because I want to give the Minister the opportunity to respond.

The Secretary of State says that this trial will help settle the evidence, but a trial that follows children for a limited period cannot by itself settle questions that may only become clear in adulthood. It cannot fully answer the questions of what a child will think at 25, 35 or 45 about decisions that were made at 11 or 12. When I was in my teens, struggling with my sexuality, it was complex enough. It was emotionally draining. It was scary. I cannot imagine how much harder that would have been if someone had added to the mix by telling me that maybe it was not my sexuality but my gender. This is why we must listen to people like Keira Bell.

We must not confuse the creation of some evidence with the resolution of all uncertainty. The Opposition’s approach is careful, proportionate and child centred. We must pause this trial, complete the analysis of existing data, publish a full account of the known risks and unknowns and strengthen non-medical support. Then, and only then, should we consider what further research should be ethically justified. This is not abandonment; it is protection.

The first responsibility of any health system is not to validate every proposed treatment, but to ask whether that treatment is safe, necessary and in the long-term interests of the patient. When the patient is a child, that responsibility is heavier still. We owe these young people more than good intentions. We owe them caution. We owe them honesty. We owe them services that see them in the round, and we owe them the humility to admit that when the evidence is uncertain, the answer is not to press ahead and hope; the answer is to pause, learn and protect. For those reasons, I urge the House to support this motion.

Spinal Muscular Atrophy: Newborn Screening Test

Stuart Andrew Excerpts

Monday 22nd June 2026 Westminster Hall

[Stuart Andrew (Daventry) (Con)]

It is a pleasure to serve under your chairmanship, Mr Mundell. I thank the hon. Member for Sunderland Central (Lewis Atkinson) for opening this important debate on behalf of the Petitions Committee. The debate is an example of Parliament at its very best.

I also acknowledge Jesy Nelson and her tireless efforts to raise awareness of spinal muscular atrophy following her twin daughters’ diagnosis with the condition. Little Mix have long used their platform to support a wide range of charitable causes, and I express my sincere thanks for their continuing to do so. However, to open up about something so deeply personal goes a step further. I also pay tribute to all the other families who have opened up to so many Members of Parliament.

I have often spoken about my time working in children’s hospices, and it was always the families’ stories that made compelling cases for the extra support that was needed. I acknowledge the work of Spinal Muscular Atrophy UK, whose dedication to supporting individuals and families affected by SMA continues to make a meaningful difference in countless lives. In this country we are lucky to have so many wonderful charities that help families through difficult times.

As we have heard, SMA is a progressive condition that causes muscle wasting and weakness. It is a most awful condition that is not reversible with treatment and, as we have heard, there are several types. SMA type 1, which my right hon. Friend the Member for Melton and Syston (Edward Argar) talked about Harvey having, is a severe form that develops between birth and six months of age. Without intervention, life expectancy is often less than two years. Type 2 develops between six and 18 months of age; children usually cannot walk unaided and may suffer respiratory complications into adolescence. Type 3 develops after 18 months of age; individuals can usually walk independently, although that may become progressively more difficult over time.

Before 2019, there were no effective drugs available on the NHS to treat the condition. However, over the last seven years, three transformative treatments that can stop SMA in its tracks have become available on the NHS: one is administered by a lumbar puncture every few months; the second is gene editing infusion; and the third is a treatment that patients must take orally for the whole of their lives. There is encouraging evidence that those treatments really are helping.

We have heard that SMA cannot be reversed, but NHS data from 2023 shows that children with SMA 1—the most severe form of the condition—are now surviving for longer. For families affected by an SMA diagnosis, time is everything, so that is an important start. When I worked in children’s hospices, I saw so many families go through incredibly difficult times. As the hon. Member for Portsmouth North (Amanda Martin) mentioned, it is not just about caring for a child; there is the impact on relationships, family finances and even sleep. I remember one father saying to me that if he got up eight times in the night, he considered that a good night’s sleep.

We had a saying in the children’s hospices: while we cannot add days to their lives, we can add life to their days. However, in this case we can literally add days to their lives, and we really should do so. I agree with my right hon. Friend the Member for Melton and Syston that the Minister is very diligent and clearly cares, but will she tell us how many babies and children are currently receiving the drugs I mentioned from the NHS? Will data continue to be collected to give us fresh insights into the effectiveness of those drugs over time? While the damage inflicted by SMA is irreversible, if treatment is given before symptoms begin, that damage can be prevented. Screening can therefore be an absolute lifeline for babies and families if SMA is caught early. That is why we welcome the UK National Screening Committee’s recommendation to introduce in-service evaluation, which will see newborn screening for SMA trialled in the UK, and the role that the former Secretary of State, the right hon. Member for Ilford North (Wes Streeting), played in all that. It is a positive step forward.

I want to add my voice to those of other Members today, and put some questions and points of clarification to the Minister. The ISE, recommended by the National Screening Committee, will evaluate newborn screening for SMA for some newborns in England, commencing in October 2026. However, as we have heard, reports suggest that about one third of newborns will initially not be included. Will the Minister explain the logic behind the choices that have been made?

As I understand it, the seven NHS newborn screening laboratories in England that will undertake screening are in Birmingham, Great Ormond Street, Manchester, Newcastle, Sheffield, south-east Thames and south-west Thames. Government statistics do not suggest that babies born in those regions are more likely to have SMA, and there appears to be no correlation at all between instances of SMA and the location of the centres chosen to screen newborns for the condition. I could also find no correlation with the efficiency of delivery for the screening programme. That begs the question: what is the rationale for choosing just those centres, and why have others not been chosen?

A baby born today who is screened and treated straight away is likely to walk at three years old. One born in a non-screened area, who is treated only when they become symptomatic, is very unlikely to walk and may not even be with us for very long. NHS England is responsible for organising the screening, but we know that the Government are going through with its abolition, along with the reorganisation of integrated care boards, so what assessment has the Minister made of the impact the restructuring may have on the capacity to deliver screening? That is an important point to bear in mind.

There are other conditions that are excluded from newborn screening, such as metachromatic leukodystrophy. I met a mother who has been campaigning hard on that, along with other campaigners. Will that condition and others also be included in newborn screening in the UK? Surely we should help if we can, because, as I say, the impact is really difficult for those children and their families. I am a huge fan of early intervention, so if we can do something about it early on we should—I cannot remember which hon. Member said this, but even if we just look at it through the hard lens of finances and public money, we would save a huge amount of money over the years.

It is desperately sad to see babies and their families affected by SMA. I hope that the Minister can provide some reassurance to those families that the forthcoming screening that they have long been fighting for will be fair, effective and accessible to all newborns in the UK. As I mentioned, the families I used to work with in children’s hospices would often say that, when their child was born or diagnosed with whatever condition it may be, their hopes and dreams for their child changed. When the baby was first born, they thought about the first day at nursery, primary school or secondary school, and then doing exams, going on to get married and have children and so on, and suddenly those dreams had to change because their life would be different. If we do this screening, some of those families, can keep their original dreams and we can add days to the lives of those children.

Oral Answers to Questions

Stuart Andrew Excerpts

Tuesday 9th June 2026 Commons Chamber

[Mr Speaker]

I call the shadow Secretary of State.

[Stuart Andrew (Daventry) (Con)]

I begin by welcoming the Secretary of State and the Under-Secretary of State for Health and Social Care, the hon. Member for Birmingham Edgbaston (Preet Kaur Gill), to their places.

The Secretary of State was in the Treasury when it imposed VAT on compassionate access medicine programmes, which provide some patients—especially children with cancer—with a vital last chance to access treatment. The policy has already led to the closure of one scheme. Will he now commit to abolishing this tax before any more follow suit?

[James Murray]

One thing I learned when I was in the Treasury is that decisions about tax are taken by the Chancellor at fiscal events, so I am certainly not going to start taking decisions about taxation in my new role at the Dispatch Box today. The broader point is how important it is to ensure that we have the medicines that we need for the future. That is why this Government are investing so much in research, development and innovation, to ensure that we have the drugs and medicines we need for the healthiest possible population in the future.

[Stuart Andrew]

I am sorry, but that was simply waffle. This matter needs decisive action now; these drugs are absolutely critical to some children. This cancer drugs tax has already closed one scheme, and companies are making real-time decisions now about whether to continue programmes in the United Kingdom. The Secretary of State must urgently get the Treasury to exempt compassionate use medicines permanently, so that the patients in most need can get these vital drugs, which, in some cases, are simply their only hope.

[James Murray]

I have explained the position about decisions on tax. More broadly, it is critical that we have the medicines of the future that we need. One of my very first visits as Secretary of State for Health was to a company that is using AI to determine new opportunities for medicines and drugs to tackle cancers and some of the other illnesses that people face. Making sure that we are investing in businesses—British businesses—to drive that innovation is crucial, not just to the future health of our country but to economic growth.

Health Bill

Stuart Andrew Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

I begin by welcoming the Secretary of State to his new post, and thank him for sharing his very personal story about what the NHS means to him. I look forward to our future exchanges, however long he is in post. I also pay tribute to the former Health Secretary, the right hon. Member for Ilford North (Wes Streeting), with whom I have had a few moments across the Dispatch Box. I know that the NHS has also been very important to him personally. During my time in hospices, I saw the incredible work that the NHS does, and despite the politics that we may have—and I will be referring to the right hon. Gentleman a bit more later on—we all care deeply about the national health service and want the very best for it.

There are moments in politics when one almost has to admire the confidence of Governments—not their competence, necessarily, or their judgment, and sometimes not their timing, but certainly their confidence—and nowhere has that confidence been more magnificently displayed than in the presentation of the Health Bill. If one had listened carefully to the former Secretary of State for Health and Social Care over the past two years, one could conclude only that this Bill was not merely legislation, but apparently the parliamentary equivalent of the second coming. In every speech, interview and carefully staged hospital visit with sleeves rolled up, they delivered the same message: at last—at long last—the NHS was to be modernised, integrated, digitised, streamlined, revolutionised and transformed into a gleaming technological marvel, where patients floated frictionlessly through a system powered entirely by innovation, efficiency and ministerial self-belief.

I say gently to Ministers that whenever a politician begins using the phrase “once-in-a-generation change” on such a regular basis, it is usually wise to place one’s hands protectively over one’s wallet, given the sheer cost of what is to follow. What became increasingly striking was not simply the scale of the promises, but the sheer showmanship of them, with the former Health Secretary speaking less like a Cabinet Minister wrestling with one of the most complex public services in the world and more like a man auditioning to narrate the trailer for his own leadership campaign documentary. And now, Madam Deputy Speaker, we arrive at the great political twist: the man who spent two years announcing the future has departed before the delivery date arrived, like an architect unveiling magnificent blueprints before quietly moving abroad just before construction begins.

Into this situation walks the new Health Secretary. Members can imagine the scene: the Prime Minister sits stubbornly in No. 10, grinning with all the reassuring confidence of a man standing knee-deep in a flooded rowing boat insisting that the situation merely requires a modest redistribution of water. Into this bunker is summoned the new Secretary of State—formerly the Chief Secretary to the Treasury, the very man who helped to allocate the famous £202 billion funding settlement now repeatedly cited as proof that every problem in British healthcare has theoretically already been solved.

[Jessica Toale (Bournemouth West) (Lab)]

I would not give the right hon. Gentleman’s political adviser a raise for their speechwriting abilities just yet. Why does he think we are having to talk about once-in-a-generation change to the NHS?

[Stuart Andrew]

I would point the hon. Lady to how the NHS was being run in Wales—it certainly was not the great success that she is trying to allude to.

In politics there are difficult jobs and there are impossible jobs, and then there is inheriting a Department after one’s predecessor spent two years promising the electorate that this is the one Bill to rule all Bills and fix virtually everything short of death itself. This was not just a hospital pass, but a hospital pass delivered by catapult.

One can almost hear the poor Secretary of State gulping. “Thank you, Prime Minister,” he replies faintly, in the tone of a man accepting command of the Titanic after it has already struck the iceberg. Off he trudges to the Department of Health and Social Care, where the automatic doors open and his nostrils are struck immediately by a strange, lingering aroma. It is not the scent of modernisation or the smell of efficiency, and it is certainly not the fragrance of falling waiting lists. No—it is the unmistakeable odour of political panic, mixed delicately with the perspiration of failed leadership manoeuvres and lightly seasoned with the ashes of abandoned promises. There waiting for him, naturally, is Sir Humphrey—because however much Governments modernise, digitise, integrate, recalibrate or synergise, Whitehall always produces a Sir Humphrey.

I can imagine the conversation. The new Secretary of State says brightly, “Good news, Sir Humphrey. I understand that my predecessor has already solved everything through the Health Bill.” At this point, an eerie silence descends. Civil servants suddenly become more fascinated by ceiling tiles, and one junior official attempts to escape through a stationery cupboard. Sir Humphrey clears his throat in the way only permanent secretaries can; a sound rather like an early—

[Wes Streeting (Ilford North) (Lab)]

Will the right hon. Gentleman give way?

[Stuart Andrew]

Give me time, give me time.

“Well, indeed, Minister,” says Sir Humphrey.

“I understand,” says the Secretary of State, “that abolishing NHS England will instantly reduce bureaucracy, improve accountability and unleash vast efficiencies.”

“Well, Minister, it will certainly create a large number of meetings.”

“And the single patient record will revolutionise healthcare, won’t it?”

“Yes, Minister—assuming the NHS IT systems eventually stop communicating with each other via what appears to be medieval semaphore.”

“But we have delivered 5 million more appointments.”

“Certainly, Minister—only 1.5 million appointments behind the last Conservative Government.”

“And integrated care boards now answer directly to Ministers.”

“Yes, Minister.”

“So accountability is now indisputable.”

“Well, Minister, blame certainly is.”

And so the conversation goes on. The Secretary of State asks, “And what about the workforce plan?”

“Still developing, Minister.”

“And social care?”

“Still delayed, Minister.”

“And mental health implementation?”

“Still proceeding at approximately the speed of continental drift.”

“And pharmacies?”

“Still under pressure.”

“And GP contracts?”

“Still alarming GPs.”

“And productivity?”, the Secretary of State asks desperately.

“At present, Minister, the NHS measures productivity in the same way that astronomers in ancient Greece measured distant planets: with great optimism and very limited visibility.”

At this point, the Health Secretary clearly begins searching the office for the exit map. “But Sir Humphrey,” he says, “surely my predecessor left me with a fully deliverable programme.”

After a long pause, Sir Humphrey replies, “Well, your predecessor was primarily focused on a different pathway.”

“A different pathway?”

[Wes Streeting]

rose—

[Stuart Andrew]

“Yes—the pathway to No. 10.”

And now I will give way to the right hon. Member! [Laughter.]

[Wes Streeting]

I am sure that sounded really good in the mirror when the right hon. Gentleman practised this morning, but can I bring him back to the real world, where the permanent secretary is, in fact, a woman and an outstanding leader at that? In the real world, I am able to say something that not one of my Conservative predecessors was able to say when they left office, which is that I left the NHS in a better state than I found it. Why is he so determined to defend the bloated bureaucracy that his party created over 14 failed years?

[Stuart Andrew]

Well, let me say directly to the right hon. Gentleman that there have been a lot of announcements from the Government. We know all about the fall in waiting list figures, and not just from comments from us in this Chamber challenging what is really happening—we are receiving email after email from people who have been taken off waiting lists despite still needing treatment. Patients are being taken off waiting lists, sometimes without their knowledge. This has not been about more appointments for patients—it is about massaging the figures, and he knows it.

There is a lot in this Bill that we will support, and there are many areas where we would like the Government to perhaps go further, but there is also a rhetoric that needs to be addressed, because there are unresolved problems still. Social care is unresolved. Workforce pressures are unresolved. Mental health backlogs are unresolved. Productivity is unresolved. Pharmacy pressures are unresolved. GP satisfaction is unresolved. The Secretary of State is inheriting not just a Department but an expectations crisis, because the greatest danger in politics is not under-promising; it is convincing the public that complexity itself can be announced away.

The Bill abolishes NHS England and centralises significant powers to be governed by the Secretary of State. It takes control out of patients’ hands.

[Jim Shannon]

The shadow Secretary of State rightly said that there is a lot in the Bill to be welcomed in principle, including the cutting of red tape, and we must recognise that, but unchecked state control must be resisted. The shadow Secretary of State mentioned accountability. Does he agree that we must ensure that accountability is part of the Bill?

[Stuart Andrew]

The hon. Gentleman raises an important point, and it is exactly the sort of issue that will need further scrutiny in Committee. I note that local authorities will not have the same seat at the table and that it will be transferred for mayoral regions, but what about regions that do not have a mayor? That measure will create a real democracy deficit in the NHS. I hope that we can look at this in detail in Committee, because that serious oversight absolutely needs addressing.

[Gregory Stafford]

On the point of accountability and scrutiny, the Government are looking to abolish HSSIB or bring it into the CQC, they are getting rid of Healthwatch—which serves my constituents so well—in places such as Surrey and Hampshire, and they are getting rid of governors from the boards of foundation trusts. That does seem to suggest that they have not really thought the accountability point through. Would not this be the occasion for the new Secretary of State to stamp his mark on this Bill by conceding that some of the changes in the Bill are not what was intended, and to take this opportunity to give confidence back to the public that they will have the accountability and scrutiny that they deserve?

[Stuart Andrew]

My hon. Friend raises a very important point; it is an area that the Committee will have to look at very carefully.

I listened carefully to what the Secretary of State said, and I believe that he wants there to be a patient voice, but there is a serious flaw in the Bill. Abolishing Healthwatch and HSSIB is a terrible mistake, and I praise my hon. Friend the Member for Harwich and North Essex (Sir Bernard Jenkin) for the work that he has been doing on this. The reality is that HSSIB gives members of staff who work in the NHS the confidence to come forward and be a whistleblower. We need that. We need people to feel that they are in a safe environment. The CQC is a totally different beast in the minds of people who work in the NHS and social care, so to put those functions within that organisation is a terrible mistake and one that I hope the Committee will look at very carefully.

[Saqib Bhatti (Meriden and Solihull East) (Con)]

The shadow Secretary of State is making an excellent speech, and I commend his speechwriter! I am sure my right hon. Friend wrote it himself.

On accountability, the Secretary of State spoke repeatedly about devolving powers, but this Bill is a massive power grab by the Secretary of State, and our constituents will not get the accountability that they crave and that some of the reforms we implemented in 2022 gave them. Does my right hon. Friend share my concern?

[Stuart Andrew]

I am genuinely concerned about that. Members of Parliament from across the House have often brought to the House some very serious cases—things that have gone terribly wrong for their constituents, services that have been commissioned in their area, and awful things that have happened to patients. It is because of organisations like Healthwatch and the HSSIB that those issues have come to light, and work has gone into improving those services. That is what we all want to see, but I am really worried that that progress will be lost. If those functions are absorbed into the Secretary of State’s office, I really do not think it will be able to cope with the sheer volume. It needs to be done on a much more localised basis.

[Robin Swann (South Antrim) (UUP)]

I thank the Secretary of State for raising that. If I read the Bill right, schedule 8 allows the CQC to carry out investigations into Northern Ireland and Wales, whereas the CQC has no presence or remit within Northern Ireland, because health is devolved and those functions are carried out by the Regulation and Quality Improvement Authority. Can the shadow Secretary of State comment on how the Secretary of State is now reaching into devolved matters in regards to regulation, quality, improvement and assessment?

[Stuart Andrew]

That is exactly one of the issues that needs to be ironed out. I am sure that the hon. Gentleman will ensure that the Committee considers the impact for devolved Administrations, particularly where they have responsibility for health in their areas. I hope that he will raise that with members of the Committee.

[Anna Dixon (Shipley) (Lab)]

I worked in the Department of Health at the time that NHS England was created. I have always been sceptical about the Lansley fantasy that somehow the NHS could be made separate from the Department of Health and Social Care. I saw at first hand man-marking and duplication of function. This Bill finally puts the nail in the coffin of the complex arrangement of masses of arm’s length bodies that was created by Andrew Lansley. Will the right hon. Gentleman please agree that this is the time to restore stronger democratic accountability for our NHS?

[Stuart Andrew]

I gently remind the hon. Lady that it was the former Secretary of State who said that he did not want to go through another reorganisation, because it would be very costly. We still cannot get a clear answer from the Government about how much this is all going to cost the taxpayer, and there are estimates of £1 billion. There are still serious questions to be answered. The hon. Lady talks about democratic responsibility and accountability, and she is right to do that. She is fortunate—depending on one’s point of view—to have a mayor, but my constituency and county do not. Will my constituents get less of a voice in their NHS than her constituents in Shipley? That does not seem fair to me.

[Jen Craft (Thurrock) (Lab)]

Is it not the case that transferring powers from an unelected quango to the Secretary of State, who is directly accountable to this very House, increases, not diminishes, accountability in the NHS?

[Stuart Andrew]

I am talking about trying to get accountability down to the local area. That is where it matters, and that is where my constituents want to see it. They know their local services and the hospitals in their areas, and they are the ones who should have their voices.

[Dr Spencer]

I am glad that we are having this important debate on accountability. Is there not a danger that the centralisation of this direction power in the Secretary of State effectively signals to MPs, “Don’t engage with ICBs, as they will not have accountability to local MPs. If you want changes to happen, go through the Secretary of State rather than engaging locally, because that is where the power is going to lie”?

[Stuart Andrew]

Yes, and this is—[Interruption.] It is slightly patronising to say to someone, “Read the Bill”. Clearly my hon. Friend has, and we have been talking about this in great detail.

There is a real concern here. We need much clearer answers to these questions, which many of our constituents will have. Those who give up their time to work in organisations to make the NHS better deserve decent answers to those questions and concerns. I certainly hope that reflection will be taken on those points.

At its heart, the Bill is not simply a debate about technology or bureaucracy; it is about who holds, controls and safeguards the most personal data that any of us will ever possess. This is one of the most significant reorganisations of the NHS in modern political history, but it is wrapped carefully in the language of managerial simplification.

Perhaps part of the Bill will help, and of course some reforms are necessary. Conservatives are not afraid of reform—definitely not. Indeed, if the NHS is to survive the demographic, technological and fiscal pressures ahead, modernisation is essential. That is because technology matters, innovation matters, integration matters, data matters, prevention matters, productivity matters and, yes, accountability matters too. That is why, where we see good work in the Bill, we will back it, and where we think there are questions that need to be drilled down into, we will do so. We want to ensure that the Bill works.

There is a difference between modernisations rooted in political realism and announcements designed primarily for political theatre, and too much of the approach we have seen so far is Whitehall talking to itself; meanwhile, outside this Chamber, reality continues uninterrupted. Patients still wait, ambulances still queue outside A&E, the family still worries, the exhausted nurse still works a double shift and the GP still battles impossible demands.

Here is the truth: the NHS does not primarily suffer from a shortage of announcements; it is marked by a persistent lack of grip and direction. The Government today increasingly resemble a man frantically changing labels on a filing cabinet while the building itself quietly catches fire.

The Government say that abolishing NHS England will reduce bureaucracy—perhaps it will—but let us not forget that Whitehall sometimes possesses a remarkable historic talent for abolishing bureaucracies ceremonially before quietly recreating them under another name with slightly different headed paper. We need to ensure that that does not happen in this instance.

We also have to think about the huge amounts of public money involved—yes, nearly £202 billion; an extraordinary sum of money. We understand that pressures rise—of course we do—we understand about ageing populations, we understand that medical advancement increases costs and we understand the aftershocks of the pandemic. But when a Government spend record sums while presiding over delays, workforce uncertainty, transformation paralysis, productivity collapse and public frustration, eventually the British public are entitled to ask a simple question: where has all my money gone? The Government are not judged by the size of the press release; they are judged by whether the thing actually works.

We must now do everything to ensure that the Bill goes through with great scrutiny, as it needs to do, because healthcare is difficult, trade-offs are real and workforce shortages cannot simply be rebranded as opportunities. Indeed, the public increasingly suspect something very different here: they suspect that too much of modern politics has become performance without consequences, announcements without accountability and presentation without delivery. That is ultimately why the Bill matters. If this enormous centralisation of power succeeds, Ministers will claim vindication, but if it fails and bureaucracy persists, waiting lists remain stubborn, workforce pressures deepen and promised transformation dissolves into another cycle of reorganisation, the Government will no longer possess anyone else to blame—not NHS England, local structures, quangos or the system—because the Bill places responsibility squarely where the Government claim it belongs, on the shoulders of Ministers. Perhaps that honesty will prove the Bill’s greatest contribution.

The British people are patient, but they are not naive. They can distinguish between serious transformation and political choreography, and they increasingly understand that there is no technological shortcut around the fundamental challenge facing healthcare. The Government cannot run a service this large, pressured and so deeply connected to people’s lives and wellbeing primarily through presentation. Eventually, every Government collides with reality, and reality—unlike leadership campaigns—cannot be managed through slogans. That is the inheritance facing the new Health Secretary, and that is why the House should approach the Bill not with breathless excitement but with very hard-headed scrutiny indeed so that we get the NHS we all want to see.

[Several hon. Members rose—]

Oral Answers to Questions

Stuart Andrew Excerpts

Tuesday 14th April 2026 Commons Chamber

[Mr Speaker]

I call the shadow Secretary of State.

[Stuart Andrew (Daventry) (Con)]

The latest industrial action by the British Medical Association has now ended, yet many will be appalled by reports of individuals boasting online that

“the ability to have 10 days off will make turnout quite high.”

Does the Secretary of State agree that this behaviour is indefensible and represents a slap in the face to patients whose treatments have been cancelled, as well as to the NHS staff who have been left to pick up the pieces?

[Wes Streeting]

Yes. It reflects very poorly on the BMA and the cavalier way in which it has inflicted disruption and a £300 million bill on the country in straitened times. It was also unnecessary. Although the resident doctors committee chose to reject a generous offer, that did not mean that it needed to rush out and announce six days of strike action the very same day. With the BMA, strike action is a first resort, not a last resort. It needs to change its tune, because the country cannot afford to fund its reckless behaviour.

[Stuart Andrew]

This is a rare occasion, as I agree with the Secretary of State. The increasingly militant stance adopted by the BMA is plainly out of step with some resident doctors, who continue to report for duty. The Government’s handling of this dispute has been marked by inconsistency. First, they attempted to buy their way out of trouble, then they withdrew the training places that this House voted for. Instead of persisting with a failed strategy, is it not time for the Government to heed our calls and bring forward legislation to ban doctors from striking?

[Wes Streeting]

The Government’s approach has been consistent. We recognise that resident doctors suffered years of pay erosion and worsening conditions under the Conservatives. We came in and sought to address that substantially with a 28.9% pay rise and an offer on the table that would have gone further on pay, gone further on training places and cancelled exam fees, which is the best deal that anyone will have got in the entire public sector. Resident doctors have rejected that approach, but the shadow Secretary of State reminds the BMA that however much it might disagree with this Labour Government, the alternatives are far worse. It is far better to work with us than against us, but we will not cave.

Resident Doctors: Industrial Action

Stuart Andrew Excerpts

Thursday 26th March 2026 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

I am grateful to the Secretary of State for advance sight of his statement. Only yesterday he was boasting about progress in the NHS. Today we are back here again, facing more strikes, more disruption and more uncertainty for patients—quite the contrast. In opposition, he made resolving these strikes sound straightforward: “Just get around the table. Just negotiate. Just sort it out.” He repeatedly stated that the power to stop the strikes lay in the Government’s hands. Well, the power is now in his hands. He has had every opportunity to prove it, and yet here we are again. Not so easy after all, is it?

The Government came into office promising to end these disputes. Instead, they have conceded heavily on pay, at enormous cost, and still failed to make it work. The Secretary of State says a comprehensive deal was on the table, developed with the BMA leadership. Despite that, we still face further strikes, so what exactly has this strategy achieved? After all the concessions, all the cost and all the disruption, there is still no resolution. If, as he says, the BMA leadership helped to shape the deal, why did it not secure the support of the wider committee? This morning, the chair of the BMA’s resident doctors committee said that all the Secretary of State needs to do to avoid these strikes is come back with a better offer. That was the Secretary of State’s argument in opposition, too. He has now had every opportunity to test that theory in government, and it has not worked, just as we warned.

There is also an irony here that will not be lost on the public. The BMA says that a 3.5% pay rise for doctors is a “crushing blow”, yet it is offering its own staff just 2.75%. While it demands more from the taxpayer, it will not even meet its own standard for fairness. The inconsistency is obvious and hypocritical.

The Government’s own position on affordability no longer seems to add up. In October, Ministers were clear that anything above 2.5% would have consequences for wider NHS commitments. They said that every additional 0.5% would cost around £750 million, yet we are now beyond what they previously said was affordable, so what has changed? Were those warnings overstated, or are other parts of the health budget now going to pay the price? The Secretary of State even pointed to global events as a reason for future constraints. That is a long way from “just negotiate and sort it out”. After repealing minimum service levels, the Government cannot now be surprised that patients are once again exposed to greater disruption.

Labour promised to end the strikes. It paid a very high price, and it still did not get the result. Ultimately, it is patients who are caught in the middle of all this, but it is unfair on others in the NHS, too. Consultants are left picking up the pieces yet again. Other doctors and NHS staff are expected to carry the burden and keep services running—they do not get to walk away. That is not sustainable, and it is not fair.

The Secretary of State says he may now have to call time on the extra jobs he announced. Were those jobs ever truly secured, or were they always conditional on the BMA accepting the deal in full? When he says that strike action will consume the money set aside for this deal, is he not really admitting that his own approach has ended up burning through the very resources he said would improve pay, jobs and conditions? What is the cost of this latest round of strikes expected to be, and where will that money now come from? What assessment has he made of the impact on patient safety, consultant morale and the training progression of junior doctors? What is his plan to end this dispute, rather than simply manage the next round of disruption?

Patients need certainty. The NHS needs stability. That is why we have been clear that doctors should not be allowed to strike and that minimum service levels must be restored to protect patient safety.

[Wes Streeting]

I thank the shadow Secretary of State for his response and questions. Beneath some of the criticism of the Government was a consistent message about the unreasonable and unnecessary position of the BMA, but let me address his criticism none the less.

The shadow Secretary of State accused me of “boasting” yesterday about the progress this Government are making on the NHS. For once, I cannot say we are following the pattern of our predecessors, because of course, they did not make any progress. From the moment they entered government, we saw the NHS begin to slide in the worst direction, to the extent that we went into a modern health emergency—the pandemic—woefully underprepared, leaving our country more damaged as a result. I am proud of the progress we are making. We know that what we have seen in terms of results and patient satisfaction are grounds for optimism, not cause for complacency. What we are trying to do as a Government is absolutely essential for the country, to give it back an NHS that is there for people where they need it, when they need it. That is why the BMA’s position is both disappointing and self-defeating for all of us.

The shadow Secretary of State talked about the approach I took in opposition. There is a difference between the approach that this Government have taken and the approach of our Conservative predecessors. We have always been prepared to get around the table; we never close the door. As I said from the other side of the House, the power to end strikes does sit with the Government when they are willing to compromise, willing to negotiate and willing to treat the workforce with respect. That is what this Government have done, in contrast to our Conservative predecessors, which is why it is so disappointing that with a deal available—a good deal—the BMA is turning away.

The BMA should reflect not just on the contrast with the past, but on the contrast with the future. There is no more pro-NHS, pro-doctor Health Secretary or Government waiting in the wings. I am not even sure that the alternative is a Conservative Health Secretary; that person may well come from Reform UK—the party whose Members occasionally turn up and sit in the corner, when they can be bothered and when they are not flouncing out in a hissy fit. Catch them on a good day and Reform Members may even say the quiet bit out loud: they do not believe in the NHS. They do not believe in it as a public service free at the point of use, and they are certainly not going to treat the BMA or resident doctors with more respect or generosity than a Labour Government. I think the BMA needs to reflect on that.

The shadow Secretary of State asked about affordability. One of the great things about the deal that we agreed is that it is affordable because it involves productivity gains—not just the productivity gains that we have already achieved in the NHS, the target being 2% and the reality that we have achieved 2.7%, but the productivity gains built into the pay structure reform.

The shadow Secretary of State asked about the jobs. I will be honest, and I am sure NHS chief executives will want to say more about this. The fact is that I and Jim Mackey have had to do a considerable degree of persuading and arm-twisting to persuade NHS trusts to create additional specialty training places, because they have not been convinced of their necessity or utility. Part of their reservation has been about the conduct of resident doctors and the BMA. I have had a hard job to do to sell that. Those jobs will not materialise if the BMA rejects this deal, I am afraid. There is a not a “something for nothing” culture here.

I say to the crab people who still believe that they are pursuing a really effective “bank and build” strategy that they should look at what they are confronting now, and look their members and their colleagues in their eye. This is not bank and build any longer; this is a high-and-dry strategy, and it is not going to work. That is why it is important that we end this dispute and that we do it together, in the spirit of partnership. There is still time to do that—there is still a week. The door is not closed; the offer is still there, and I urge them to take it before it goes.

Meningitis Outbreak

Stuart Andrew Excerpts

Tuesday 17th March 2026 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

I am grateful to the Secretary of State for advance sight of his statement and for the clarity that he has provided to the House this afternoon. Our thoughts are also with the families of the two young people who have so tragically lost their lives—I cannot imagine the pain that they must be going through at this difficult time. This will also be an extremely distressing time for parents, students, staff and the wider community across the south-east, especially as I understand that two more cases have just been announced. Yesterday, friends of mine were very anxious about their own son, who was in the vicinity over the weekend. I pay tribute to the NHS staff, public health teams, school and university leaders, and all those working at pace to respond.

I welcome what the Secretary of State has set out on the daily publication of figures, the scale-up of antibiotic provision and the decision to introduce a targeted vaccination programme for students in halls of residence, alongside seeking further advice from the JCVI. However, a number of important questions remain. First, concerns have been raised out there on the timeline. The Secretary of State has set out the sequence of events in detail, but can he be clear about the threshold used for wider public communication? Is that threshold being reviewed in the light of this outbreak? He also set out that headteachers were contacted on Monday morning. Can he clarify when those schools were first identified, and whether there is a need to review how quickly educational settings are brought into the response, given that cases were identified several days beforehand?

Secondly, turning to the nature of the outbreak, while many cases are linked to a single venue, can the Secretary of State confirm whether all cases are believed to be part of one cluster, or whether there remains a risk of multiple sources of infection? Thirdly, on escalation, given the involvement of both a university and schools, can he set out what criteria are being used to determine when more extensive interventions are required across educational settings? This situation will undoubtedly cause concern among families, particularly with the end of term approaching.

Can the Secretary of State therefore set out what steps are being taken to manage the risk of onward spread as students return home, and what advice is being provided to families and local health services in other parts of the country? Can he also confirm that public health messaging is fully consistent across schools, GPs, local authorities and NHS services, so that families receive clear advice wherever they turn? What steps are being taken to counter misinformation online, where false claims may undermine confidence in public health advice? Can he also confirm that local laboratories, intensive care capacity and public health teams are fully resourced to manage any increase in cases, and that supply chains for antibiotics and vaccines are resilient, should further clusters emerge?

Finally, although I welcome the targeted vaccination programme and the decision to seek further advice from the JCVI, the Secretary of State has acknowledged that most students will not have been routinely vaccinated against meningitis B, and protection among older teenagers is clearly not as strong as it is in infancy. Does he accept that this creates a particular vulnerability among older teenagers and young adults, and will he ensure that any further advice on eligibility or wider catch-up measures is brought forward as quickly as possible?

This is a serious public health situation. It is right, though, that the response remains calm, evidence-led, and focused on protecting patients and supporting those families affected.