Sepsis Awareness Month

Vikki Slade Excerpts

Tuesday 15th September 2026 Commons Chamber

[Mike Wood (Kingswinford and South Staffordshire) (Con)]

I beg to move,

That this House has considered World Sepsis Awareness Month.

As co-chair of the all-party parliamentary group on sepsis, I would like to begin by expressing my gratitude to the Backbench Business Committee for granting time for this debate. To the best of my knowledge, this is the very first debate in the House of Commons Chamber dedicated to sepsis. In the past, this devastating condition has been discussed only in Westminster Hall debates or raised through brief interventions and questions. Having sepsis debated on the Floor of the main Chamber during Sepsis Awareness Month is a major milestone, not only for Parliament but for the clinicians, charities and bereaved families across the country who have campaigned tirelessly to bring this condition out of the shadows.

I would also like to thank the co-sponsors of this debate: the hon. Member for Ashfield (Lee Anderson), who cannot be here this afternoon but who led an important Westminster Hall debate on this subject two years ago, and the hon. Member for Dartford (Jim Dickson), vice-chair of the APPG.

Sepsis strikes indiscriminately, ruthlessly and with terrifying speed, without regard for background, class or, indeed, political allegiance. It is vital that we all stand united in our determination to tackle this deadly condition. It is a challenge that completely transcends party politics.

On Sunday, communities across the world marked World Sepsis Day. The international theme for this year could not be more apt: “Invest in Sepsis—Save Lives.” The World Health Organisation recognises sepsis as one of the leading causes of death and disability globally, estimating that sepsis-related illnesses account for one in every five deaths worldwide. In the United Kingdom, NHS England has made it clear that sepsis claims more lives each year than lung cancer and represents the second biggest killer in our hospitals after cardiovascular disease.

Every single year, an estimated 245,000 people in the UK develop sepsis and, tragically, more than 48,000 lose their lives. That is a higher annual death toll than bowel, breast and prostate cancers combined. Behind every one of those figures is a family left grieving and asking the same agonising question: what if? What if the symptoms had been recognised an hour earlier? What if antibiotics had been administered sooner? What if someone had simply asked, “Could it be sepsis?”?

Madam Deputy Speaker, as you know, I do not approach this debate purely as a parliamentarian dispassionately analysing policy responses to one of the leading causes of avoidable death. I stand in this Chamber today because almost a decade ago, by the grace of God and the extraordinary skill and care of NHS staff, my life was saved.

In January 2017, I was a relatively fit and active 40-year-old Member of Parliament. I had developed what I assumed was merely a winter infection. Like many people would, I assumed that I could push through it, take some paracetamol and carry on working. I travelled out to Strasbourg to take part in the Parliamentary Assembly of the Council of Europe on the Sunday evening, but within days my condition collapsed. An ordinary throat infection triggered a catastrophic immune response. My body, in attempting to fight the infection, began attacking its own tissues and organs.

By Thursday, after seeing a French GP, I flew back to Britain. On Friday, I attended the official launch of the local enterprise zone that I had campaigned hard for in my constituency, but as soon as I arrived there I was so ill that I had to rest in the back room. On Saturday morning, I got out of bed, started putting my suit on over my pyjamas and told my wife Laura that I had to come down to Westminster to vote. Like many in politics, my behaviour can at times appear to some people to be a little idiosyncratic; fortunately, Laura realised that, even for a Member of Parliament, that was not entirely normal behaviour.

Laura rushed me to Russells Hall hospital in Dudley, where my blood pressure plummeted into septic shock and my organs began shutting down. My life was hanging by a thread. The medical team had to place me in a medically induced coma. Doctors told my family that my chances of pulling through were no better than one in 10.

For 11 days, I lay in intensive care on life support—or, as my family sometimes remind me, I slept through the difficult bits. When I did finally wake up, my muscles had wasted away—I could barely lift my arms, let alone stand or walk—but it could easily have been so much worse. What if Laura had left me to get some rest that Saturday morning while she took our daughter to her dance class? Above all, what if the nurse who examined me at the accident and emergency department had not had the insight to check whether the symptoms, which could easily have been mistaken for other illnesses such as flu or meningitis, might be sepsis? I owe a debt of gratitude to the doctors, intensive care nurses and other staff at Russells Hall hospital that I can never repay, but as long as I have the honour of serving in this House, I will use my voice to fight for sepsis patients and their families.

There is a common misconception that sepsis is primarily the result of hospital-acquired infection, but the evidence demonstrates the exact opposite. A major 2024 population study led by Professor van Staa, analysing linked primary care and hospital data in England, showed that the vast majority of sepsis cases are community acquired, developing in homes, workplaces and local communities long before a patient reaches an acute hospital bed. That research also uncovered deep health inequalities in sepsis risk.

The risk of developing sepsis is significantly heightened by socioeconomic deprivation, by frailty, by being housebound and by chronic conditions such as cancer, diabetes and learning disabilities. Exposure to antibiotics in the previous two months was also identified as a strong risk factor. While ethnicity was not an independent biological factor, black and Asian individuals suffer from a higher prevalence of predisposing conditions including diabetes, chronic liver disease and severe anaemia, which puts them at a greater risk, so tackling sepsis is not merely a technical, clinical issue but a fundamental challenge of health inequality and community prevention.

One of the most critical clinical lessons learned in recent years is the direct link between viral infections and sepsis. For decades, the public and the medical community viewed sepsis almost exclusively as a bacterial complication, but the covid-19 pandemic demonstrated that viral infections can trigger the exact same catastrophic septic response. The overwhelming cytokine storms, microvascular clotting and rapid progression to acute respiratory distress syndrome and multi-organ failure seen in covid intensive care units are classic manifestations of viral sepsis. It is thought by many experts in the field that the vast majority of covid deaths were a direct result of septic reactions.

Sepsis is not defined by the pathogen; it is defined by the body’s life-threatening immune reaction to any severe infection, whether bacterial, viral or fungal. That reality extends directly into long-term recovery: millions who had covid-19 are still living with long covid. Sepsis survivors have known that reality for generations under the name of post-sepsis syndrome. In my case, it is little more than some nerve damage and tiredness, even a decade later, but for many the symptoms are more severe. Up to 50% of sepsis survivors suffer prolonged physical, cognitive and psychological impairments from debilitating fatigue and cognitive brain fog to severe muscle weakness and post-traumatic stress disorder. The clinical insights gained from viral sepsis during the pandemic must now be used to build integrated recovery pathways for all sepsis survivors.

To curb preventable deaths, a health system must act decisively in several areas; in the interests of time, I will go through just four. First, the system must ensure consistent rapid recognition. Time is the single most decisive factor in sepsis survival. Clinical research shows that administering appropriate antibiotics within the first hour of a patient presenting to an emergency department with sepsis reduces the risk of death by a full one third compared with delayed treatment.

Secondly, the system must ensure that where sepsis is suspected, appropriate clinical escalation pathways are in place. Where sepsis is suspected, early warning systems such as the national early warning score 2, or NEWS2, have saved countless lives, and the ongoing roll-out of Martha’s rule across NHS trusts, which has already saved thousands of lives, is vital in ensuring that patients and loved ones can trigger an immediate independent critical review when they sense deterioration.

Thirdly, we must take advantage of innovation in rapid diagnostics. We know that administering broad-spectrum antibiotics within the golden hour that I spoke of massively increases survival rates, but clinicians often face the dilemma of judging whether that is compatible with responsible antimicrobial stewardship. Deploying rapid molecular diagnostics, bedside biomarker technologies and wearable continuous physiological monitors can remove that guesswork, and provide targeted care before septic shock takes hold and it can be too late.

Fourthly, although Britain has in many ways led the way in developing and enhancing sepsis care and treatment, we must be open to learning from established international models and practices. Sweden utilises standard sepsis alerts to prioritise patients at triage, and implements mandatory post-discharge telephone follow-ups. France, where I was when I was taken ill, has since introduced an integrated national sepsis plan spanning pre-hospital recognition, emergency pathways and structured rehabilitation to help patients return to employment. Australia established a national sepsis clinical care standard built around seven quality statements, ensuring end-to-end consistency from triage through to survivorship. The publication in July of the sepsis modern service framework by NHS England and the Department of Health and Social Care is an important step towards doing that and learning the lessons from around the world; I warmly welcome it. The framework is one of the first to be published under the 10-year health plan. Its headline goal,

“to reduce deaths, severe complications and long-term harm from sepsis…by at least 25% by 2035”

is a target that every member of this House can endorse.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

The hon. Gentleman is making a really moving speech. Although one in 100 cases of sepsis in adults is linked to meningitis, it is one in 10 for children—with harrowing consequences. One of those children is Hamish, who was a classmate of my nephew Louis in Sussex. He had all four limbs amputated, and I pay tribute to his resilience in getting on with life and going to university. Because of the link between vaccines and the prevention of sepsis, will the hon. Member join me in calling for the menB vaccine to be repeated for teenagers next year and every year until all children are protected, so we can reduce the risk of sepsis in young people?

[Mike Wood]

The hon. Lady makes a really important point. We know how these conditions can come round in a cycle. In order to break that cycle, we will need multiple years of vaccination.

The modern service framework contains a number of vital commitments, but I particularly welcome: action 4 on improving the audit and feedback of sepsis-related clinical data across trusts; action 5 on updating training for NHS staff, social care workers and unpaid carers; action 9 on optimising care pathways and expanding access to rapid diagnostics and specialist advice; action 11 on standardising digital specifications for early warning systems such as NEWS2; and action 12 on reviewing and addressing capacity gaps in critical and enhanced care.

A strategy on paper will not be enough to save a deteriorating patient on a cold winter weekend in an overcrowded emergency department. In the other place, my noble friend and our former colleague Lord Mackinlay of Richborough, who has spoken with enormous courage about his own life-altering encounter with sepsis, has repeatedly tabled written questions seeking clarity on how this framework will be delivered. Regrettably, the answers provided by Ministers in the Lords to date have been rather generic and vague, and lacking in operational detail. We cannot accept boilerplate responses on a condition that kills 48,000 people each year, so I have two direct questions that I hope the Minister will answer in her response to today’s debate. First, what are the specific milestone-driven timelines for the delivery of each of the actions set out in the modern service framework, and when will trusts and integrated care boards be expected to have these standardised pathways fully operational? Secondly, can the Minister assure the House that the Department of Health and Social Care is prepared to commit the dedicated investment required to make this framework work?

When we call for investment, we must be clear that funding sepsis care is not an open-ended cost. It is one of the most cost-effective investments that the Department can make. Sepsis currently places an enormous financial burden on the national health service and the wider economy. Too often, cases of missed or delayed diagnosis and treatment result in weeks of high-cost intensive care unit admissions, in emergency readmissions due to incomplete recovery, in complex surgical interventions including amputations requiring lifelong prosthetic and social care support, or in the permanent loss of working-age adults from the workforce. Investing in rapid bedside diagnostics, digital early warning systems, specialist outreach teams and structured post-sepsis rehabilitation can dramatically reduce the lengths of stay in intensive care, lower readmission rates and keep people in work. Early intervention is not only clinically imperative; it is economically sound, and the theme “Invest in sepsis—save lives” is a call for smart preventive healthcare investment.

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[Jim Dickson (Dartford) (Lab)]

I am pleased to co-sponsor the debate alongside the hon. Members for Kingswinford and South Staffordshire (Mike Wood) and for Ashfield (Lee Anderson), both of whom are fellow officers of the all-party parliamentary group on sepsis. I pay tribute to the hon. Member for Kingswinford and South Staffordshire for that amazingly moving and revealing speech and for sharing his experience in a way that I hope all Members will take note of and that will make a difference to the way the Government take these issues forward. I am grateful to the Backbench Business Committee for granting time for this debate on Sepsis Awareness Month, with World Sepsis Day having taken place on Sunday.

I was pleased to welcome my constituent, John Snow, to Parliament last year and am extremely appreciative that he is with us today in the Gallery, alongside his wife Karen and his daughter Gracie. John developed sepsis in 2024. After first believing he was suffering with muscle pain, the situation rapidly deteriorated, resulting in hospital admission with heart attack-like symptoms and his lips turning blue. John and Karen were not aware at this point that John had many of the signs of sepsis. Within hours, his kidneys had shut down, needing dialysis, and his body went into septic shock with doctors putting him into an induced coma. It was unclear if John would survive, and the coma lasted for two weeks, during which time John was transferred from Darent Valley hospital in Dartford up to St Thomas’s just across the river from where we are now.

After a month, thankfully, John pulled through. But this good news was accompanied by the desperately difficult decision from his doctors that he needed to have a quadruple amputation. He has received amazing support from the Dartford community, which has rallied round to help fund support for his family. A special mention must go to the wonderful Dartford working men’s club, led by the amazing Nick Byram. The club not only held fundraisers for the family but has held sepsis awareness events to ensure that more people know the symptoms.

Notwithstanding this great community effort, there remains so much to do to improve post-infection support for people like John. I have been privileged to have kept in touch with John and Karen during John’s exceptionally brave recovery journey. When we met in July, he told me of the exceptionally long delay he was experiencing in receiving his new prosthetic hand. John was cast for the prosthetic at the end of last year, but due to issues relating to the move of his local prosthetic centre, it was not assembled, leaving him worried that his body may change and the prosthetic would not fit. The challenges that causes are compounded by the fact that he cannot have the casting for the second prosthetic hand until he has had the first one for a year—a timer that has not yet been able to start. John has also experienced delays and dysfunctions with his facial surgery, which he is currently undergoing with the support of surgeons and doctors.

John’s case illustrates how much we have to do to spread knowledge about sepsis and to improve care for those who have it. As others have done, I commend the campaigning work of Lord Mackinlay of Richborough, who has not only helped to raise awareness of sepsis in our health system, but has met John and provided encouragement to him in his recovery journey.

[Vikki Slade]

I too pay tribute to Lord Mackinlay because when Hamish’s story made the papers, he did not hesitate to visit Hamish, an 18-year-old, and help him through his recovery. When I first met Lord Mackinlay myself in Buckingham Palace when we had just been elected, I went to him and said, “What a hero. What an incredible man to do that every time a similar case happens.”

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

I start by declaring my interest as an NHS consultant paediatrician, a member of the Royal College of Paediatrics and Child Health, a member of the British Medical Association and a mother of three children.

I congratulate my hon. Friend the Member for Kingswinford and South Staffordshire (Mike Wood) on securing this debate, alongside the hon. Members for Dartford (Jim Dickson) and for Ashfield (Lee Anderson). In particular, I thank my hon. Friend for his speech, which was hugely moving. I cannot believe that it has been such a long time since his illness happened, but it is great to see him looking so well today. I express my condolences to the hon. Member for Carlisle (Ms Minns) and thank her for the brave speech that she gave.

I remember sitting in this Chamber a little over two years ago—I am sure you were there too, Madam Deputy Speaker—when the then Member for South Thanet, now Lord Mackinlay, received a rare standing ovation from the House and from the Gallery as he returned to Parliament following his remarkable recovery from sepsis. His journey has been incredible, and his story has brought renewed attention to a disease that kills nearly 50,000 people every year. For context, that is around the same number of people who die from bowel, breast and prostate cancer combined. However, with attention to prevention, early identification of infection, early diagnosis, better treatments and the avoidance of antimicrobial resistance, we can reduce that number and save people’s lives.

As I said, raising awareness of sepsis and how suddenly it can change someone’s condition is vital, and the previous Conservative Government got the ball rolling in that regard. My right hon. Friend the Member for Godalming and Ash (Sir Jeremy Hunt) adopted the UK Sepsis Trust’s “Just ask ‘Could it be sepsis?’” campaign in 2016 when he was Health Secretary. The Conservatives also backed sepsis research with more than £1 billion through the National Institute for Health and Care Research. Research is important, because it will help us to improve diagnosis and treatment and to better understand why some people get an infection and it makes them a little bit ill, but some people get an infection and it turns into sepsis.

That was a good start, but of course, as always with medicine, there is more to do, and it was pleasing to see the previous Starmer Government build on this work by introducing the modern service framework for sepsis. We have modern service frameworks for other diseases, and it seems good to have one for sepsis specifically. The guiding light of this framework is the Government’s ambition to reduce sepsis deaths by 25% by 2035, with which I think we could all agree. But simply saying it will not deliver it; it has to have a plan, and the plan has to be deliverable and funded. What funding have the Government committed to implement that framework?

As we know, early diagnosis is paramount, but sepsis is notoriously difficult to diagnose and very rapid. I remember seeing a patient whose mum had got up in the middle of the night to use the bathroom—not something she did normally, and she was not quite sure why she had on that particular night—and when she was walking back along the landing, she thought, “It’s a bit cold—I’ll just check.” She checked her son had his blankets on and was warm, but as she did so, just in the light from the landing she spotted a little mark on the little boy’s leg. She turned the light on, and saw that he was developing the rash, which does not blanch, that goes with meningococcal sepsis. She brought him in, and he survived and he went home well, but I shudder to think what would have happened if she had waited till she woke up routinely at 7 o’clock in the morning. So someone was watching to make sure he was safe, and I am so glad that was the case, but it is so very rapid, as others hon. Members have testified.

There is no single test. There is no single thing we can monitor or measure that helps. Flu-like symptoms mimic many other common illnesses, and on top of that, as we have heard, diagnosis and treatment are absolutely time-critical. The UK Sepsis Trust has developed the sepsis six—oxygen, cultures, antibiotics, fluids, lactate management and urinary output monitoring—and all these should be carried out within the first hour. The Government’s MSF commits to rapid diagnostic tools and more advanced genomic sequencing. What infrastructure and workforce investment is required by the Government to set this up, and over what timeframe do they envisage that it will be achieved?

Talking about the workforce, the Government decided to ditch the previous Government’s NHS workforce plan to create their own, which is of course their right. However, their replacement was originally due to be published in early 2025 and was most recently promised as “imminent” just before the summer recess, but we are now well into September 2026 and there is still no plan. The Minister in the other place was asked for more details about the workforce plan, but her written answer simply stated that the Government

“will provide an update on the 10 Year Workforce Plan in due course.”

Could the Minister please update us on when this plan is going to be published, preferably with a date rather than an expression of “soon” or “imminent”?

I want to mention group B streptococcal infection, which I have seen in paediatric practice, particularly in babies. It is a common bacteria that lives harmlessly in the gut or lower reproductive tract, but there is a risk that it can enter the bloodstream, causing neonatal sepsis when passed to newborns. The GBS3 trial is looking to prevent and reduce the impact of group B strep, and the Government’s framework commits to supporting that. Could the Minister tell us more about how the Government plan to do that?

I also want to talk about prevention, which the Government have said is one of their big shifts in medicine. Some sepsis can be prevented or reduced, and research has shown that, for example, if ibuprofen is given to children with chickenpox, it increases the likelihood of their developing sepsis. We know that completing the antibiotic course is important. We also know that handwashing technique is important, and that keeping things clean is important, particularly in preventing the sepsis that is acquired in hospitals. Management of chronic disease reduces the risk, too, and then there is vaccination.

Meningitis B is possibly one of the most scary infections and conditions that one sees as a doctor, because it progresses so quickly—and it can cause brain damage, amputations and death—but there is a highly effective vaccine, which was introduced for infants born from the middle of 2015 onwards. However, as the outbreak in Kent, Dorset and Berkshire showed last year, when three young people died, it can still come back in older children. The Joint Committee on Vaccination and Immunisation met in July 2026 and suggested an increase in the vaccination schedule for those young people. It recommended that young children who had had one dose of vaccine should have another at age 15; that those who had not had the vaccine should have two doses; and that older people starting university should have a catch-up.

Very shortly, it will be freshers week, and around 580,000 young people will head off to university for the first time with great excitement. University students are seven times more likely to get invasive meningococcal sepsis than people who do not go to university, and the Government have only managed to vaccinate 246,000 of those young people—something that the UK Health Security Agency issued a document about last week. It said that last year, 97% of invasive meningococcal disease in 15 to 24-year-olds was caused by meningitis B, so I will ask the Minister some questions that I asked her during last week’s vaccine debate and have not yet received an answer to. When is she going to review and respond to the requests for vaccines for younger children who have not had them yet—the doses at 15 and the two doses for those who have not had a dose yet? What is she doing to increase awareness among people starting university in the next week or so?

[Vikki Slade]

I am really grateful to the shadow Minister for raising this issue, which I also raised earlier in the debate. My son George and his girlfriend Maisie both had their two doses in the past few weeks as they turned 18, but my constituent Victoria asked me to write to the Minister a few months ago about education and awareness. I was really disappointed that the Department for Education did not think it was necessary to add meningitis awareness into the personal, social, health and economic education programme in secondary school. Will the shadow Minister support me in advocating for that?

[Dr Johnson]

It is clearly important that young people are aware of the signs of infection, particularly such a serious infection, so I agree with the hon. Member about that.

I am interested in what the Minister is doing to try to prevent these infections by ensuring that the right people have the right vaccines. The Government are changing the way in which vaccines are being commissioned from NHS England, which they are abolishing. [Interruption.] Madam Deputy Speaker seems to have a cough, so I will finish my speech. The integrated care boards are going to be responsible for vaccinations. How is that change going to impact vaccines, particularly for students who live in one place and go to university in another?

To sum up, the Government’s ambition to reduce sepsis and sepsis deaths should be welcomed, and it is good to have the modern service framework in place. However, I am sure that charities such as the UK Sepsis Trust and families affected by sepsis would be most grateful if the Minister could provide further clarity on the Government’s road map and the funding required to reach this important destination.

Health Bill

Vikki Slade Excerpts

Report stage
Monday 7th September 2026 Commons Chamber

[Tom Gordon]

I completely agree with the hon. Gentleman. My hon. Friend the Member for Westmorland and Lonsdale (Tim Farron), who is not here, is campaigning tirelessly on radiotherapy and radiography. The point I was making about those health inequalities is that regions such as Yorkshire have a high incidence of cancer and of poorer outcomes, so we need to close that funding gap to close those inequalities.

New clauses 61 and 93, both in my name, pertain to NHS dentistry, and I have also added my name to and support many other new clauses. New clause 61 would have made sure that there is adequate provision of dental appointments in Harrogate and Knaresborough. Over the last two years in my constituency and across North Yorkshire as a whole, the number of people with access to an NHS dentist appointment is down from 50% to just 37%. When this arises in casework and at surgeries, the issue is often precipitated by those who work in A&E telling me traumatic stories of people reaching A&E as a result of emergency dental care or the lack of it. In particular, we have heard some harrowing stories from local children about their inability to focus in school. New clause 93 would require the Secretary of State to publish before Parliament a regular report on the state of NHS dentistry, including that unmet need, and also to pay particular attention to workforce capacity and distribution.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

In Dorset, we have lost 44 dentists in the last five years, and there has not been a single new contract for 10 years. Is my hon. Friend suggesting that his new plan would reverse that by enabling us to see exactly where the gaps are in the system?

Puberty Blockers

Vikki Slade Excerpts

Tuesday 23rd June 2026 Commons Chamber

[Rebecca Paul]

Yesterday, even the Secretary of State for Health and Social Care conceded—the second one to do so—that he is “uneasy” and even “uncomfortable”. I suggest that his discomfort is nothing next to the lifelong damage that the trial will potentially do to an extremely vulnerable cohort of children, whom we should be protecting. That funny feeling in his stomach—[Interruption.] Oh, he has left. That feeling is his good judgment trying to be heard—he will not hear this if he has left—and it is not too late for him to listen to it. I agree with what one of my hon. Friends said yesterday: he is a good man who is being placed under intolerable pressure on this issue. But he needs to find his courage.

The number of children and young people presenting to the NHS with gender distress increased dramatically in the years after 2009, with an exponential rise from around 2014. What is behind the increase among Gen Z is unclear, but the reasons are likely to be multifaceted. It is speculated that the factors may include 24/7 internet access, the increased acceptance of trans identities, or even peer social and cultural influences. Over the past 20 years, groups such as Stonewall and Mermaids have called for better access to treatment and more rights for trans people. Large corporates have gone big on diversity and inclusion to boost their brands.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

I am slightly concerned by the idea that trans acceptance is part of the problem. Does the hon. Member agree that trans acceptance is completely reasonable and that trans people have always been here?

[Rebecca Paul]

I am not saying that it is a negative thing; I am trying to explain why we have seen an increase in the numbers of young people with gender dysphoria. I am stating facts; we were just talking about the importance of doing so.

In 2009, only 51 patients were referred to the NHS Gender Identity Development Service for children, of whom two thirds were male. In 2016, there were 1,766 referrals and two thirds of them were female. That is quite the change. There has been an overall surge in the number of children suffering gender distress, but the increase is especially notable among girls. We also see over-representation of neurodiversity, mental health issues and trauma in this group. To put it another way, these children are much more likely to have been in care, to suffer with anxiety and depression, to be autistic and to have been abused. It is a group of incredibly vulnerable children.

GIDS was established in 1989. Its main approach to treatment at that time was therapeutic, referred to as watchful waiting. Early studies from the 1980s showed that in around 85% of cases, the gender incongruence or distress ceased in the child after going through puberty. Later studies reached a similar conclusion, with between 67% and 90% desisting after puberty. Only a small cohort of children continue to experience gender dysphoria or incongruence after puberty, and it was that extremely small group who would likely adopt a permanent trans identity in adulthood.

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[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.

Pathways Study: Puberty Suppression

Vikki Slade Excerpts

Monday 22nd June 2026 Commons Chamber

[James Murray]

We are following clinical advice. We are ensuring that there is a triple lock on the consent for children and young people to be involved in this trial, involving the consent or assent of the young person themselves, parents or guardians, and the NHS care team—the national multidisciplinary team that I mentioned earlier. That is how this trial ensures that there is a high bar for being involved in it and that all aspects of a young person’s life are considered before they are approved.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

I thank the Secretary of State for the manner of his responses.

Four years, three-and-a-half years, four years, six-and-a-half years, four years, three-and-a-half years, four-and-a-half years, five-and-a-half years, three years and nine months—those are the waits faced by young people in Dorset supported by Space Youth Project between their referral to the gender identity service and their very first appointment. None of them will qualify for this trial, and many will have gone into adulthood still waiting, despite commitments of more treatment and clinics. While I support the criteria for the trial as detailed in the statement, there is an inadequate capacity in the system, which is leading to even more distress for these children and their families. Will the Secretary of State update us on this issue? Most teenagers will be excluded from the trial, so they need to hear how they will be supported.

[James Murray]

There is a fundamental difference of approach between me and the hon. Lady. The reason for the trial is not to ensure that young people on the waiting list can get access to treatment; the trial is to find an evidence base on which to take future decisions about whether young people should be offered treatment and, if so, in what way. Talking about waiting lists and the trial combines two things that, in my view of the world, really do not have a relationship in this context.

Oral Answers to Questions

Vikki Slade Excerpts

Tuesday 9th June 2026 Commons Chamber

[Stephen Kinnock]

My hon. Friend is right that his constituents will be able to access care at the new facilities in Poole and Bournemouth thanks to the Government’s investment in the new hospitals programme, but there is more to do. We are committed to addressing poor-quality NHS infrastructure and ensuring that facilities such as Forston clinic are safe, comfortable and capable of high-quality care. That is why we are investing £30 billion over five years for the maintenance and repair of the NHS estate. We would be delighted to meet the hon. Members and local NHS leaders to discuss the issue further.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

I thank the Minister for his comments about Forston, which some of my residents use. Evidence suggests that half of mental health conditions are established by age 14, and three quarters by age 24. In Dorset, our rates of hospitalisation for self-harm are almost twice the national average for 15 to 19-year-olds. I recently met Anya, a student at Lytchett school and deputy Member of Youth Parliament for Dorset. She has launched her “Health in Mind” campaign to ease young people back into school following periods of mental or physical health issues. It is so inspiring to see the work that she is doing, but will the Minister meet me and Anya to hear more about her campaign and to see how we can reintegrate children more successfully back into school after ill health, particularly mental ill health?

[Stephen Kinnock]

I pay tribute to Anya for the outstanding work she is doing. We are providing early intervention for children’s mental health and wellbeing by rolling out mental health support teams to every school by 2029. We are also investing £13 million to pilot enhanced training for staff so that they can offer more support to young people with complex needs such as trauma, neurodivergence and disordered eating. If the hon. Lady writes to me with further details of Anya’s work, I am sure that we can continue that conversation.

Health Bill

Vikki Slade Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[James Murray]

I am going to make some progress, because, Madam Deputy Speaker, you have asked me and looked at me several times, suggesting that that is what I should do.

I mentioned the changes that the Bill makes to HSSIB and the CQC, but the functions of Healthwatch England—I spoke about that earlier—will move to a new patient experience directorate within the Department of Health and Social Care. The functions of local healthwatch groups will be incorporated into ICBs and local authorities. That approach brings the voices of patients closer to decision makers, so that people have a direct impact on the services they receive. Of course, the changes will neither fix everything at the stroke of a pen, nor take effect overnight, but rather than the voices of patients being kept at arm’s length, the Bill puts them where they should be: right at the heart of the NHS.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

The Secretary of State has not talked about the role of the governors of hospital trusts, which also appear to be abolished by the Bill. With the creation of mega-ICBs, the removal of healthwatch, and the removal of governors, I am worried that the voice of the local community is reducing rather than increasing.

[James Murray]

The principle behind the changes to local healthwatch organisations is to bring the voice of patients closer to those who are planning and delivering services. Whether through ICBs or local authorities for health and care, it is an important principle to ensure that feedback is followed by action, and that people can have an influence on the design and delivery of health and social care at an earlier stage in the process.

Allied Health Professionals

Vikki Slade Excerpts

Thursday 23rd April 2026 Commons Chamber

[Vikki Slade (Mid Dorset and North Poole) (LD)]

I congratulate the hon. Member for Dudley (Sonia Kumar) on securing this important debate and the hon. Member for Thurrock (Jen Craft) for introducing it.

During the Easter recess, I was invited to meet the Dorset Younger Onset Parkinson’s group in Wimborne. Two of the people I met, Simon and Julia, had been diagnosed with the condition in their 30s. The impact on their decisions about family life, their ability to work and save for the future and the effect on their families, who have had to take on caring responsibilities much earlier than most, was clear to see. They told me about the success of their open water swimming group and, in particular, about the impact of the recently introduced walking football team. The Dorset Parky Striders were named team of the year in the impairment section by the Walking Football Association in its grassroots awards last year, and achieved fantastic results at the Sport Parkinson’s walking football tournament earlier this month. Both programmes boost physical health and mental wellbeing and provide peer support.

Simon and Julia shared their concerns about the complete loss of Parkinson’s nurses in the county of Dorset. I have since engaged with University Hospitals Dorset NHS foundation trust to call for the service to be restored without delay, and we have discussed the severe shortage of neurologists across the country, made more acute by our ageing population.

Yet it is not just doctors and nurses who can make a positive difference for people living with Parkinson’s. Neuro physiotherapy focuses not on muscles or joints, but on improving movement, balance, co-ordination and overall quality of life for people living with neurological conditions. At its core, it aims to restore as much independence as possible, using targeted techniques to help people regain their function, relearn movement and adapt to physical challenges. It can be life-changing for individuals recovering from trauma or surgery, as well as for those living with long-term neurological conditions. If people with Parkinson’s can improve their balance and gait, they reduce their risk of falls—incidents that can have a profound impact on their independence, confidence and long-term health. This branch of physiotherapy also benefits people who have experienced strokes, live with multiple sclerosis or have acquired brain injuries. The mental health and wellbeing benefits are significant, as is the reduction in pain that can be achieved through that approach.

I highlight the crucial role of occupational therapy, particularly in educational settings. Around one third of children starting school are not considered to be school-ready, often lacking the communication or functional skills needed to mix confidently with other children. Schools already under pressure are then required to provide significant extra support. Many children who spend more time using tablets than colouring books lack the fine motor skills needed to write, while others struggle with everyday activities such as eating a school meal with a knife and fork. Paediatric occupational therapy offers practical, play-based support and can prevent children from losing confidence or developing a fear or aversion of school by addressing those needs early. Children with special educational needs and disabilities can also be overwhelmed in traditional classroom environments. With growing evidence about the impact of excessive screen time on attention and regulation, small changes to the physical environment can help not only those children but all pupils to improve their focus and learning.

My constituent Anna, who is an occupational therapist, shared the importance of using the profession’s principles in classrooms. On a visit to Colehill first school last year, I was impressed by how the school had removed bright colours from classrooms, replacing them with muted shades and consistent layouts as the children move through the school to create calmer learning spaces. At my son’s specialist setting—Summerwood in Bournemouth—ceilings include sound-absorbing panels and walls are gently curved to support children with neurodiversity to regulate and to reduce distraction. Those adjustments help everyone, not just those with additional needs.

If such approaches work in classrooms, it is likely that they can be effective in workplaces and public spaces too. Reducing harsh fluorescent lighting, lowering background noise and creating opportunities for movement throughout the day are techniques that can be applied widely and successfully. However, inclusion of occupational therapy in programmes such as Experts at Hand is essential to make that happen. The Royal College of Occupational Therapists has welcomed the ambition set out in the SEND White Paper, but has raised serious concerns about whether the sector is sufficiently resourced to develop them. Its most recent workforce survey found that two thirds of respondents did not believe that the profession could currently provide the level of support that children and young people need, highlighting the need to fund more frontline teams.

Taken together, the examples make one thing clear: allied health professionals, as already referenced by the hon. Member for Thurrock, are not a nice-to-have; they are essential in helping people to live independently and participate fully in education and work, in avoiding crisis later on and in ensuring that everyone fulfils their potential. I therefore urge the Government to match their recognition of the importance of allied health professionals with meaningful action in workforce planning and resourcing. If we are serious about prevention, inclusion and long-term value for money across health and education, investing in that workforce and ensuring that funding reaches the frontline must be part of that commitment.

NHS Federated Data Platform

Vikki Slade Excerpts

Thursday 16th April 2026 Westminster Hall

[Martin Wrigley]

I absolutely agree with my hon. Friend, as do the Prime Minister and the Science and Research Minister.

Turning to the solution, the solution is wrong. There have been many attempts to unify the NHS by using a single IT system; each one has failed. In reality, we must think of the NHS as thousands of independent organisations. NHS England has been guiding organisations towards a combined data dictionary for more than 10 years, combining definitions of what data means, how it is recorded and the way it is used. After three years, about half of the 200-odd NHS trusts across 42 integrated care boards are quoted as live on the FDP, and only a quarter of them report benefits from using it.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

My hon. Friend’s expertise in this area is impressive. I recently spent a shift with the South Western ambulance service and saw how critical it was for that service to be able to access both GP and hospital data—we had a lady who had had a heart attack, and we did not know who she was. Does my hon. Friend agree that the priority should be for the different elements of the NHS to talk to each other, rather than be scraped by a third party such as Palantir?

[Martin Wrigley]

I do agree. Palantir will not enable GPs, paramedics or anybody else to see hospital data. They will have to go through Palantir to see that data, and they will not be able to access patient records from the hospital to the GP or vice versa.

Like any data warehouse, Palantir requires connecting software that reaches into each of the NHS’s internal systems and gathers data. That data gathering is being done NHS trust by NHS trust, as there are differences inside each one. That is embedding the use of Palantir-owned code inside every NHS trust by creating custom connecting software to connect and translate data.

In Devon, the local ICB has celebrated as a major success the adoption of the same electronic patient record across Devon’s four main hospitals. It has just gone live in Torbay trust, which serves most of my Newton Abbot constituency. In an organisation as diverse as the NHS, with such distributed responsibility, we can either impose one massive system to rule them all or build interoperability. Interoperability would allow GPs to see hospital records and vice versa. Palantir is not doing that.

Interoperability is how massive systems, such as the internet or mobile phone networks, work. They do not rely on one single system or supplier. In that way, a modular system, a bit like Lego, can be constructed that, overall, is immune to changes elsewhere in the wider environment, providing only the specific data required to deliver improvements in services. That form of system builds long-term capability and delivers without requiring a locked-in, expensive subscription. It can also be built by a UK tech consortium in parallel with phasing out Palantir, which would build UK sovereign solutions, tech skills and competencies.

Meanwhile, NHS England’s October 2025 medium-term planning framework mandates all NHS providers of acute, community and mental health services to sign up to the FDP, and it demands that any existing local data analysis systems are removed. That results in further lock-in.

Meningitis Outbreak

Vikki Slade Excerpts

Tuesday 17th March 2026 Commons Chamber

[Wes Streeting]

I am very grateful to my hon. Friend for his question, and I know that lots of parents will be concerned about this issue. As I have said, the first thing that individuals should do is think about their risk of exposure. We have already made available the four hubs for people to come forward and get antibiotics, and we will continue to contact people actively and trace the outbreak.

As I have previously said, there is a range of symptoms: a rash that does not fade when pressed with a glass; a sudden onset of high fever; a severe and worsening headache; a stiff neck; vomiting and diarrhoea; joint and muscle pain; a dislike of bright lights; very cold hands and feet; seizures; confusion or delirium; and extreme sleepiness or difficulty waking. Those symptoms can apply to a range of conditions, but it is good to be cautious. Students who may have been at Club Chemistry on the dates concerned should not write off some of the symptoms as a hangover. It is better to be reassured than to be ignorant, so seeking medical attention and advice is the right thing to do, rather than simply writing off the symptoms as something else. I urge parents to give that advice to young people, and students to follow the advice.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

Meningitis is one of the worst nightmares that parents worry about, particularly when their teenagers leave home and are living away. My constituent Vicki Purdey from Corfe Mullen had her life changed by meningitis two years ago, and she is still unable to walk unaided. She is calling for meningitis awareness in schools, particularly via PSHE lessons, and at university through freshers’ packs. Will the Secretary of State talk to his colleagues in the Department for Education to progress this, given the high-risk nature of those in this age group and the fact that they will not have been vaccinated as they were born before 2015?

[Wes Streeting]

I think that is a really constructive suggestion, and we will absolutely look at it.

In reply to the right hon. Member for Tonbridge (Tom Tugendhat), who had left us but has just returned fleetingly to his place—it is an amazing skill he has—I think his question was about the availability of antibiotics in Tonbridge, not necessarily at a distribution centre. I would just reassure him that there are sufficient antibiotic stocks at the university, hospitals and the ambulance service, and we are working with local resilience partners to ensure effective distribution. However, I will pick up his point about Tonbridge, given the proximity and the likelihood that many residents will have been at the club in question.

Medical Training (Prioritisation) Bill

Vikki Slade Excerpts

2nd reading
Tuesday 27th January 2026 Commons Chamber

[Danny Beales (Uxbridge and South Ruislip) (Lab)]

I thank the Secretary of State and the Minister for the Bill, which delivers on the promises made previously in this place in response to the proposed industrial action a couple of months ago. It is welcome to see the pace with which the Government have moved in progressing these important changes. It shows their commitment to backing doctors and medical professionals in this country.

There is a lot to welcome in the Bill’s provisions. Members have talked at length and with a lot of personal and professional expertise about the challenges of the medical training system. As a member of the Health Committee—alongside the Chair, the hon. Member for Oxford West and Abingdon (Layla Moran), and others who have spoken—we often hear about the need for a proper workforce plan to address the NHS’s long-term issues with training and development, which frankly have failed staff and patients.

It is important to reflect on, as others have, the important and vital contribution that doctors and nurses from around the world have made. That is the case in my constituency at Hillingdon hospital, and in GP and community-based health services. My mum recently had a stroke and, fortunately, recovered from it at University College London hospital in central London. As ever, it was doctors, nurses, speech therapists and allied healthcare professionals from almost every country around the world who helped and supported her to recover. I am sure that they will continue to serve our national health service with dedication and commitment, and I am sure that the whole of this House is thankful for their service.

As we have heard, however, it is absurd that thousands of British doctors trained by our NHS at great expense, funded by the British taxpayer, are currently unable to find jobs in the NHS after graduation. In a time of crisis for the NHS, we do not have a penny to spare, and every pound needs to go even further. It is a great waste of talent and capacity, and it is not fair to young doctors in the system, who are being beaten to entry-level NHS positions by doctors from overseas with decades of experience.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

I wonder if the hon. Member has given any thought to residents such as George and Dennis in my constituency, who are both British citizens, brought up here, but went to work abroad either because they are dual citizens and wanted to be able to learn in two languages, or because of the covid delays. They will not be included in these measures. Does the hon. Member think they should be included within the second tier of graduates from places like Iceland and Liechtenstein? Does he have any views on whether we should be excluding British citizens?

[Danny Beales]

I am about to turn to a specific issue about British citizens, so I hope I will pick up on the hon. Member’s points. More generally, there is nothing progressive about a system that promotes a brain drain from some of the most deprived and underdeveloped communities in the world, with significant health needs. To have doctors and nurses come from those systems on an industrial scale, and to take away the resources spent in those systems on education and training for our benefit in a western, developed country, is not progressive. It is important to welcome the provisions in the Bill that address those challenges.

As the hon. Member for Mid Dorset and North Poole (Vikki Slade) raised, I will press the Secretary of State—and the Minister for Secondary Care, who is now in place—on the specific language of the Bill, which seeks to prioritise graduates from medical schools in the United Kingdom, rather than UK citizens who are medical graduates.

Like other Members, I have been contacted by a number of my constituents who will be affected by these provisions. That includes Alisha, a British citizen who was schooled and grew up here; her family live in Ickenham in my constituency, and she is a first-year medical student at Queen Mary University of London’s campus in Malta, which my hon. Friend the Member for Stevenage (Kevin Bonavia) mentioned earlier. When she enrolled last year, she was given a guarantee by the university that she would face no disadvantage compared with students on the London campus.

We have heard that there can never be any guarantees; that there is not a legal contract that this Government make with individuals; and that this House is sovereign, and can make different decisions. But I think there are issues of fairness around the retrospective applications of decisions that we make that can affect people’s lives, particularly at crucial points, such as when studying or getting a job—decisions that have major impacts on someone’s future life chances.

Alisha studies a British curriculum and she will be awarded the same degree qualification as her peers on the London campus. However, if the Bill’s current wording is interpreted strictly geographically instead of institutionally, it would mean that she is categorised as an international medical graduate, despite being a British citizen, studying a British medical degree at a British university.

I ask the Secretary of State to take away this point and, with officials, to look at this specific issue in greater detail and at modelling and sharing the number of UK citizens projected to be affected this academic year by those changes. If, as has been suggested by Queen Mary University, this is a matter of 40 or 50 individuals, I ask the Secretary of State to look at whether further changes could be made to ameliorate the impact on UK citizens, at least in a transitional way, that would not bind us in future academic years. I also ask that officials have discussions with Maltese counterparts about our important and ongoing strategic relationship in health and other key areas.

To conclude, there is much to welcome in this Bill. I know that medical colleges and societies strongly support many of the provisions. I hope that they will be the start of a broader process of a comprehensive workforce plan that will address the many challenges in workforce planning, training and development and the numbers of bottlenecks that exist throughout the workforce system so that we have a training and development system for medical professionals in this country that delivers both positive results for patients and better and fairer outcomes for those applying to study, learn and train.