Caroline Johnson MP: speeches

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Speeches

26 Feb 2026 · Eating Disorders Awareness Week · Hansard source
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It is a pleasure to serve under your chairmanship, Ms Vaz. I congratulate the hon. Member for Bath (Wera Hobhouse) on securing this important debate and on her work in this area. Eating disorders are deeply complex conditions. On the surface, disordered eating can take a variety of forms, including restricting the amount or the type of food eaten; binge eating large amounts of food in a short period and then purging that food through forced vomiting; excessive exercise; and laxative misuse to avoid weight gain. Beneath that surface lay a horde of drivers, such as control, shame, anxiety, obsessive-compulsive disorder, poor body image, and mysophobia, which is also known as germophobia. The covid pandemic provoked intense scrutiny of germs and cleanliness, took away people’s control over when they could go out and when they could see their friends, and drove their activities from the personal to the online, so it comes as no surprise that it saw a spike in eating disorder referrals. By early 2021-22, 3,400 people were treated for an eating disorder, compared with 1,900 in the same period in 2019-20. The last Government introduced the mental health investment standard to increase mental health spending in local health systems, and it also included a pledge to increase mental health spending as a proportion of total health spending every year. With mental health accounting for over 20% of demand for health services, and a 2021 report finding that eating disorders cost the UK economy a £9.4 billion per year—
26 Feb 2026 · Eating Disorders Awareness Week · Hansard source
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The Minister’s speech is very interesting. He talks about an increase in capacity, much of which will require workforce. I noticed that when he mentioned the workforce plan, he said “spring or early summer”, which is a change from his previous wording, which was always “spring”. Is that a sign that it is being delayed further?
24 Feb 2026 · Preventing Ill Health · Hansard source
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I declare an interest as a consultant paediatrician in the NHS. Prevention of ill health is crucial. It is particularly important in children, perhaps most especially when one is trying to prevent ill health in children caused by doctors. I have expressed concerns previously about the puberty blockers trial, as have many in both Houses. The trial has now been paused due to a Medicines and Healthcare products Regulatory Agency letter. When were Ministers first aware of that letter and when were they first aware of the concerns described within it?
24 Feb 2026 · Preventing Ill Health · Hansard source
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That is a very interesting answer. Before Christmas, the Secretary of State had confidence in an allegedly vigorous and rigorous process. Fertility preservation techniques have not deteriorated over the last few months. The ages at which children reach the Tanner stages of puberty have not changed over the last few months, but the MHRA’s view has. Why? Given that this is such a scrutinised trial, does that not call into question the MHRA’s wider competence and due diligence? Will the Minister publish the MHRA’s letter from November referred to in the more recent correspondence published on Friday?
11 Feb 2026 · Hughes Report: Second Anniversary · Hansard source
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It is an honour to serve under your chairmanship, Dr Allin-Khan. On behalf of the Opposition, I thank the hon. Member for Chesham and Amersham (Sarah Green) for securing today’s debate. She has campaigned tirelessly on this issue, giving a voice to thousands of women who have been let down by the state. I also thank Henrietta Hughes for the Hughes report. Thousands of pregnant women were prescribed sodium valproate between 1973 and 2017 despite growing evidence of harm. In 1972, scientists found in animal studies that it was harmful to foetuses, and in 1984, foetal valproate syndrome entered the medical literature. Studies in the 2000s highlighted the link between valproate and birth defects. I remember, as perhaps you do, Dr Allin-Khan, learning about it at medical school. Yet it was only in 2018 that the valproate pregnancy prevention programme came into force, which was too late for more than 20,000 children with entirely preventable disability. Over 10,000 women in England were harmed by pelvic mesh. Mesh kits were issued in the 2000s to treat urinary incontinence and prolapse, despite a lack of long-term safety data. Women suffered hideous complications: mesh tearing through tissue, bleeding, infection and sexual dysfunction. Shockingly, it took until 2018 for NHS England to suspend the routine use of these implants. I want to raise the case of a lady, now in her 30s, who had a mesh implant put in to prevent a hernia in her abdominal wall, something that is often missed from the discussions about mesh. She describes how she is unable to leave her home because there is a hole in her stomach wall where the mesh has eroded. It cannot be removed. The surgeon described it as being stuck in there like chewing gum. She described her wish for a family. She described the smell of the constant infections. She described the fear of waiting for the next infection and wondering whether the sepsis from it will kill her. Yet there seems to be no way for her to get this mesh removed. The previous Government did not sit on their hands. The former Health Secretary, my right hon. Friend the Member for Godalming and Ash (Sir Jeremy Hunt), commissioned the independent medicines and medical devices safety review after hearing from over 700 affected people and medical stakeholders. The previous Government issued a formal apology to victims and appointed a Patient Safety Commissioner. They began to establish a network of centres to provide treatment, care and advice for those affected by the implanted mesh. I would be grateful for an update on that from the Minister, particularly in the light of the case that I described. In 2022, the previous Government asked the new commissioner to report on options for compensating victims. Dr Henrietta Hughes did so in February 2024, a full 24 months ago, and that report set out what justice should look like for victims: an interim redress scheme and a permanent one to follow. As my right hon. Friend the Member for New Forest East (Sir Julian Lewis) said, it was a package of clear, practical steps to right the wrongs done to so many women. Yet two years on, we are no further forward. After the 2024 election, the hon. Member for Chesham and Amersham asked the Government when they would respond to the Hughes report. The response was that the Government would consider the recommendations and meet with the commissioner. In January 2025, when asked by Baroness Ritchie of Downpatrick, the Government said they were “carefully considering” report and would provide an update “at the earliest opportunity.” In March, in this very room, a Government Minister said that recommendations were being actively considered and that a report was coming “at the earliest opportunity.” In that debate, the Minister suggested that research by Dr Rebecca Bromley was material. Can the Minister update us on that research? In October, when the hon. Member for Rushcliffe (James Naish) asked whether funding had been allocated for redress, a Minister said that recommendations were being carefully considered and a response would come at the earliest opportunity. In December, when the shadow Secretary of State for Health and Social Care, my right hon. Friend the Member for Daventry (Stuart Andrew), asked whether financial support was forthcoming, the Government said that recommendations were—still—being carefully considered. Last month, when my hon. Friend the Member for Harrow East (Bob Blackman) asked whether funding was forthcoming, a Minister said the Government were “carefully considering” the report and an update was coming “in due course”. What we have heard from Ministers is so frustrating. For 18 months, Members have asked what is being done, and time and again, this Labour Government have refused to give a clear answer. I note that the previous debate was responded to by the Under-Secretary of State for Health and Social Care, the hon. Member for West Lancashire (Ashley Dalton), and both she and the Under-Secretary of State for Health and Social Care, the hon. Member for Glasgow South West (Dr Ahmed), have answered questions on the matter. We have a different Minister today, and it is a delight to see her, but perhaps she can confirm which Minister takes responsibility for this issue in the Commons. I have some further questions for the Minister. On which date did work begin on a response to the Hughes report? How many civil servants are working on the response? Have there been any conversations with the Treasury about the costs of the redress scheme? If work has been taking place, why is it invisible? If, in fact, nothing has been done, why have the Government persisted in telling Members that a response is forthcoming? Why, despite Dr Hughes visiting the Department in December, has nothing materially changed? Will the Government, as my hon. Friend the Member for North West Norfolk (James Wild) asked, make an interim payment this calendar year? Over the weekend, the Patient Safety Commissioner told ITV: “This is a disgraceful way that patients and families are being treated by those in power.” She is absolutely right. The state’s No. 1 duty is to protect the public from harm, yet after inflicting harm, the state has failed to make things right. This is part of a pattern under Labour whereby systemic failings, particularly those affecting women, go unresolved. Every day that victims of mesh and valproate do not receive justice, confidence in health professionals is undermined. We know that the Chancellor is fast running out of other people’s money, but it is wrong to balance the books on the backs of those who are suffering. Justice is the state’s duty. It is not optional. It is not something just to be carefully considered for years on end, indefinitely, while women and children suffer. The Government can respect the victims and the work of the Patient Safety Commissioner today by answering our questions, or they can continue their parade of platitudes and evasions. I look forward to the Minister’s response.
9 Feb 2026 · Brain Tumour Survival Rates · Hansard source
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My right hon. Friend invites me to speak outside my area of expertise; I am afraid I do not know the answer to that.
9 Feb 2026 · Brain Tumour Survival Rates · Hansard source
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It is certainly something that I have read about. I am happy to be corrected by the hon. Gentleman if he feels that my resources are incorrect, but that was certainly one of the suggestions for how to prevent these tumours. I do not think that prevention will necessarily be the major way in which we improve the survival rate. I also do not think that it will be early diagnosis, but I would like to finish talking about that. Regular screening for people with genetic disorders can really help to identify tumours early, and the second thing that can help is access to diagnostic tests. The Conservative Government introduced community diagnostic centres across the country, which increased the number of scanners available to those who needed a scan to identify whether they had a brain tumour. This Government have said that they will double the number of scanners available. Can the Minister comment on whether they are on track with that? We need the workforce plan, so that we have the people to perform and interpret the scans. I do not know whether the Minister has had any tips on whether the workforce plan is imminent, but can he give us a date for when it is likely to be published? It has been delayed, but it is important. We have the cancer plan, but so much of it is dependent on the workforce plan. Thirdly, opticians have a role to play. Since a South Tees project pioneered in 2015, opticians have been able, during regular eye tests, to identify people who have signs of brain tumours, and to refer them, when necessary. Encouraging people to get regular eye tests may contribute to early diagnosis. The fourth thing that can help with early diagnosis is symptom awareness—among both the general public and healthcare professionals. I want to talk about HeadSmart, a 2011 programme about the types of symptoms that could help identify a brain tumour. It had quite significant cut-through with both healthcare professionals and the public. It halved the time for a scan, and for diagnosis of children with brain tumours. It also improved the cognition of survivors, but it did not significantly improve the survival rate. While early diagnosis helps a bit, it is very difficult—particularly in children, who are quite neuroplastic, so symptoms appear quite late. The location and type of tumour are more important in the treatment and prognosis, and there are many different types. That makes this area of medicine extremely complicated, so I think the answer is that we need better treatments. Treatments currently include steroids, chemotherapy, radiotherapy and surgery, but there are many others with promise. Convection-enhanced delivery enables chemotherapy to be delivered across the blood-brain barrier more effectively. Many hon. Members have talked about freezing, and last month there was a debate on the topic of freezing brain tumour samples; does the Minister have an update following that debate? His colleague, the Under-Secretary of State for Health and Social Care, the hon. Member for West Lancashire (Ashley Dalton), said that she would look at the detail and report back, so I hope that he will have an update for us this evening. Gene therapy has also shown a lot of promise, and there has been talk this evening about the trial in which an adeno-associated virus is used as a vector to seek out the glioblastoma cells and use the patient’s immune system to kill the tumour cells. That trial has promise; if it works, it could lead to real improvements in treatment. Research will be key. BioNTech’s 2023 partnership promised that there would be 10,000 patients in cancer vaccine trials by 2030, but new innovators face barriers. This is a global fight; work is going on right across the globe, and we need to make the UK’s environment one that stimulates and supports research, so that British people can have the earliest possible access to the newest treatments. At the moment, the wider economic picture for research is not great, and we have seen some researchers pull out of investments in the UK. Taxation, national insurance, employment rules and the speed of adoption by the NHS are all factors that I hope the Minister will try to improve. The hon. Members for Edinburgh South West (Dr Arthur) and for Strangford (Jim Shannon) talked about the devolved Administrations. Could the Minister comment on how he and his team are working with those Administrations to encourage research right across the United Kingdom? I also wanted to talk about rural areas, because it is all very well encouraging trials in the UK or England, but so many of those trials are in the centre of London, or in the other big cities; it is much more difficult for people living in rural areas, such as my constituents in Sleaford and North Hykeham, to access them. Could the Minister please update the House on how he is making it easier for research to occur in rural spots? The hon. Member for Witney summed it up perfectly when he said that ambition is important, but actions, not words, are the key. We need specific, measurable targets, not just warm words—this Government have been very good at warm words on health, but much poorer on delivery. For the sake of the one in two people who will get cancer, and all their friends and loved ones, I hope that on this occasion, there is more action, not just words.
9 Feb 2026 · Brain Tumour Survival Rates · Hansard source
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I will, particularly if the hon. Gentleman has an answer for my right hon. Friend.
9 Feb 2026 · Brain Tumour Survival Rates · Hansard source
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I thank the hon. Members for Mitcham and Morden (Dame Siobhain McDonagh) and for Witney (Charlie Maynard) for bringing forward this debate on a very important subject. The hon. Member for Mitcham and Morden talked about the people she had met who had experienced brain cancer and brain tumours. For me, this debate is about my grandfather, who sadly died of a brain tumour some years ago. Some 12,000 people have a brain tumour diagnosed each year, and this debate is supposed to focus on how we improve the survival rates for this condition, which are very poor. It is the leading cause of cancer deaths among children and adults under 40. The five-year survival rate is poor and—unlike the rate for many other cancers over the last few years—has not really moved at all. How can we improve the survival rates for people with brain tumours? There are essentially three areas that we can look at: prevention, early diagnosis and better treatment. On prevention, if we look on the NHS website to see how we can prevent a brain cancer or brain tumour, it talks about having a good diet and preventing obesity. These things are important, but not specific to brain cancer. It also talks about trying to avoid head injury, for example by wearing helmets. What about early diagnosis? Some people have genetic conditions, such as neurofibromatosis, Li–Fraumeni syndrome, tuberous sclerosis and Von Hippel-Lindau syndrome, that make them genetically predisposed to having tumours in their central nervous system. Those individuals can receive regular screening, which can help identify these tumours at a much earlier stage, but what about people who do not have such conditions?
4 Feb 2026 · Engagements · Hansard source
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I have been campaigning for a Lincoln dental school for some years. I am pleased to be able to tell the House that, thanks to the hard work of, among others, Professor Juster, Professor Read and Susie MacPherson, Lincoln medical school is now in a position to take on its first cohort from 2027. Will the Prime Minister provide the necessary funding for this cohort of students to start to help improve the oral health of people right across Lincolnshire?
4 Feb 2026 · Lord Mandelson · Hansard source
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The Prime Minister said clearly today that when he appointed Peter Mandelson to the job as His Majesty’s ambassador, he knew that he had an ongoing relationship with the paedophile Epstein. Can the Minister tell us what sort of relationship he thinks would be acceptable when appointing such a person?
4 Feb 2026 · Lord Mandelson · Hansard source
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The transparency point is really important. Peter Mandelson was a Labour politician and this is a Labour Government. It may be that Peter Mandelson was an isolated bad apple, and that no one knew anything about what he was doing until this document release last week, but the public will wonder, and they will question. If a Labour Government cover up things by being anything less than fully transparent, the public will wonder who they are covering up for, and why.
4 Feb 2026 · Lord Mandelson · Hansard source
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The right hon. Lady is making strong and clear points about the relationship between Epstein and Mandelson. The Prime Minister was clear at Prime Minister’s questions that he knew the relationship was ongoing, and he knew that at the time he appointed him. What sort of ongoing relationship with a non-related convicted paedophile is acceptable to the right hon. Lady for someone who is meant to represent our country on the world stage?
2 Feb 2026 · Points of Order · Hansard source
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On a point of order, Madam Deputy Speaker. I listened to the last debate carefully, and I wondered whether you could help me with a procedural question. Would it be orderly for the Government to bring forward legislation, as soon as they wished to do so, to relieve Peter Mandelson of his peerage?
2 Feb 2026 · US Department of Justice Release of Files · Hansard source
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It is disgraceful that the Government are choosing not to bring forward legislation to remove Peter Mandelson from the House of Lords; it is entirely within their gift to do so. The public know that, and will be not only alarmed by the fact that the Government are not doing that, but questioning the motive for their delay. On what date exactly did Peter Mandelson cease to be paid by the Government?
28 Jan 2026 · Youth Unemployment · Hansard source
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My hon. Friend is making an excellent speech, and I am sorry to interrupt it. I want to ask her about the people who are writing hundreds and hundreds of applications for graduate schemes, and who are finding that they are locked out of those schemes, having been deprioritised because of the colour of their skin. Why should the Deputy Prime Minister’s son or the children of the Leader of the Opposition be prioritised for jobs over a tractor driver from Lincolnshire?
28 Jan 2026 · Youth Unemployment · Hansard source
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Will my hon. Friend comment on the proportion of benefits claimants who are under the age of 24? In Sleaford and North Hykeham, 25% of people on unemployment benefit are under the age of 24, which is clearly a very large amount.
28 Jan 2026 · Youth Unemployment · Hansard source
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In the Minister’s speech, she seemed to be lauding jobs created by the Government. Does my hon. Friend agree that it is ridiculous to suggest that the Government should create jobs instead of business?
27 Jan 2026 · Medical Training (Prioritisation) Bill · Hansard source
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I will speak to the amendments tabled by the Opposition. First, amendment 9 would require that from 2027, priority is given to British citizens on UK foundation programmes, and that they are prioritised for interviews and places on specialty training programmes. Clause 4 defines a UK medical graduate as a “a person who holds a primary United Kingdom qualification within the meaning of the Medical Act 1983 (see section 4(3) of that Act)”. However, it does not include “a person who spent all or a majority of their time training for that qualification outside the British Islands.” The Secretary of State has stated his intention to prioritise UK medical graduates, but he has failed to protect all British citizens in doing so. Our amendment would ensure that British citizens who study on an eligible medical course overseas were still prioritised in the Bill. There are many scenarios in which we may need to ensure that we protect British citizens. Consider, for example, a spouse, partner or child of a serving member of the UK armed forces who completes relevant training overseas while their relative is posted in Cyprus; a student at Queen Mary University of London who has completed the bachelor of medicine and bachelor of surgery course at its Malta campus but received a UK medical degree; a young British citizen who has studied in the US or France, owing to a family relocation; or, given that the largest bottleneck is not in training places but in getting a place in medical school at all in some cases, a British student who has gone to study overseas because of their fervent desire to become a doctor. Those are all entirely possible and plausible scenarios in which British citizens have completed their relevant training, and wish to bring their skills back and to relocate in their homeland for the rest of their career, but may not be covered by the Government’s prioritisation model. The Government’s prioritisation model is based on where the degree was taken, rather than also considering who did it. The Secretary of State must ensure that we do not overlook our own citizens if we are to fairly address the competitive landscape for training posts. The Opposition therefore urge the Government to accept amendment 9. Amendment 10 is a probing amendment to explore the effects of the Bill on military personnel. As a Member of Parliament representing an area with a large armed forces community, I know that medical trainees are an integral part of our serving community. The world is becoming an increasingly dangerous place, and junior trainees may be sent abroad earlier in their career than is currently the case. It is clearly wrong to penalise people who are doing brave work caring for our armed forces. They ought to be provided with optimal opportunities, and the Secretary of State has a duty to ensure that they are not overlooked. I would be grateful if the Minister covered that in her response. New clause 3 would require the Government to make an annual report to Parliament about the Bill’s impact on the number of international students at UK medical schools, and the financial impact on UK medical schools. We talked about the bottleneck, and the balance between UK and international students training at UK medical schools; clearly, becoming a UK graduate will now come with a significant premium. What impact will that have on British children getting to make their choices and become doctors if they want to? What incentives does it provide to universities to increase the number of international students, and what effect will that have overall on UK medical schools? New clause 2, tabled by my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer), is about places for UK foundation and speciality training programmes, and the importance of allocation on merit, because we all want the very best doctors. When I became a doctor—believe it or not, it was 25 years ago this year, Madam Deputy Speaker—I applied for a job as a junior house officer, as it was called then. I applied for the jobs I wanted, I was interviewed by the consultants who would have been supervising my training, and then I was offered the jobs. The experience of students today is very different. They are allowed to put in a preference and say which deanery or foundation area they would like to work in, but that is all. After that, the application goes into a computer system, which gives them a single rank that is not based not on anything they have done at university, or on whether they got good results or worked hard, or anything like that. The computer system will do a first pass, and if the first choice is available, it will give the student their first choice. If it is not available because by the time its gets to that student those places have gone, the computer system will miss the student and go on to the next one. When it has completed its full pass of the list, it will start again, and when it comes to that student next time, it will give them the highest preference that is still available. Once the student has been allocated a foundation deanery, the process starts again within the locality, and I mean “locality” in the loosest possible sense. Take those applying for the Trent rotation; they could be posted in Lincoln, Boston, Nottingham, Derby or Burton. The doctor has no control over where they will go, and very little ability to express a preference. My hon. Friend the Member for Weald of Kent (Katie Lam) spoke about a student in her locality who had not been able to get a place, despite being at the top—third, I think—of their university class. It is clearly not fair to give people no opportunity to control their future. By the way, there is no right of appeal, so having been given their place, the choice for the student is: that place or no place. The hon. Member for Sunderland Central (Lewis Atkinson) spoke about ordinary children from the north-east. Having once been an ordinary child from the north-east, I agree that it is important that people have opportunity, but it is equality of opportunity, not equality of outcome, that matters. I worry that the system creates equality of outcome. We therefore support new clause 2, tabled by my hon. Friend the Member for Runnymede and Weybridge. Amendment 1 would require the Bill to take effect on the date of Royal Assent, as opposed to a date at the discretion of the Secretary of State for Health and Social Care. The Bill is deemed necessary emergency Government legislation to prioritise medical graduates in the United Kingdom for places on medical training programmes. When he announced the Bill in an attempt to avert industrial action by resident doctors in December, the Secretary of State told the House that he had been working intensively with his team to “to see how quickly we could introduce legislation” —[ Official Report , 10 December 2025; Vol. 777, c. 430.] However, the Bill does not commit to a date when these measures will be enacted. Instead, the power lies in the hands of the Secretary of State, giving him a clear bargaining chip for future negotiations. It is clear that the Government intend to pass this legislation urgently, as they have said. However, without a commencement date, there are clear concerns that the Bill is just a negotiating tactic to prevent industrial action by resident doctors, and can be scrapped at a later date. There remains the prospect of further industrial action, despite the legislation being introduced. The Secretary of State should not be asking Parliament to pass a Bill that he has no intention of enacting if the British Medical Association plays ball and holds off on strikes. Either the Secretary of State thinks that this is emergency legislation that we need to get on with and enact, or he does not. It is vital that the legislation is enacted straight away, because students are due to be given their training programme places now, and they need to decide where they are going to live. They cannot put their life on hold, and measures to prioritise UK doctors cannot be held off, until the Secretary of State has finished dangling a carrot in front of the British Medical Association. The Opposition are clear: while we are supportive of the principles of the Bill, it must be used for offers made this year. Amendment 8 would clarify that under clause 5, a UK foundation programme is a programme where the majority of training takes place inside the United Kingdom. A foundation programme is defined as “an acceptable programme for provisionally registered doctors” in section 10A of the Medical Act 1983. It is vital to clarify that a UK foundation programme is a programme where a majority of training takes place inside the United Kingdom. That is because the General Medical Council can approve foundation programmes overseas. If it is not explicit that a foundation programme needs to be in the United Kingdom, a loophole is created whereby a foundation programme could be approved overseas, creating a back way into the system and circumventing the measures that the Government have tried to put in place. I encourage the Minister to look at that carefully as the Bill progresses. In summary, we support the Bill, but we have concerns about some of the clauses, so we have tabled amendments that we hope the Government will look at carefully.
27 Jan 2026 · Medical Training (Prioritisation) Bill · Hansard source
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I am pleased to respond on behalf of the Opposition, but first I should declare my interest as a consultant paediatrician and member of the British Medical Association. Medicine is a vocation, but it is also an art and a science, and training takes a long time. After, in general, five years as a medical student, new resident doctors need to train further in a specialism such as orthopaedics, ophthalmology or, in my case, paediatrics. Postgraduate training varies in length and structure among the specialties, but in broad principle it is divided into a foundation programme and more specialist training. The foundation programme is two years long and teaches a variety of skills. Specialist training is more specific, and there are well over 60 different specialties that people can choose from. It is those two phrases—the foundation programme and specialist training—that the Bill refers to. We are in a situation where there has been a huge surge in the number of applications per training post. One reason for that is the substantial increase in the number of medical school places. That was caused by action by the previous Conservative Government to improve the number of doctors in the long term. The previous Government opened five medical schools—at Sunderland, Anglia Ruskin, Kent and Medway, Edge Hill and, very close to my constituency, Lincoln. The first students at those universities graduated in 2023, 2024 and 2025, which increased the number of students looking for posts. At the time there was also a widespread expansion of existing medical school places—and, of course, there was the pandemic. During the pandemic, students who had applied for medical school and accepted offers found themselves unable to take their exams, and teacher-assessed grades meant that there was a huge increase in the number of successful applicants who got the grades they needed. There were more compared with the number that was statistically expected. The Government lifted the cap, and there was a huge number of medical students in that period. Many of them qualified last summer. That is why there is a huge increase in the number of local graduates. In response to my hon. Friend the Member for Farnham and Bordon (Gregory Stafford), the Secretary of State talked about his pledge to double medical school places, but there does not appear to have been an increase in the number of medical school places this year, and a statement from the Department for Health and Social Care at the weekend suggests that it is not a Government commitment. When the Secretary of State was asked whether he stands by his pledge, he seemed to say no, so I would appreciate it if the Minister clarified that issue. In 2024 at a visit to the Royal Derby hospital, the Secretary of State said that that site would be part of delivering the doubling of the number of medical school places that Labour is committed to in order to ensure that the NHS has the staff it needs to treat patients on time. He then encouraged people to vote for that in the 4 July general election. Will he clarify whether he stands by his pledge, and if so, when does he expect to start delivering on it? UK factors are not the main cause for the rise in numbers. The BMA has published figures from freedom of information requests that show that the number of UK graduates applying for training programmes went up from 9,273 in 2023 to 12,305 in 2025, which is an increase of about a third. Over the same period, the number of international medical graduates applying for specialist training went from 10,402 in 2023 to 20,803 in 2025, which is a doubling of applications. The surge in numbers has left British graduates facing unemployment. Some may pursue careers overseas and not return. The valuable contributions from international medical graduates are appreciated, but many complete training and return to their home nation, which could leave us with a potential shortage in the long term of consultants and GPs. The Government are right to step in to prioritise local talent. As such, we support the principles behind the Bill. However, there are some issues that we have questions about. First, the foundation programme applications are in progress. An application window closed on 8 October, and pre-allocation outcomes were due in mid-December. Foundation school applications due on 26 February are also to be delayed. The foundation programme website states that allocations can only occur once the Bill receives Royal Assent. That delay in itself, and the uncertainty associated with it, is difficult enough for young doctors and their families. Yet the Secretary of State creates an extra layer of uncertainty by adding clause 8 and the right to withhold activation of the Bill to a day of his choosing. Why is he doing that? What are the foundation programme and the people who run it to do? Should they wait, based on, “Will he, won’t he?” and, “When will he allocate it, when will he not?” Should they allocate places anyway, on the basis, as has been said already, that people need to know where they will live and sort out their arrangements? Or will they have to reallocate if the Secretary of State activates it, after it was allocated on the basis that he had not done that yet? That is not the way to treat professional, hard-working people. As my hon. Friend the Member for Farnham and Bordon said in his speech, this is not just about doctors; it is about patient safety now and in the future. The Conservatives have submitted an amendment that would activate the Bill on Royal Assent. I urge the Secretary of State to do what is right for the country and for patient safety and support it. Secondly, Labour has forgotten the British people—those we represent and should prioritise. I will say more as we consider the specific amendment, but under Labour’s Bill, foreign nationals completing a primary medical degree in Iceland, Norway, Liechtenstein, Switzerland and the UK are in a priority group. Yet a British citizen who trained in the USA, Canada, France or even the Malta campus of a UK medical school are not. The hon. Member for Sunderland Central (Lewis Atkinson) talked about the likelihood of international medical graduates leaving the UK after training, but surely that is an argument to ensure that British trainees are prioritised wherever they have trained—if the degree is suitable. The Conservative amendment ensures that British people are always front and centre, and we urge the other Opposition parties to back it. The issue of British citizens was raised earlier too. I want to clarify for the avoidance of all doubt that when we say “British citizens” we mean those from England, Wales, Scotland and Northern Ireland. There are other clarifications, which I will be grateful if the Minister can address when winding up. On military doctors, what position is in place to ensure that military resident doctors are able to access the posts that they need? What impact will the Bill have on them, particularly if, as the world is more dangerous now, they spend more time overseas in future than at present? As Conservatives, we believe in meritocracy and, as such, I support new clause 2 tabled by my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer). We all want excellent doctors and—I will say more about this in Committee—a random allocation does not encourage excellence. It produces stress and uncertainty, it does not encourage excellence, so I support the amendment. We agree with the principle of the Bill, but we encourage the Government to accept amendments that encourage excellence, to think through the detail, to put politics aside and do what is right for the country, to prioritise British citizens and to activate the Bill immediately on Royal Assent.
21 Jan 2026 · Draft Medical Devices (Fees Amendment) Regulations 2026 · Hansard source
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It is a pleasure to serve under your chairmanship, Ms Jardine. I agree that post-market surveillance is important for patient safety, but predictability for businesses and reducing the burden on them is also important. On 12 May 2025, the Minister for Secondary Care, the hon. Member for Bristol South (Karin Smyth), said that the SI that we were discussing on that occasion—the Draft Medical Devices and Blood Safety and Quality (Fees Amendment) Regulations 2025—would increase the fees across the MHRA for devices from June. That included fees for various things, most of which were increased by between 9% and 16%, but some fees, such as for clinical investigation charges, were increased much more. She said at the time that this would “ensure cost recovery until 2027”. —[ Official Report, First Delegated Legislation Committee, 12 May 2025; c. 3.] It is now January 2026 and the Government are back for more money. Why is that? They increased the fees for regulation 53 of the Medical Devices Regulations 2002—a regulation that the regulations that we are debating today also affect—from £240 to £261 back in June, and they plan to increase them again. Let us consider why. In May, I raised some questions about the impact assessment produced for that legislation, for two reasons. First, it did not appear that the national insurance increase or the reduction in the national insurance threshold had been accounted for in the calculations. Secondly, the impact assessment assumed a 2.2% pay rise for civil servants for the years 2024-25 to 2026-27. Even then, that level was below inflation. Regarding staff costs, the Minister in that debate said she thought they were NHS staff, but she later wrote to me to confirm that the national insurance contribution hikes were payable by the MHRA because the staff were civil servants. In response to my written questions, the Minister declined to say whether national insurance was included, but assured the House that the MHRA had “modelled…future costs”, that the uplift would be enough until April 2027 and that the MHRA would find “efficiency savings” if required to manage any future shortfall. I asked the MHRA, by way of a freedom of information request, what increases it faced in national insurance costs as a result of reductions in the thresholds and increasing the rate. It said that it faced a yearly cost of £1.9 million. I also asked: “What estimate has the MHRA made of the additional cost arising from the difference between” the pay rise estimated in the impact assessment and the actual pay rise that was given. The answer was £1.2 million. That is a shortfall of £3.1 million, or 20% of the increase in fees from the last SI. The MHRA said at that time that “we believe that, while this extra cost” —national insurance— “was not included, our fees cost-recovery methodology and approved fees are still sufficient to cover projected costs over the next two years, without any negative impact on service delivery or financial sustainability.” That letter was dated 1 August 2025, which is after that PMS legislation came into effect. There was a significant difference between the calculations that the MHRA produced and the £3.1 million figure, which raises questions about their accuracy and the grip that the Government have on the detail and our public finances. The Government are now here again, wanting to increase the registration fee by an additional 15% to £300, but this time with no impact assessment. The regulations that we are discussing today not only increase the registration fee by 15% from April 2026, but add a maintenance fee of £300 for each device in a category listed, starting with “the fee period immediately following that in which the person paid the fee for the device registration…due on the first day of each…period”. That would seem to mean that if a device is registered between now and April, they pay £261 now and £300 on 1 April, which will presumably incentivise delaying any current registrations. I can see that the Minister has adjusted for this in future years, but he does not seem to have done so for those registering this year. I am interested in how sure the Minister is that his estimate for the increase in the post-market surveillance of £17 million is robust, given that we are back six months after the Government were sure they had enough. This year, the de minimis assessment says that £6 million will come from grant in aid from DHSC, £4.9 million from DHSC financial support and £6.1 million from the fee income. The current registration fees are predicted to produce £1.6 million, leaving a difference of £4.5 million to be covered by fee increases. The de minimis assessment’s best estimate says that the MHRA needs to make £4.3 million of that, which is £300 a year on each of the devices, in the way that the Minister described. However, it also says that “we plan to seek approval for full cost recovery fee for subsequent years”, which the Minister has confirmed is his plan today. Why is that not in today’s regulations? Is that because it would have required an impact assessment? How much will this cost businesses? This will be a further £10.9 million and, if £300 a year will get the Minister £6.1 million, then for £17 million he will need about £836. That is a massive increase on businesses coming down the track next year, which I do not think he has fully considered. Burdens on businesses are important because they stifle activity and innovation. This Government have already added significant burdens to businesses: higher taxes and national insurance rates, the reduction of the national insurance threshold, the Employment Rights Act 2025 and, for family-owned businesses, the business property relief. They are now adding further costs, and I am concerned about the effects on innovation and early access to devices for patients. What is the Minister’s assessment of international comparators? In recent times we have seen a loss of pharma investment in the UK. Will the extra fees this year, and the prospect of hikes next year, deter investment? There is no impact assessment, so how can we be sure? I am particularly concerned about small businesses and microbusinesses. The de minimis assessment says that it is not possible to exempt microbusinesses. Why is it not possible? It is a political choice not to exempt them, but it is certainly possible to produce regulations that do. As the Minister described, the consultation revealed widespread concern, with only 10% support. Changes have been made following discussion with a trusted advisory group. Who is in the trusted advisory group? Whose voices from micro and small businesses were heard in that group? There has been no further consultation and no impact assessment on the regulations the Minister has presented today. I also have some specific questions about obsolescence. Do businesses need to pay a registration maintenance fee for putting a product on the market to sell or lease? That was previously a single charge that lasted for the product’s lifespan, however long that would be. There is now an annual fee. What provision is made for the clinical use and post-market surveillance of items that cease to be registered because a company goes bust or stops selling the item? Can the item still be used? How would a clinician know that the lapse of a previous licence had stopped, particularly if it was a personal piece of medical equipment such as a stethoscope? How does that affect post-market surveillance? Could registration be discontinued for some items, where someone has several categories possible, in order to register another category and force obsolescence? For example, I have seen one case where the failure to produce spare parts lead to an entire trust having to replace every single defibrillator, at great expense. If a company went bankrupt and was no longer able to pay its post-market surveillance fee, the item would no longer be registered. How would that work? I also want to ask about categories. Originally, as described in the consultation, the GMDN category was level 5, which is extremely specific. It is now level 2, which is better, but microbusinesses still pay the same charges as larger businesses, so a business selling one product would pay the same as a business selling dozens of products in the same category. Also, there is no accounting for the size of the product or the surveillance required. For example, the charge for an MRI scanner, worth £2 million, would be the same for as a single-use scalpel worth less than £1. Is that fair? I appreciate that people may sell more scalpels than scanners, but what about an umbilical artery dilator, of which not too many are used, at £24 each? Producers of inexpensive but highly specific and useful devices may be disadvantaged. What will the effects be on costs for patients? Again, there is no impact assessment, so we do not know. How much of the cost produced by these regulations does the Minister expect to be transferred back to the Government in paying for more expensive devices? Overall, there are many more questions raised than answered by these regulations. Patient safety is paramount. There is, of course, a cost to ensure that devices are properly and proportionately regulated, but the Government also need to be responsible and careful with money. As they are, the regulations are a blunt tool adding costs to businesses and a promise of much more cost to come. There is no proper impact assessment, and there is a risk to small businesses and microbusinesses and to inexpensive, low-volume items. As such, I cannot support the regulations.
21 Jan 2026 · Draft Medical Devices (Fees Amendment) Regulations 2026 · Hansard source
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If a device ceases to be registered, can a doctor still use it in the NHS—legally?
21 Jan 2026 · Draft Medical Devices (Fees Amendment) Regulations 2026 · Hansard source
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Will this post-market surveillance continue if a device ceases to be registered?
21 Jan 2026 · Draft Medical Devices (Fees Amendment) Regulations 2026 · Hansard source
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The Minister is making a great speech, but he is not answering lots of the questions—I appreciate that he may not have all the answers. Can he commit to answering them by letter? Will he also talk about the possibility of obsolescence? If an item ceases to be registered—he is encouraging people to deregister things that they are no longer selling—can it still be used in the NHS? How would a doctor know whether something had ever been registered in the past and was safe?
14 Jan 2026 · Ukraine · Hansard source
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Four years ago, when Putin invaded Ukraine, people around this country opened their hearts and their homes to Ukrainian people, and I thank them for their generosity. I particularly thank those in my constituency who welcomed people to their homes, supported them, and continue to support them to this day. According to the latest council figures, there are just over 1,000 people from Ukraine in Lincolnshire, and I want to focus on them. Just last weekend in Sleaford, I met a group led by Kelly Breislin and Betty Berthebaud. I thank them for their work in trying to bring the Ukrainian community together, and in helping them to navigate the various different systems within the British state. I met women, predominantly, and children. I also met an accountant, a doctor and a dentist, and I met a masseuse who had set up her own business in my constituency. They were grateful first to the British state and to the former Prime Minister Boris Johnson for supporting them and their country, but they were also thankful to the people who had supported them as their hosts. The Ukrainians told me of their trips out of Ukraine and the fear that many of them felt. I met two young ladies, who were just 18 when they left, as friends together, to come across to live with a family in Ruskington. I thought of my own daughter at a similar age, and how it would be to let her go to an unknown country, to live with an unknown family, in such circumstances. They told me about the cultural and language challenges they had. One of them told me about her recent visit to Ukraine at Christmas and the five days of power outages she had there, as well as about the difficulties and fear she had going back for that short period. One lady explained about how her life was on hold. When the Ukrainians first came here, they were quite content just to be safe and to have no fear of bombs. However, as time has gone by, they think of the jobs and careers they had, the futures they want to have and the difficulties they have in progressing them. For example, one young lady talked about the training challenges. She cannot do an apprenticeship because her visa does not last long enough for that, and if she wants to do a university course or a training course, she will have a similar problem. Someone wanting to stay has to apply for a new visa, and they cannot apply until 28 days before they are due to leave, but that causes problems with employment, and they are all very keen to work. I want to ask the Minister specifically about Ukrainians in the medical profession, because it seems to me that we have a shortage of both dentists and doctors. For example, the cardiothoracic waiting list went up not just last month, but over the last year, and it is higher than it was when we left office. Yet there is a cardiothoracic surgeon in my constituency who is currently unable to practise, and is instead working in a factory. I appreciate that time is very short, so I am not able to go through all the examples I would like to give, but could he or the relevant Minister write to me with the various schemes available for people with such skills to be able to use them to the fullest while they are in this country?

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