Caroline Johnson MP: speeches

Speeches

• 14 Apr 2026 · “For Women Scotland” Court Ruling: First Anniversary · Hansard source

  More

  I wonder if the hon. Gentleman would reflect that there is a biological difference between an individual with a disorder of sexual differentiation, whom the hon. Member for Chelmsford (Marie Goldman) referred to as an intersex individual, and a biological male who feels that he prefers and is more comfortable living his life as though he were a woman.

• 14 Apr 2026 · “For Women Scotland” Court Ruling: First Anniversary · Hansard source

  More

  The hon. Lady is making a very good speech. Does she share my concern that it plays out in the scientific arena as well? The UK Health Security Agency has been collecting data in relation to sexual health infections on the basis of gender rather than sex.

• 14 Apr 2026 · “For Women Scotland” Court Ruling: First Anniversary · Hansard source

  More

  Will the hon. Lady give way?

• 14 Apr 2026 · “For Women Scotland” Court Ruling: First Anniversary · Hansard source

  More

  The hon. Lady has talked about the courage of the people who stood up on this issue, but will she reflect on the people who felt censored? For example, I spoke to a young lady in my constituency who participated in a hockey club, but she stopped going. The parents of another girl stopped her going to the same club, because there was a man on the young ladies’ hockey team who insisted on using the changing room and the girls felt uncomfortable changing in front of him. The issue is reducing the participation of particularly young women in sport, which is regrettable. Guidance from the Government to make things clear will help to ensure that women can participate in sport fairly and safely.

• 14 Apr 2026 · “For Women Scotland” Court Ruling: First Anniversary · Hansard source

  More

  Could the hon. Lady say what her ideal situation would be? Would it be that if a gentleman walked into the ladies’ changing rooms, perhaps at a swimming pool, it would be illegal to stop them or even ask them? Would the solution be that any man could go into any women’s changing room if he wished?

• 14 Apr 2026 · “For Women Scotland” Court Ruling: First Anniversary · Hansard source

  More

  Will the hon. Member give way?

• 14 Apr 2026 · “For Women Scotland” Court Ruling: First Anniversary · Hansard source

  More

  The hon. Lady is being extremely generous with her time. Does she feel, as I do, that a lack of political courage is what has delayed the new guidance? That lack of political courage has fallen on the heads of people having to make these decisions, such as nurses on wards, people working in sports centres and the like. They do not have the Government guidance to stand behind and say, “This is what the law says. This is what I’ve got to do”, so they are having to make decisions and then take the flak and sometimes abuse from people who are disappointed by their choice.

• 13 Apr 2026 · Middle East · Hansard source

  More

  I would like to ask the Prime Minister about food security. In response to an earlier question, he suggested that the answer to food security was to go further and faster on renewable energy. Does he recognise that carpeting some of the country’s best farmland—indeed, some of the world’s best farmland—in Lincolnshire in solar panels is counterproductive to that aim?

• 13 Apr 2026 · Southport Inquiry · Hansard source

  More

  As a consultant paediatrician, I have to undertake Prevent training at regular intervals. On each one of those occasions, I have raised with Ministers my concerns about either the quality or emphasis of that training, or both. Can the Home Secretary say whether she feels that in this particular situation, the problem was mostly that the perpetrator did not conform to the usual patterns that people were being trained to spot; that people were being badly trained; that people were not using their training diligently; or that the actions once the case had been reported were not followed through? Which does she think was the major factor?

• 24 Mar 2026 · Sudden Unexplained Death in Childhood · Hansard source

  More

  It is a pleasure to serve under your chairmanship this morning, Sir John. I declare an interest as an NHS consultant paediatrician and as a member of the Royal College of Paediatrics and Child Health. I congratulate the hon. Member for Rossendale and Darwen (Andy MacNae) on securing today’s important debate. The death of a child is every parent’s worst nightmare. It is perhaps even more horrific when such a death happens suddenly, without warning and when no explanation can be found. I would like to convey my condolences to the family of Frankie Grogan, to Cheryl, Darren and Louis, to Nathan and Fiona, to the Rogers, Pitts and Williamson families, and to all other families grieving such a profound loss. Childhood death is thankfully rare. However, more than 3,400 children aged nought to 17 die in England each year, and in around 40 cases the death cannot be explained. Parents are left with more questions than answers. Why has this happened? Why now? Since many cases are unwitnessed, did the child suffer? What was the cause? Could it have been prevented? Will it happen again to a sibling or a future child? I want to focus on two questions today: how do we identify the cause of death in more cases? And how can we use that information to prevent future deaths? We can do that because we have done it before. In the 1980s, 2.35 children per 1,000 live births died within between a week and two years. That has been reduced by over 90%. The key factors were research, the Back to Sleep campaign, general safe sleeping advice and the avoidance of cigarette smoke. There is more to be done, but with the right plan, we have shown that lives can be saved. I would first like to acknowledge some progress, including through the work of Baroness Kennedy, whose 2004 report and subsequent work with the Royal College of Pathologists and the Royal College of Paediatrics and Child Health led to the introduction in 2008 of a standard set of clinical samples, called Kennedy samples, that must be taken in the event of a sudden child or infant death. In most of the trusts I have worked in, there is now a box in each emergency department with all the samples and a list of what needs to be taken so that nothing is missed in any cases. Child death overview panels, which were also established in 2008, are multidisciplinary panels to review the deaths of all children aged nought to 17. That process was further updated in 2018. When a child dies, all registrars must inform the child death overview panel, of which there are currently 58 in England. An expected death goes to a review meeting to look at the detail of the causes and whether it can be prevented in the future. In an unexpected death, there is an urgent joint agency response meeting including police and education, and a review meeting takes place later. All that information then feeds into the national child mortality database, set up in 2019, which is there to spot patterns and aims to prevent future deaths. It produces several reports each year with detailed guidance for Government on how deaths can be prevented. It might be helpful to discuss an example. In December 2024, the NCMD published a report on child deaths due to asthma or anaphylaxis. I commend those who produced that report, including my medical colleague Dr Emilia Wawrzkowicz. They found that certain factors increased the risks of asthma or anaphylactic death in children, and that milk was most likely to trigger a fatal reaction. They found problems with auto-injectors that were forgotten, out of date or not with the child, or that the training had not been adequate, particularly in schools. They found issues with indoor air pollution, a failure to recognise life-threatening asthma and that children did not have asthma action plans. Work has been done in many of those areas, which will have saved children’s lives since. My hon. Friend the Member for Rutland and Stamford (Alicia Kearns) has been promoting Benedict’s law, which hon. Members voted for just last week, to ensure that children at school are protected from anaphylaxis. Can the Minister update the House on progress in delivering the recommendations of the national child mortality database’s report? At the moment, the Government are not obliged to produce a response to the recommendations of the national child mortality database’s reports, unlike many other reports, and I think they should be. A more recent report was on the effect of consanguineous marriage on the rate of child deaths. It would be helpful to have Government responses to show that those reports are being read and acknowledged, and that the work that has been done is leading to change. I worry about the effect of the imminent abolition of NHS England on the national child mortality database’s work. Child death overview panels do very good work in investigating each child death individually, but ICB funding cuts mean that not only bereavement staff, but investigatory staff, are being cut. The mergers of ICBs mean that local knowledge may be lost as the areas become very large. That is not in line with the statutory guidance in the Children Acts. Can the Minister update us on the Government’s plans in that area? Whole genome sequencing offers an increased likelihood of finding children’s causes of death, but there is a long wait for results; it can take six months. Families are in great distress while they wait for those results, as we have heard. The Government suggest that they want to expand genome sequencing work, but it has already taken a very long time and the workforce plan has not yet been published. What are the Government doing to make sure we have the right staff and the right capacity to deliver that ambition? Skin biopsies can be very helpful, particularly in diagnosing inborn errors of metabolism, which in children can cause illness and death, but they are not yet available everywhere. Can the Minister update the House on what is being done to roll out these tests so that, where possible, all causes can be found? The Liberal Democrat spokesperson, the hon. Member for Mid Sussex (Alison Bennett), mentioned the fact that there are not enough pathologists. That is very important because it causes distress and delays, including to post-mortems, and it means that families have to wait much longer for results. Also, some children tragically die overseas, as happened to one of my patients relatively recently. In such cases, SUDC panels rely on being told about it and find it more difficult to investigate. Does the Minister have any comments on that? Hon. Members talked about research. The Lullaby Trust has been doing gene sequencing on tissue samples from children who died of sudden unexplained death. In four of 20 cases, the tests were able to find evidence of infection, so there is hope that people who have been bereaved by a sudden unexplained death in the past can, with more modern techniques and retained tissue samples, discover the cause in the future. However, that will only happen if the research takes place. This research is charitably funded. We heard about the charity-funded research being done in Bristol, but the Government also need to fund research so that we get as much information as possible to prevent these deaths. Lastly, I will talk about bereavement support. We have heard about the vital role that it plays in helping families, including siblings, in their time of grief, but I have heard about cuts to that as a result of mergers and funding changes to ICBs. In one case, a phone line has been taken away, meaning that families who want to approach bereavement support have to email and wait for a response—I can see hon. Members frowning. This is clearly not good enough, so I urge the Minister to look carefully at it and take the time to find out what is going on in each ICB regarding the commissioning of these services, so that we are not leaving families without the support they need during the most awful time they could ever experience. What we have heard today is a call for action. We have heard a call to explain the unexplained, support families better, improve on research and, ultimately, to prevent the deaths of children.

• 24 Mar 2026 · Sudden Unexplained Death in Childhood · Hansard source

  More

  My point was less that mergers of ICBs would make services more efficient, but more that that is leading to services being cut, which may make them less good, and that the principle that CDOPs look at the local area is diluted if the local area becomes very large.

• 23 Mar 2026 · Puberty Blockers Clinical Trial · Hansard source

  More

  It is a pleasure to serve under your chairmanship this afternoon, Mr Mundell. I must first declare an interest as an NHS consultant paediatrician. I thank James Esses for the petition and the thousands of people who have signed it, including many of my constituents, for enabling today’s important debate. I also thank the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) for leading the debate so well. The petition asks the Government to cancel the puberty blockers trial and to safeguard vulnerable children. Perhaps it is worth considering whether clinical trials in children are a good idea in principle. The answer, of course, is yes. Children are not just small adults; they have different illnesses from adults, they present with different symptoms and respond differently to medication, and they require different doses at different ages. Properly designed clinical trials ensure that children’s medicines are safe and effective for them. However, today we are discussing one particular trial: a proposal to give puberty blockers—gonadotrophin-releasing hormone analogues—to children, specifically for gender incongruence. Perhaps at this point it is worth considering why doctors and others prescribe medication; we do it to treat or cure disease, to treat or lessen symptoms and to aid in diagnosis. What does this trial seek to do? On the face of it, it seeks to establish whether puberty blockers are a safe and effective treatment for gender incongruence. ICD-11 defines gender incongruence as: “A marked and persistent incongruence between an individual’s experienced gender and the assigned sex”. To suggest persistent incongruence with gender stereotypes is wrong could undo years or decades of rolling back gender norms. If it is not causing the person any distress, why would we want to treat it, especially when we know that most children, even those with gender dysphoria who do have distress, will get better without any puberty blockers? Currently, there is no way to identify which children will persist with a trans identity as adults and which will not. The much-delayed data linkage study could help with that. It could enable more targeted interventions and may also provide information on the long-term outcomes for people who have taken puberty blockers in the past. However, the Government insist on pushing on with the puberty blockers trial anyway, before the data linkage study is complete. Why? In written parliamentary questions, Ministers have said that they expect the data linkage study to be finished by April 2027, so what is the rush? What is the point of the treatment? It has been suggested that it helps transgender adults pass more easily as the opposite sex and potentially avoids surgical operations in adulthood, but how on earth can it be ethically, morally or medically right to treat a large group of children with risky medication to give cosmetic benefits to a much smaller number of adults? There are also cosmetic risks to the treatment. The penis grows very little between the ages of three and 10 years. The use of puberty blockers restricts growth, meaning those with a persistent trans identity may struggle with having enough tissue for a vaginoplasty surgery, and those who do not have a persistent trans identity may struggle with normal intimate relationships. As mentioned earlier, the Secretary of State has said that he has confidence in this trial. Now it has been paused, we can presume that he is not quite so sure. But can we, patients and the general public have confidence in this trial? There are certainly causes for concern. In fact, there are so many that I cannot speak of them all today, but I would like to speak of a few in the time I have available. First, on the selection of patients, we have had a dramatic change in the demographic. There has always been a small number of children uncomfortable in their own bodies, but there has been a rapid increase, which is not fully understood, particularly among girls. Many of them are in care, some have autism spectrum disorders and many are same-sex attracted. We need to understand this before prescribing irreversible treatments. We do prescribe—and I have prescribed—drugs that are high risk or potentially harmful to children. An easy example would be chemotherapy, but that is being given to save a child’s life; it is not used to pause a perfectly normal physiological process in a physically healthy child. The risks of these treatments have been listed today, but I will list just a few: fertility problems; idiopathic intracranial hypertension; demineralisation of bone density, leading to fractures; in some studies, an increase in depression and anxiety; and the long-term loss of sexual function in some patients. We have discussed consent. How do you get consent from a parent of a child—a boy or a girl at Tanner stage 2—about long-term sexual function and fertility? On the design of the trial, it is said to be a randomised controlled trial. Well, it is, but that is a bit of a fudge, because instead of an actual randomised controlled trial where some patients receive puberty blockers and some do not, it has given some now and some slightly later, with a very short difference in the timing. The comparison group that does not have any puberty blockers at all is taken from a slightly different population, which introduces an unnecessary bias. The trial’s organisers have said that they are doing that because they think the children would get the drugs from elsewhere or from abroad, but that is not how we do medical trials. When I have raised this issue, Ministers have responded that it cannot be blinded, but blinding and randomisation are not the same thing. The trial is also far too short to provide data on long-term outcomes. On the process of the trial, the hon. Member for Gower (Tonia Antoniazzi) raised questions about what children are being asked as part of this trial. Why is the trial proposing to ask children about their sexual experiences? Why is this helpful to the trial?

• 23 Mar 2026 · Puberty Blockers Clinical Trial · Hansard source

  More

  I will not because I am aware of the time. The Commission on Human Medicines’ report heard that, because trials of puberty blockers have been blocked, some clinicians are trying to use other drugs to limit puberty, such as spironolactone and cyproterone acetate. There have been reports that the number of prescriptions for spironolactone in 10 to 17-year-olds is going up. Could the Minister confirm whether that is the case and what the Government are doing to look into it? The MHRA was happy with the process; now it is not. What has changed? None of the issues raised seem to have not been raised before. The Government are being secretive about it: in February, Ministers brought forward a written statement referencing an MHRA letter in November, but the Minister is refusing to publish it. I have asked Ministers whether they talked to MHRA officials about the trial before February 2026, and they will not answer the question. There was a letter between the MHRA and KCL; I asked when it was received, when the Department became aware of it and when Ministers became aware of its contents. They will not tell me. What about the people controlling the trial? As has also been mentioned during this debate, Professor Jacob George has been recused from further involvement. According to the MHRA’s statement, this is “a precaution”, because of social media posts made before his involvement. Why have those who have made the opposite type of comment not been recused too? This will inevitably make members of the public think there is bias involved. There is an oversight board. What has the Minister done to ensure that the clinicians and scientists on that board are impartial, and that it is balanced between both perspectives? The Tavistock trial was supposed to report to the MHRA, but it did not, seemingly with no consequence. There will be lay members on the board with lived experience; will one of those be a detransitioner, or will they all be people on one side? That would increase the perception of bias in this trial. In summary, this is a trial of risky medication on healthy children, most of whose features of gender incongruence will resolve in time, given normal puberty. What is particularly worrying is that, at the end of this treatment, the trial has so many flaws that it is bound to be disputed, whatever the result. To give this treatment, the lead clinician will need to think that there is a reasonable prospect of a patient benefiting from puberty blockers. Given all that has been said, how can any clinician believe that that is the case? I hope we can all agree that we do not need a clinical trial to know that helping a child to be at peace with themselves and their body is infinitely preferable to a lifetime of harmful medical intervention.

• 10 Mar 2026 · Courts and Tribunals Bill · Hansard source

  More

  I will not. This legislation is potentially just a distraction—something that makes people feel like they are doing something and making a difference, when the impact assessment that the Government have produced suggests it will not. Is this change going to make any difference or not? Is this a lost opportunity to improve the risk assessments, children’s representation and social work and to actually make a difference?

• 10 Mar 2026 · Courts and Tribunals Bill · Hansard source

  More

  I give way.

• 10 Mar 2026 · Courts and Tribunals Bill · Hansard source

  More

  I should first declare an interest as an NHS consultant paediatrician who has given evidence in court in that capacity. The references to the Magna Carta are particularly profound for a Lincolnshire MP, because one of the copies of Magna Carta from 1215 is kept in Lincoln. The Father of the House, my right hon. Friend the Member for Gainsborough (Sir Edward Leigh), and my right hon. and learned Friend the Member for Torridge and Tavistock (Sir Geoffrey Cox) talked eloquently and at length about jury trials, why they should remain, and why removing the right of appeal for magistrates court decisions is the wrong thing to do, so I will not focus on that in the few minutes I have. I will focus on clause 17, which removes the presumption of involvement of parents in their child’s life. When there is dispute over who cares for a child, courts can make decisions: they can decide who a child is to live with; they can decide who has contact with the child, for how long, and when; they can decide what form that contact takes, whether it is by telephone, in a supervised contact centre or face to face; and they can make specific decrees such as where the child is to go to school. The law is clear that when courts are making those decisions, the welfare of the child is paramount. They can take into account the child’s wishes if old enough and capable of making decisions in that respect. They can think about whether the child has been subject to any harm. They can talk about whether the child is at risk of further harm. They can talk about whether the parents are capable of providing for the needs of the child. However, section 1 of the Children Act 1989 is clear that the courts must presume, unless shown otherwise, that the involvement of both parents is in the child’s best interests.

• 10 Mar 2026 · Courts and Tribunals Bill · Hansard source

  More

  I understand what the hon. Gentleman is saying. I will continue my speech and perhaps he will listen to what I have to say. The purpose of court decisions is, as the hon. Gentleman said, to prevent unsafe contact and to prevent tragedies. As a paediatrician, I have seen situations where children have been given back to parents and have come to significant harm as a result. I have dealt with and looked after those children, and unfortunately they have not been protected or saved in every case. The law is there to prevent unsafe contact, but the children’s needs must be put first, with the power to restrict access where they are in danger. The court must listen to all the evidence available, but no system is infallible and sometimes judges get it wrong. When they do, the outcomes can be hugely tragic, leading to the loss or serious injury of a child. I know that this legislation has been brought forward with good intentions. The test is whether it will prevent such harm and such tragedies. I think that it might not. The reason is that the impact assessment produced by the Government says that it is “unlikely to materially change” the outcome in court. If that is the case, what is the point of the legislation? Will it, on the other hand, reduce the likelihood of children seeing their parents? Will that, in and of itself, cause some harm? Will it prevent some children from having the contact they need with their family members? Will it prevent the tragedies that we wish to prevent or not? Will it isolate those children who will come to harm? Do we have the right risk assessments to do that? Every single one of us in this House wants to protect children. We need to improve the risk assessments and ensure that social workers have time to make proper risk assessments so that they identify the children who may be at risk and separate them from those who are not. We also need to improve the representation of children in court. I was once in court, in the witness box, and the barrister who was representing the children got up to speak. He asked me a question, but he had forgotten the name of one of the two children in the family and I had to remind him from the witness box. We really need to improve the quality of the representation of children.

• 10 Mar 2026 · Courts and Tribunals Bill · Hansard source

  More

  Not for the moment. Article 8 of the European convention on human rights provides the right to family life and suggests that consideration be given to all alternatives before ordering no contact. The Government, however—

• 10 Mar 2026 · Courts and Tribunals Bill · Hansard source

  More

  That is why I have explained that the presumption is that the parents have involvement. The court must take the risks to the child into consideration and, unless shown otherwise, give contact to both parents. If the child is at risk, however, the court has the absolute right to prevent the child from seeing those parents or to restrict contact to different forms and timeframes. The welfare of the child is key in those decisions. That is in line with international law, which I know the Government are fond of. The UN convention on the rights of the child says that parents and children should maintain “personal relations and direct contact with both parents on a regular basis, except if it is contrary to the child’s…interests.”

• 9 Mar 2026 · Type 1 Diabetes: Infant Testing · Hansard source

  More

  It is a pleasure to serve under your chairmanship, Sir Alec. I declare an interest as an NHS consultant paediatrician and a member of the Royal College of Paediatrics and Child Health. I congratulate the Minister on her new role. It is a very important role in the Government, and I know that she will do it with great care and thoughtfulness. I congratulate the hon. Member for North Ayrshire and Arran (Irene Campbell) on introducing this important debate. I also give condolences to Lyla’s family and commend them on their bravery and their courage. I pay tribute to their work to prevent the same tragedy from happening to other families. When one becomes a doctor, one gets trained in resuscitation. Many people are familiar with the resuscitation ABC—“airway, breathing, circulation”—but the full version is ABCDEFG: “airway, breathing, circulation, don’t ever forget glucose.” Sadly, some people do, as we have heard today. Every doctor is taught the signs of diabetes mellitus, what to look for and when to test sugar. I am hesitant to legislate medical guidance, because that still requires the awareness of the guidance’s existence. Changing the guidance in law instead of simply in practice may also reduce flexibility as evidence-based judgment comes to the fore. What is the Minister doing to increase awareness among doctors and wider clinical teams, as well as families and the wider public, so that we do not see cases of tragedy and near misses like those that we have heard about today? Diabetes type 1 can present at any age, but it commonly presents in primary school and the early years of secondary school. Detection before it develops is challenging, and presentation is often very acute in children. It is an autoimmune condition, so antibodies are developed by the insulin-producing cells in the pancreas, creating a deficiency in insulin, which is the cause of the illness. The ELSA study, which has been mentioned, is looking at how we can detect that before a child becomes sick. It will look at 70,000 children. It starts with a simple finger-prick test, similar to that for sugar. It tests for three antibodies; if the person has any of those, they get a second test for four antibodies. We know that if they have two or more of those antibodies, their chance of becoming diabetic in the next 10 years is 75%. We also know that a medication called teplizumab, which was licensed in August 2025 for children over eight years old, may be able to prolong that time. There may be opportunities for further awareness and investigation for early diagnosis, but also for further drugs to be developed, which can delay the onset of diabetes in people who are susceptible to it. The analysis for the first 17,000 patients showed that 75 children had one antibody and 160 had two antibodies. One of the challenges is determining the best age to test. When did these antibodies develop? What do they develop in response to? Does the test need repeating? If so, how often? I commend my hon. Friend the Member for South Northamptonshire (Sarah Bool) for her ten-minute rule Bill, which will provide leadership on those very important questions. I also want to ask the Minister about diabetes treatment. For those who are diabetic, blood sugar control is a lifelong preoccupation, as my hon. Friend described. This is not just about the short-term risks of hypoglycaemia and diabetic ketoacidosis, although those are serious enough; the long-term complications from poor diabetic control include heart failure, strokes, amputation and blindness. The latest report from the Royal College of Paediatrics and Child Health showed that there were 33,437 children in England with diabetes mellitus, of whom 93.3% have type 1. These children have regular health checks, but only 66% of the over-12s receive those health checks. What is the Minister doing to increase the proportion? Haemoglobin A1c, or HbA1c, is a chronic measure of what the sugar level has been over time. It is 70.8 in black children, compared with 63.1 in white children and 63.9 in Asian children. What is the Minister’s understanding of what causes that disparity and what is she doing to improve the HbA1c in all children? Technology can really help. The latest figures from an RCPCH study in this area, from 2023-24, show that continuous glucose monitoring of children increased from 49% to 79%, insulin pump usage increased from 45% to 56% in a year, and the use of the hybrid closed loop system increased from 15% to 36% in just one year. Such devices really improve diabetic control. What are the Government doing to increase the rollout of these technologies? No one in this House wants to see any child become very sick or to see any family suffer the heartache that Lyla’s family have suffered. I pay tribute once again to Lyla’s family. This debate, the petition and the media reporting of this debate will all raise awareness, and I have no doubt that that will contribute to saving the life of some child somewhere in our nation. I look forward to hearing the Minister’s response on how she will increase clinician awareness and widen public awareness, improve research into screening and new treatments, improve early diagnosis, and roll out the best technologies and treatments to improve diabetic control for patients with diabetes.

• 3 Mar 2026 · Draft Human Medicines (Amendment) Regulations 2026 · Hansard source

  More

  Can the Minister confirm that the vaccine group direction—unlike a patient group direction, which ultimately needs to be signed by a clinician—would not need to be signed by a clinician, and can instead be signed by a senior manager either within a company or department?

• 3 Mar 2026 · Draft Human Medicines (Amendment) Regulations 2026 · Hansard source

  More

  Before the Minister moves on, can I just ask him why ODPs appear to have been removed from the list?

• 3 Mar 2026 · Draft Human Medicines (Amendment) Regulations 2026 · Hansard source

  More

  It is a pleasure to serve under your chairmanship, Mrs Harris. The Opposition do not intend to divide the Committee on these regulations, as anything that improves trust in medicines and vaccines is important. We need to increase the uptake of vaccines; it has fallen gradually and continues to fall, and we need to reverse that. I have a couple of technical questions. As the Minister said, the principle behind the amendment to regulation 3 of the 2012 regulations is to make prescribing pharmacists equivalent to doctors and dentists. However, regulation 3(8) currently refers to, “another doctor or dentist…of the same…practice.” Given that pharmacists will now also be included, should that be amended to “another doctor, dentist or pharmacist”, or “a doctor or dentist”? Regulation 5 redefines an “occupational health vaccinator” and refers to a list in part 4 of schedule 16 to the 2012 regulations. That significantly broadens the list to include individuals such as speech and language therapists who are not accustomed to dealing with injectable medications, but appears to exclude operating department practitioners, who, as the Minister will be aware of from his practice, are used to dealing with injectable medications. Could the Minister explain the reason for removing those practitioners from the list? Regulations 8 and 9 talk about the vaccine group direction. The patient group direction is essentially a group prescription, where a clinician signs off the circumstances in which medication—say, paracetamol —may be given by a non-prescriber. We had such a direction for the covid-19 vaccine during the pandemic. This vaccine group direction would be different, so why does the Minister feel that we need a different process to the patient group direction that is already available for vaccines, which are prescription medicines? Instead, those directions can be signed by someone who is not a clinician—such as a manager in the Department of Health or, in fact, a private company—and they do not need to have any clinical skills or qualifications at all. A clinician, or one of the people listed, must decide whether the conditions have been met, and they can then give the patient the medicine without having prescribed it. I want to ask a couple of questions on this issue. How does that improve trust, when we have a vaccine-sceptic population and lots of material on social media, some of which is not entirely accurate? How does allowing a prescription to be written by someone with no clinical experience help with trust and those rates? Is there a plan to contract out vaccine provision to the private sector, because that is what this provision allows for? Who is ultimately responsible? Is it the non-clinician who signs the vaccine group direction? Who is the clinician ultimately responsible for the decision to give the vaccine in the event that someone has an allergic reaction or an adverse reaction of some other type?

• 26 Feb 2026 · Eating Disorders Awareness Week · Hansard source

  More

  I am sorry. The last Government’s work to channel more resources into mental health could not have been more welcome. This year, 2025-26, will be the first since 2016-17 that mental health spending has not risen as a proportion of health spending. That contravention of the mental health investment standard has raised alarm bells at the Health and Social Care Committee. Can the Minister enlighten us as to why the Government have decided to break the mental health investment standard after nearly a decade of progress? Does he think the percentage is now about right? Does it concern him that some ICBs have cut funding for mental health services? How does he expect that to impact on patients suffering from eating disorders? I am particularly concerned about the impact on children and young people, and I declare an interest as a consultant NHS paediatrician. Some 6.4% of adults have a diagnosed eating disorder, but 12.5% of 17 to 19-year-olds have been diagnosed with an eating disorder since 2023. That amounts to one in five girls in that age group—four times the prevalence in boys. What specific action is the Minister taking to improve early intervention? The previous Government got the ball rolling on establishing mental health support teams in schools, and had reached 35% coverage by the time of the general election, with a commitment to increase that to 100% of schools and colleges in England by 2030. Does the Minister plan to build on that work? What further action is he taking to improve links between eating disorder services, schools and families to ensure a joined-up approach to accessing specialist help and early diagnosis, which, as we have heard, is critical? The hon. Member for Didcot and Wantage (Olly Glover) spoke of the challenges of transition. As a paediatrician, I see the challenges of transitioning many paediatric and adolescent conditions between children’s and adult services, but can the Minister say what he is doing specifically for those transitioning with eating disorders? In my role as chair of the APPG on emerging drugs and online behavioural trends, I know the effect of social media on children’s and young people’s behaviours. Researchers from University College London, who examined evidence from 50 studies in 17 countries, found that social media usage is linked to eating disorders in young people, as it viciously promotes the idea that it is essential to be thin and fit, triggering a potentially extreme preoccupation with body image, weight and shape. Those obsessions are compounded by AI content, which can depict simply unachievable so-called perfection. As the hon. Member for Bath said, there are harmful videos online, with algorithms driving that harm, and those who look at these things seeing them more and more. I recently held a policy debating competition among year 10 and year 12 students in my constituency, where students chose the topic of debate. Many of them spoke in favour of a social media ban for children as young as 16. It is a difficult issue, and that is not a perfect solution, but having just got a new mobile phone myself, I wonder why, when someone buys a phone, it cannot be set at a fixed age that can be changed only by the adult who pays the bill. A change in the law to restrict social media for under-16s would help to reduce that problem. I am interested in the Minister’s thoughts on that. NHS guidance on eating disorders for ICBs has been raised in the debate. The NHS has refreshed that guidance, which is welcome, but patients will feel the difference only if it is actually implemented. The Minister has confirmed that there will not be a dedicated strategy for eating disorders, and there is no mention at all of eating disorders in the 70,000-word 10-year plan. Is the Minister confident that the refreshed guidance for ICBs will be sufficient on its own to improve care for people with eating disorders and to get waiting lists down? Does he have a strategy for how it will be enforced? We have talked about the effects on families and carers. What action is the Minister taking to engage families, carers and supportive charities in plans for care? What support is available for parents, carers and siblings? Workforce is key to delivering this strategy. We know that waiting times for eating disorder treatment are getting worse; analysis from Beat found that, in some cases, people with eating disorders face a three-and-a-half-year delay between falling ill and starting treatment. For someone with an eating disorder, that is three and a half years deeper into the illness. As we have heard, that makes it all the more difficult to treat the patient effectively and quickly pull them out of that difficult, dark place. What steps is the Minister taking to increase workforce capacity to help treat these patients and restore some stability and normality to their lives? I feel as though I ask this question every time, but the NHS long-term workforce plan is still not with us, having been delayed from last year, so when will it be published, and what tangible action will it take to boost the NHS eating disorders service? It is not just about hiring more staff; it is also about where we are hiring them. That is important work, but more needs to be done to build on the progress. The Healthcare Quality Improvement Partnership produced a highly detailed report about in-patient eating disorder service provision in the UK. As expected, there were blackspots for those vital services in many rural and coastal areas, such as in Lincolnshire. For adults and families in constituencies such as mine, where the closest service may be an hour’s car journey away, accessing eating disorder services is remarkably difficult. The Government have been insistent that rural and coastal areas will not be left behind on healthcare, but the blackspots tell us otherwise.

• 26 Feb 2026 · Eating Disorders Awareness Week · Hansard source

  More

  I completely agree. This is not just about people who have a car; for people who do not have a car and who are reliant on public transport, it can be even more difficult. People also struggle to take time off work because of the financial cost. For those who do have a car, there is also the cost of the petrol or diesel to get to the appointment. I would appreciate it if the Minister could update us on what he is doing to ensure that the neighbourhood and community slant of the three pillars of his health improvement plan are working in that regard. As the hon. Member for Bath said, in-patient services are limited in capacity. In my paediatric practice, I have seen patients waiting on acute general paediatric wards—sometimes for several weeks—but those are really not the right place for them to be cared for. Could the Minister update us on what he is doing about increasing capacity in regional services? I would like to speak a little about two other types of eating disorder: avoidant/restrictive food intake disorder and Prader-Willi syndrome. ARFID involves limiting the amount or variety of food consumed. It is not just picky eating. I have seen a teenager who lives on just plain pasta, nuggets and chips, and a younger boy who lives on a single flavour of one brand of milkshake and no solid food at all. That can be driven by fear and sensory and other issues. What is the Minister doing to make sure that services are available for these young children? NHS England’s refreshed eating disorder guidance recommends: “ICBs should develop and deliver ARFID care pathways”. What steps is the Minister taking to improve early diagnosis of ARFID, and what work will be done to train primary carers to identify it in children and adults, particularly in cases of neurodivergence? Prader-Willi syndrome is a rare genetic disorder causing excessive appetite and overeating, which can lead to dangerous weight gain and restricted growth. Around 2,000 people live with Prader-Willi syndrome in the UK, and there is no cure. It is not mentioned in the NHS guidance, so what work is the Minister doing to ensure that people suffering from PWS have access to the care they need? What steps are we taking to expand genetic testing at birth to identify PWS and improve early access to treatment for these patients? To sum up, mental health challenges are on the rise, and eating disorders are no exception. I urge the Minister to implement a clear approach to tackling eating disorders for adults, children and young people.