Caroline Johnson MP: speeches

Speeches

• 7 Sept 2026 · Local Government Reorganisation · Hansard source

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  The Labour leader of City of Lincoln council has put forward suggestions that votes should be weighted on the basis of deprivation, leading to proposed wards with an electorate of 2,100 electors per councillor and others with 4,700 electors per councillor. Does the Secretary of State agree that all our votes should be created equal?

• 7 Sept 2026 · Health Bill · Hansard source

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  I will try to keep my remarks brief. I thank my right hon. Friend the Member for Daventry (Stuart Andrew) for all the hard work he has done over the past year in holding the Government to account on health and social care, the whole Conservative health team for their support, and every member of the Committee that, as the Minister said, scrutinised the Bill in detail in such a hot and sticky room before the summer. I also thank my parliamentary team for their support. Finally, I congratulate the Minister on her reappointment and thank her for the time that she has taken to engage with the Opposition on the Bill. I must also declare an interest as an NHS consultant paediatrician, a member of the British Medical Association and a member of the Royal College of Paediatrics and Child Health. This is not a small Bill. It runs to more than 200 pages, and there are almost as many pages of amendments, with around 180 different MPs signing or supporting different amendments. I do not agree with every one, but I welcome thoughts and ideas from right across the House—well, from most of the way across the House; we did not see much from Reform. The Bill has scale, but does it have direction and clarity of purpose? Leadership sets direction—a destination—and from that follows a path, as smooth as possible, from A to B, with appropriate milestones. However, the Bill, like so many of this Labour Government’s, came as an announcement without enough thought. Let us go back. The Government started with the Darzi report. I will not restate the arguments about why it was done or the weakness of the claims that it is independent, but suffice to say it is their report, published by a Labour peer and former Labour Minister for a Labour Government. It says a few things about reorganisation. Lord Darzi wrote that “a top-down reorganisation of NHS England and Integrated Care Boards is neither necessary nor desirable”, yet the Government decided to abolish NHS England, restructure the ICBs and halve the ICBs’ budgets all at once, without properly planning for what would come next. That is clause 1—abolishing NHS England. One of the main arguments provided related to the unnecessary bureaucracy and duplication of staff. As a Conservative, I accept that there is a strong case for efficiency: the Government must use taxpayers’ money wisely. In a letter that the permanent secretary sent to the Public Accounts Committee, officials estimated savings of £1 billion a year by abolishing NHS England and redundancy cost payments of approximately £1 billion to £1.3 billion, but we have not seen the calculations behind that. It was announced in March 2025 that the restructure would be completed in two years, yet we are now 18 months in and Ministers do not seem to be on track. From March 2025 to July 2026—a year, and three quarters of the time they have given themselves—total headcount across NHS England and the Minister’s Department decreased by 12.9%, which is nowhere near what the Government need to deliver their promised savings. We have therefore tabled amendment 102, which would require the Government to publish a full workforce transition plan, and new clause 153, which would require the Government to publish precisely how many people they make redundant. I would like to raise a contradiction: the Government talk a lot about devolution and local decision making, but the Bill does the opposite. It will remove councils of governors from foundation trusts, give Ministers the power to hire and fire health leaders, and put an end to local Healthwatch. It will give the Secretary of State the power to set and adjust annual funding allocations for ICBs, and direct them to ringfence funding for service integration. It takes away local decision making. The Bill is also inconsistent with what the Prime Minister said the other day. In response to a question about the Bill, he said: “I do not like the idea of a postcode lottery in the national health service.” —[ Official Report , 1 September 2026; Vol. 790, c. 61-62.] But if decisions are taken locally, they will be different in different areas, which will lead to a postcode lottery. Will Ministers shed some light on what they actually believe? Do this Government want decisions made locally and accept that those will be different, or do they want decisions made centrally? Lord Darzi said something else in his report: “Constant reorganisations are costly and distracting. They stop the NHS structures from focusing on their primary responsibility to raise the quality and efficiency of care in providers.” Indeed. In fact, that is not too dissimilar from what the Minister for Secondary Care herself previously concluded, when in opposition. She said: “The reorganisation of health services always distracts from people’s jobs, destroys morale and wastes money”. —[ Official Report , 22 September 2020; Vol. 680, c. 809.] How is the NHS performing? Let us take a look. The total number waiting for appointment has gone down a bit, as the Government have said, but in trauma and orthopaedics, ophthalmology, cardiothoracic surgery, elderly medicine and gynaecology, it has gone up, and in some cases is higher than it was before the election. For those waiting for an admission who need a procedure or an operation, it is not only going up month on month and year on year; it is higher than it was at the time of the general election. What about accident and emergency? The number of people waiting for more than 12 hours after a decision to admit was 29% higher in July 2026 than in July 2024, and that is despite the fact that there were fewer such admissions in July 2026 than in July 2024. How have the Government performed in other health areas? Childhood vaccination rates are in decline. The workforce plan has not been published, despite the Minister saying it was “imminent” months ago. Fracture liaison clinics have not been delivered, despite allegedly being one of this Government’s planned “first acts”. I could go on, but we do not have much time, and I think I have demonstrated the point: NHS reorganisation is distracting from delivery. One of the things I want to talk about that the Government are not delivering is the response to the Hughes report. I thank Dr Henrietta Hughes, the Patient Safety Commissioner, for her hard work on the report. When the trauma and suffering that some people, particularly women, have experienced from mesh repairs, and the harm that children have suffered because of exposure to valproate in the womb, became apparent, we were all horrified. The previous Government changed the way that valproate was prescribed and commissioned regional surgical centres of excellence to provide care for women who suffer from the effects of a mesh repair. The Conservative Government also commissioned the Hughes report, published in February 2024, that investigated compensation schemes for those affected, but the general election was called just three months later, so delivering compensation and on the report became the Labour Government’s job. Sadly, Ministers have dithered and delayed for more than two years now. We have had written question after written question, several debates and a lot of warm words, but still no response to the report. It is simply not good enough. Those suffering should not have to wait any longer, and that is why we have tabled new clause 145, which would provide a legal backstop, ensuring that the Government publish their response to the Hughes report within 30 days of the Bill becoming law at the latest. That is still not soon enough for those affected, but it is the only way of putting in an effective backstop so the Government can stop fobbing off victims and start delivering justice. Let me turn to other amendments. The Government announced out of the blue that ICB running costs will be halved. Why 50%? I have no idea, but ICBs scrambled to respond. We know from those inside the health service that it has been a major distraction, with a massive opportunity cost for patient care. When the Bill came, Ministers chose to change the composition of ICBs, too, removing the voice of hospitals and primary care from boards as well as the voice of local authorities, severing that link with social care. Integrated care partnerships will also be abolished. There will instead be a focus on mayoral representation, even for mayors where there is little role, if any, in delivering social care. In Lincolnshire, for example, instead of a local authority and an ICB on the same geographical footprint working together over the same area to cover health and social care, we now have the Government conspiring to give us an ICB covering three counties, with no voice for the local authorities, which are unsure after today’s announcement whether they will be split up. We discussed at some length in Committee the importance of health and social care working together, so I welcome the Government’s U-turn on day one of this term to reinstate local authority representation, but I urge the Minister to consider, as the Opposition parties have proposed, reinstating primary care and secondary care representatives, too. Given the time, I will speak briefly to the three amendments on workforce. First, new clause 154 would require the Secretary of State to increase the number of medical school training places to 15,000 by 2031-32. Why? Put simply, because they promised they would and they have not. Secondly, new clause 152 is on merit-based applications. Doctors used to be allocated their first jobs through a system based on performance—that was the case when I was a junior doctor. Now it is done by computer algorithm prioritising choice. This is unfair, demoralising and destroys the incentive to study hard. We believe in meritocracy, and I urge the Government to accept the new clause. Thirdly, I urge the Government to support new clause 144, which would address the plight of a small but significant group of people: a group of medical students subject to a great injustice. These are British citizens studying at a British university, predominantly Queen Mary University in London, who were told four and a half years into their degree that they would not be able to have places on the foundation programme but would be at the back of the queue. The Medical Training (Prioritisation) Act 2026 has meant that non-prioritised doctors got only 1.8% of the jobs—the last 1.8% left. That was the point of the Bill, but the Government should put this particular group of British citizens into the priority group. We will no doubt talk about our other amendments in the Lords. New clause 155 on self-care would give people more autonomy over their own care. New clause 101 is on the national commissioning of low-volume, high-complexity services, and would ensure that the Government cannot just move them into ICBs without a proper consultation and plan. Amendment 95 on the patient choice duty would ensure that patients have choice over the care they receive in neighbourhood services as well as hospital services. Amendment 88 is on the single patient record. The single has the potential to be truly transformative, bringing the NHS in line with other modern healthcare systems. It can prevent people from having to repeat themselves. But there are lots of questions for the Government that have not been answered. This is another example of making an announcement without thinking it through. How will existing health records be linked? How will patients, carers and clinicians have access? Who will control the data? How will it be kept safe? Amendment 88 would require the Secretary of State to publish a full plan before making changes. There are some parts of the Bill that the Opposition can support, but in the Government’s hurry to make announcements, they often do not seem to think things through properly. That is the story of local government reform that we heard in the House earlier today; it is the story of the much-delayed workforce plan; and it risks becoming the story of this NHS reorganisation. In health, there are life and death situations, so we cannot afford for the Government to get it wrong. The Opposition have made a series of sensible amendments and will be grateful for the Minister’s support.

• 4 Sept 2026 · Infants, Parents and Carers Bill · Hansard source

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  I congratulate my right hon. Friend the Member for New Forest West (Sir Desmond Swayne) on bringing forward this important Bill and on winning first place in the ballot. I would like to put on record my thanks to the hon. Member for Washington and Gateshead South (Mrs Hodgson) for her work on this topic. I also thank Will Quince and Andrea Leadsom and the 1001 Critical Days Foundation for their work. I must declare an interest: I am a consultant paediatrician, a member of the Royal College of Paediatrics and Child Health and a mother of three. The Chair of the Education Committee, the hon. Member for Dulwich and West Norwood (Helen Hayes), spoke of the importance of universality and concerns faced by all parents, especially first-time parents, and I agree. I was very familiar with babies when my first was born—I was working as a registrar in a large, highly specialised neonatal intensive care unit looking after babies with sepsis, babies born months early and those who were having surgical operations—but being a parent is different: the love, the joy, the sheer responsibility of looking after that little bundle of love. I am grateful to the midwives who provided me with support at that time, and I particularly remember Marie, who was good to me throughout all three of my pregnancies. The 1,001 day window from conception to age two is crucial. It is where the human brain is most malleable. It grows and develops rapidly and is making literally millions of connections. The care received and the opportunities provided through that period affect brain growth and the child’s development. Positive interactions—play, reading, singing and cuddles—strengthen that process. They improve brain connections, support healthy development, and improve emotional regulation and social skills. This continues into the long term. Sadly, the converse is also true: unresponsiveness, neglect and trauma interfere with this biological process. They disrupt the white matter structure connections. They affect a child’s brain growth. Successive Governments have recognised how crucial the early years are, and have tried a combination of various types of services—some universal, some targeted, but all with the same aim of improving children’s lives. Sure Start has been mentioned. The ringfence was removed, allowing local decision making—I believe that the new Prime Minister calls this “devolution”. The overall budget was strained, resulting in difficult choices, and under pressure, councils of all colours made some unwise decisions to cut some services. Previous Conservative Governments tried to support children with funded nursery and childcare hours, tax-free childcare and family hubs. In a recognition that children spend most of their time at home, the Hungry Little Minds programme supported parents in helping their children at home. The 1,001 days from conception to two years are key, but I draw the House’s attention to the fact that care for a baby can start before conception. The national health service website advises women considering a pregnancy to ensure they have had a measles, mumps and rubella vaccine, smear test and sexually transmitted infection checks; have stopped smoking; and are a healthy weight. It advises them to take vitamin D and folic acid, and to discuss any prescription medicines with their general practitioner to see whether they are suitable for pregnancy. The Government have ensured that, by the end of this year, non-wholemeal wheat flour must be supplemented with folic acid, which will reduce the number of neural tube defects. The Tobacco and Vapes Act 2026, when it starts to have effect, will also help to reduce problems in pregnancy. The Bill has been produced with the support of the Department of Health and Social Care, but it requires work across Government. It is not just the health service that will deliver better opportunities for children. There is obviously a role for the Department for Education, and things like air quality, transport services for people to access the services provided, and a strong wider economy are all important. My hon. Friend the Member for Bexhill and Battle (Dr Mullan) said that fewer people live near their extended family than was previously the case. That is something important to consider as we ensure that people have local support. The Bill will put children’s services on a statutory footing, but regulations will determine what that means. I am particularly interested in whether the Bill would have helped to protect two services that were given to my constituents. The Safe Families edge of care service provided befriending, practical help at home and daytime care. It ended on 30 June and has not been recommissioned by the Reform county council. This service tried to help children and families who were in difficulty and whose children were at risk of being taken into care; it tried to keep families together while ensuring that the child was safe. That has been cancelled. Reform also stopped Lincolnshire county council’s voluntary youth services grant funding. I am interested in understanding the Government’s plan for the regulations, because although the Bill protects services, regulations will say what those services will be and whether they will be funded. I am interested in hearing from the Minister about that. I am also interested in the use of the services themselves. We had a debate on vaccinations in Westminster Hall just the other day. Vaccinations are available for free for everyone, but not everyone takes them up. We can have the best services in the world, but if they are not used by the people who need them, they will not be effective. I am interested in understanding how the Minister intends to ensure a good uptake of the services. Every single baby is precious. As we have heard, everyone across this House wants children to have great opportunities. We all want them to achieve their best potential. That requires teamwork—parents, wider family, friends, community and tax-funded services. We must all play our part. Supporting the Bill may help to support children, and I will support it today.

• 16 Jul 2026 · Health Bill (Seventeenth sitting) · Hansard source

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  New clause 87 would amend the Medical Training (Prioritisation) Act 2026 so that British citizens who have studied at international branch campuses of UK higher education institutions can be prioritised for foundation programme training places. Prioritising British students in the selection process would have been the right thing for the Government to do, but way the Medical Training Act has been drafted places British students who studied at international branch campuses of British universities at a disadvantage. On Second Reading of the Act, a Member spoke of a constituent who had been given “a formal guarantee that he would be at no disadvantage if he chose to study at the Malta campus.” —[ Official Report , 27 January 2026; Vol. 779, c. 801.] Another Member said that he had “representations from all quarters, both in the UK and in Malta, about the impact on Malta of this.” —[ Official Report , 27 January 2026; Vol. 779, c. 802.] My right hon. Friend the Member for South West Wiltshire (Dr Murrison) asked about “British students who for various reasons train at, for example, St George’s in Cyprus or St George’s in Grenada and who then want to come back and practise in our national health service”. —[ Official Report , 27 January 2026; Vol. 779, c. 803.] The hon. Member for Uxbridge and South Ruislip (Danny Beales) spoke of a constituent who was schooled and grew up here and was “given a guarantee by the university that she would face no disadvantage compared with students on the London campus.” —[ Official Report , 27 January 2026; Vol. 779, c. 842.] These concerns are shared across the House. Young British people who have trained at a British or London-based university and gone to study in Malta, perhaps in an adventurous spirit—it is a beautiful place to go—and have graduated with a British degree have found themselves at the back of the queue, unable, round after round, to get jobs in the foundation programme in their home country. That will not just be the case for students who are due to start their degree; it is the case for students who have just completed their degree. They have done the five years of training, they have worked really hard and they have passed their exams, but suddenly they cannot get a job on the foundation scheme in their home country to complete their full registration with the General Medical Council. Our new clause would ensure that British citizens who studied at international branch campuses of UK higher education institutions can be prioritised. I invite Members to do right by our constituents and the NHS and to vote for it.

• 16 Jul 2026 · Health Bill (Seventeenth sitting) · Hansard source

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  I beg to ask leave to withdraw the motion. Clause, by leave, withdrawn. New Clause 52 Access to dental provision: Dental deserts “(1) Within six months beginning on the day on which this Act is passed, the Secretary of State must establish a scheme to improve access to dental provision (‘the Scheme’). (2) The purpose of the scheme is to end dental deserts. (3) A dental desert is defined as any local authority area with fewer than ten active dental practices per 100,000 people. (4) The scheme must make provision to support integrated care boards to— (a) guarantee emergency access to an NHS dentist, (b) provide free dental checks up for— (i) children, (ii) mothers within one year of having given birth, (iii) pregnant women, and (iv) low-income households, and (c) guarantee dental appointments for persons commencing— (i) surgery, (ii) chemotherapy, or (iii) transplant procedures. (5) The Secretary of State must, before publishing the scheme, issue a reformed dental contract. (6) The Secretary of State must, within six months of the establishment of the scheme, publish a dental workforce plan to support delivery of the scheme.”— (Helen Morgan .) This new clause would establish a scheme to support integrated care boards to end dental deserts. Brought up, and read the First time. Q uestion put, That the clause be read a Second time.

• 16 Jul 2026 · Health Bill (Seventeenth sitting) · Hansard source

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  I beg to move, That the clause be read a Second time. The new clause is a probing amendment. The aim is to press the Government to explain why the Bill does not include provisions to implement statutory regulation of NHS management, as they had said they would, and to commit to a timetable for bringing the regulations they promised into force. I am an NHS consultant paediatrician and am regulated as such by the General Medical Council. The GMC regulates doctors, the Nursing and Midwifery Council regulates nurses and midwives, and different bodies represent other professionals in the health service—but not managers. The Government said that there would be such a register. I know that there are many excellent managers—the Minister was one—but as in every profession, bad apples need to be identified and managed appropriately. The Times has reported that senior bosses at Leeds teaching hospital NHS trust asked consultants and nurses to work in ways that lie outside the national service recommendations. We have also heard from Donna Ockenden that of the 66 former senior staff members in Nottingham she approached, only 35 agreed to be interviewed. The former Secretary of State for Health and Social Care, the right hon. Member for Ilford North (Wes Streeting), has said that he finds it “unconscionable that people who worked for the NHS would deny them”— the families— “an honest account of what went wrong”. Establishing a register would be the first step in ensuring that bad apples can be held to account. Those who bully staff, cover up problems, endanger patients or misappropriate funds should not be allowed to fail upwards. The NHS benefits from having outside experience, including from the private sector and the armed forces, so I am looking not for full occupational licensing, but simply for a register of those who are not suitable to be appointed. We should not see managers going from one trust to another and another after they fail at the first. I should finish by declaring that I worked at Nottingham University hospitals NHS trust during late 2012 and early 2013.

• 9 Jul 2026 · Health Bill (Fifteenth sitting) · Hansard source

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  I rise to speak to new clauses 14, 79 and 80, tabled by the Liberal Democrats. New clause 14 would require the Secretary of State, within six months, to establish a statutory target for healthy life expectancy in England and then to produce a strategy every two years to meet that target. This is not the first time the House has heard about life expectancy targets; as I am sure you will remember, Ms Lewell, the previous Government’s 2022 levelling-up White Paper talked about narrowing the gap in healthy life expectancy between the areas where it is highest and lowest, and aimed for healthy life expectancy to rise. As the hon. Member for Winchester said, life expectancy has increased quite dramatically over the last century, but that is largely due to improvements in child mortality. That is a good thing, but it is worth looking at how healthy life expectancy is calculated. The Sullivan method starts by looking at mortality rates over a specific timeframe for a specific population, and then takes data from a cross-sectional study where people are asked to rate their own health, multiplies them together and produces a figure for healthy life years. Therefore, the main element that separates healthy life expectancy from unhealthy life expectancy is survey responses; it is not a clinical metric. If somebody on a huge amount of medication and treatment feels healthy, they are healthy. If someone on very minor treatment feels unhealthy, they are unhealthy. It is a self-reported measure. The Government’s website says that if mortality improves by 2%, healthy life expectancy increases a very small amount; if self-reported feeling healthy goes up 2%, there is a much bigger increase in healthy life expectancy. We want people not just to live longer but to live well, but it is a case of how we measure it and how we ensure that there are no perverse incentives. We should look at it over time in the same individuals. How do people feel when they get up in the winter, when it is cold, dark, raining or icy? They may feel less healthy than when the sun is shining, it is the weekend or England have won the world cup. The Government’s own figures show that musculoskeletal health is particularly important. Musculoskeletal conditions are prevalent among 17.2% of the population, and people with them are three times more likely to have self-reported ill health. We have asked before if the Government will introduce a modern service framework on musculoskeletal disease, having scrapped our long-term conditions strategy. I would be grateful if the Minister could say whether the Government have given more consideration to that and are now willing to do an MSF on musculoskeletal health. New clause 79 would require the Government to create a committee across Government, including the Prime Minister, all Cabinet members and one Minister from each Department. The idea behind the new clause—that we need to work together—is important, but I would be grateful for the Minister’s comments on how feasible, practical and effective that would be. Finally, new clause 80 concerns the duty to promote public health. Of course, it is the Minister’s duty to do his or her job, and part of that is promoting public health. What does the Minister think the practical effects of that new clause would be on bureaucracy in Departments?

• 9 Jul 2026 · Health Bill (Fifteenth sitting) · Hansard source

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  I thank the Minister for her good wishes. The council has not just proposed closing Swallow Lodge; it has also recently closed the memory support service. I listened to what my hon. Friend the Member for Isle of Wight East said about services for people with dementia, and this is another area where people will suffer because of the closure of vital services.

• 9 Jul 2026 · Health Bill (Fifteenth sitting) · Hansard source

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  I beg to ask leave to withdraw the motion. Clause , by leave, withdrawn. New Clause 28 Appeals against health and social care provision in EHC plans “(1) The Special Educational Needs and Disability Regulations 2014 (S.I. 2014/1530) are amended in accordance with subsections (2) and (3). (2) After regulation 42, insert— ‘42A Other matters relating to EHC plans against which appeals may be brought (1) In addition to the matters set out in section 51(2) of the Act, a child’s parent or a young person may appeal to the First-tier Tribunal against the matters set out in paragraph (2), subject to section 55 of the Act (mediation). The matters are— (a) a decision of a local authority, following an EHC needs assessment, that it is not necessary for health care provision or social care provision to be made for the child or young person in accordance with an EHC plan; (b) where an EHC plan is maintained for the child or young person— (i) the child’s or young person’s health care or social care needs as specified in the plan; (ii) the health care provision or social care provision specified in the plan.’ (3) In regulation 43 (appeals), after paragraph (2) insert— ‘(3) When determining an appeal on the matters set out in regulation 42A(2)(a), the First-tier Tribunal has the power to order that— (a) health care needs, or health care needs of a particular kind, which relate to the child or young person's special educational needs are specified in the EHC plan in accordance with regulation 12(1)(c); (b) social care needs, or social care needs of a particular kind, which relate to the child or young person's special educational needs or to a disability are specified in the EHC plan in accordance with regulation 12(1)(d). (4) When determining an appeal on the matters set out in regulation 42A(2)(b), the First-tier Tribunal has the power to order that— (a) the health care needs specified in the EHC plan in accordance with regulation 12(1)(c) are amended; (b) the social care needs specified in the EHC plan in accordance with regulation 12(1)(d) are amended; (c) health care needs, or health care needs of a particular kind, which relate to the child or young person's special educational needs are specified in the EHC plan in accordance with regulation 12(1)(c) where those needs have not been specified in the plan; and (d) social care needs, or social care needs of a particular kind, which relate to the child or young person's special educational needs or to a disability are specified in the EHC plan in accordance with regulation 12(1)(d) where those needs have not been specified in the plan. (5) When determining an appeal on the matters set out in regulation 42A(2)(a), the First-tier Tribunal has the power to order that— (a) health care provision, or health care provision of a particular kind, is specified in the EHC plan in accordance with regulation 12(1)(g); (b) social care provision, or social care provision of a particular kind, is specified in the EHC plan in accordance with regulation 12(1)(h). (6) When determining an appeal on the matters set out in regulation 42A(2)(b), the First-tier Tribunal has the power to order that— (a) the health care provision specified in the EHC plan in accordance with regulation 12(1)(g) is amended; (b) the social care provision specified in the EHC plan in accordance with regulation 12(1)(h) is amended; (c) health care provision, or health care provision of a particular kind, is specified in the EHC plan in accordance with regulation 12(1)(g) where that provision has not been specified in the EHC plan; and (d) social care provision, or social care provision of a particular kind, is specified in the EHC plan in accordance with regulation 12(1)(h) where that provision has not been specified in the EHC plan. (7) When the First-tier Tribunal makes an order in respect of health care needs or health care provision, it must send a copy of the order to the responsible commissioning body. (8) When sending a copy of an order, the First-tier Tribunal may also send a copy of the decision which disposes of any appeal brought under section 51(1) of the Act or under regulation 42A to the responsible commissioning body. (9) The responsible commissioning body must respond within 5 weeks beginning with the date of the order to— (a) the child's parent or the young person, and (b) the local authority that maintains the EHC plan. (10) The time limit specified in paragraph (9) does not apply where the First-tier Tribunal directs that a different time limit is to apply for the responsible commissioning body's response. (11) A response under paragraph (9) must— (a) be in writing, (b) state what steps, if any, the responsible commissioning body has decided to take following its consideration of the order, and (c) give reasons for any decision not to follow the order, or any part of it. (12) The local authority must send a copy of the response received from the responsible commissioning body under paragraph (9)(b) to the Secretary of State within 1 week beginning with the date it was received. (13) When the First-tier Tribunal makes an order in respect of social care needs or social care provision, the local authority must issue the amended EHC plan to the child's parent or the young person within 5 weeks beginning with the date of the order. (14) The time limit specified in paragraph (13) does not apply where the First-tier Tribunal directs that a different time limit is to apply. (15) The local authority must send a copy of the amended EHC plan under paragraph (13) to the Secretary of State within 1 week beginning with the date on which this is issued to the child's parent or the young person.’ (4) The Special Educational Needs and Disability (First-tier Tribunal Recommendations Power) Regulations 2017 (S.I. 2017/1306) are revoked. (5) In consequence of the revocation made by subsection (3), the following 15 provisions of the Special Educational Needs and Disability Regulations 2014 are also revoked— (a) regulation 10(3)(e); (b) regulation 14(2)(e); (c) regulation 201(11)(e); (d) regulation 21(10)(e); (e) regulation 22(5)(e); (f) regulation 25(2)(e); and (g) regulation 31(3)(e).”— (Dr Chambers.) This new clause extends the powers of the First-tier Tribunal so that when it is determining an appeal it may order that Education, Health and Care plans must include health and social care needs and provision, rather than just making recommendations on these matters. Brought up, and read the First time.

• 9 Jul 2026 · Health Bill (Fifteenth sitting) · Hansard source

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  This group of new clauses is about carers and how we look after them. They do so much work for so many people across the country by looking after their loved ones. Many of them are not necessarily in good health themselves, and some are even children. These new clauses have a positive intention: to try to improve carers’ lives and make sure that they are recognised. I congratulate the hon. Member for Winchester on his success in keeping open his respite care centre. Perhaps he could share his notes with me, because the Reform county council in Lincolnshire is currently trying to close Swallow Lodge, a respite care centre that provides for people of working age who have severe disabilities. The council wants to close it, and the people there are devastated by that suggestion. We had a public meeting, which many people came to, and they had not been consulted at that point. I think that an assumption was made that they are not able to communicate, but many of them are able to do so with support. However, that communication had not happened. It has caused fear for people. They are worried about where they will go instead and whether it will be suitable. What about the people they made friendships with at the centre? Many of them have elderly parents—in their 80s, in some cases. It is also economically short-sighted, because people may end up going into full-time care, which will ultimately cost the council more. The council has now been persuaded to do a full consultation, which will happen over the next few months. If the hon. Member can share anything with me that was successful for him that could help me keep Swallow Lodge open against the Reform county council’s changes, I would be very grateful.

• 9 Jul 2026 · Health Bill (Fourteenth sitting) · Hansard source

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  I want to briefly discuss these new clauses because I think that they are important, particularly because they were tabled by the hon. Member for Worthing West (Dr Cooper), who is an expert in the field. New clauses 11 and 24 relate to directors of public health. We know from the Government that prevention, and therefore public health, is extremely important. New clause 11 says: “Each integrated care board must, for the purposes of exercising any public health functions directed by the Secretary of State, appoint a lead director of public health.” New clause 24 sets out the requirements and functions of directors of public health—what such an individual will do. Currently, every local authority must have a director of public health, which is set out in statute. They focus on three areas: health protection, health improvement and healthcare public health. They take the evidence in relation to their population, produce a vision, develop aims, deliver those aims and then produce a report annually to say how they are getting on with that process. The National Health Service Act 2006 says that that must be done across an upper tier or unitary local authority area, and that directors of public health must provide advice about public health to any ICBs that overlap with their area. ICBs also have a legal duty to seek advice on protecting public health when they are exercising their functions. I think that we all agree across the Committee that public health is important, but I do have some questions. Unfortunately, the hon. Member for Worthing West is not a member of the Committee, so she is not able to respond to any questions today. We have talked in this Committee about the representation of local authorities on ICBs and the fact that Government cuts of 50% have led to a merging of ICBs in a somewhat haphazard fashion, which means that there can be a clash between different areas. I guess that my question for the Minister would be this: if this clause were to come into force and the ICBs that are no longer coterminous with the local authority upper-tier or unitary authority areas, would there be a duplication of work? My other concern would be that it would lead to a situation where there might be one director of public health with a vision to go one way, and another with a direction to go the other way. If that happened, how would the negotiation process work? I think this measure was brought in with good intent by a lady who is an expert in the field, but I have more questions than answers about how the clause will work in practice.

• 8 Jul 2026 · NHS Corridor Care · Hansard source

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  I should begin by declaring my interests as a member of the British Medical Association, a member of the Royal College of Paediatrics and Child Health, and an NHS paediatric consultant. I thank the hon. Member for Tooting (Dr Allin-Khan) for initiating the debate. I know that, as a practising doctor like me, and, in particular, as someone who works in an emergency department, she understands the importance of this subject. Let me also pay tribute to the staff who work throughout our health service, some of them in quite difficult circumstances. I am glad to respond to this debate on what is a very important but very difficult issue. Every day in May, nearly 3,000 patients spent time in so-called clinically inappropriate spaces. These may be corridors, but as we have heard, they may also be cupboards or waiting areas. That is not good enough. Corridors are no place to provide clinical and nursing care. There is no privacy and dignity for people getting changed or being examined, and others may overhear what is said about their medical conditions. It is not safe. The hon. Member for Mid Sussex (Alison Bennett) pointed out the infection control risks. Availability of oxygen has also been mentioned. If someone has a cardiac arrest and collapses, where is the space for them to be looked after? I wonder if the Minister can tell us whether the Government intend to support new clause 84 of the Health Bill when we discuss it in Committee, probably next week. The new clause requires the number of patients who have died when 12-hour waits in A&E departments were a contributory factor to be recorded. We have heard upsetting stories this afternoon, and I have heard some myself in my constituency, including that of a gentleman who sat for more than 60 hours in a plastic chair while receiving intravenous antibiotics for sepsis. These are all examples of a much broader and more serious problem. Every day, patients, often frail and elderly, are kept for hours on trolleys in corridors or on chairs in waiting rooms. As we heard from the hon. Member for Stroud (Dr Opher), we have an ageing population, so this problem is applying more pressure. A&E attendances increased by 2.5% last year. The latest figures show that in May this year alone, 50,212 patients waited in A&E for more than 12 hours after a decision to admit them to hospital. That represents a 17.1% increase since last May. Last year, the Government produced their urgent and emergency care plan, in which they set their targets, including the target for an absolute minimum of 78% of patients to be admitted, transferred or discharged within four hours. That target is well below the NHS constitutional standard, but, furthermore, the latest NHS data shows that the Government have missed it, with 25.7% of patients seen within four hours in May 2026, down from 76.9% in the previous month. Things are actually going in the wrong direction. We need to consider why patients are being cared for in corridors. Essentially, it is a reflection of the lack of appropriate spaces, often spaces in an in-patient ward. We therefore need a structured plan. The hon. Members for Shipley (Anna Dixon) and for Worthing West (Dr Cooper) spoke about where we should start. We should start with prevention, care at home and virtual wards. We need to think about delivery in rural areas. The hon. Member for Bury St Edmunds and Stowmarket (Dr Prinsley) talked about care and treatment in the community, and others have talked about improved social care. I hope the Minister will tell us whether, when we debate the Health Bill in Committee, she will accept new clauses 105 and 106, which relate to how people can care for themselves, to education and to the safety and classification of prescription-only medicines, so that the more simple conditions can be managed closer to home by pharmacists.

• 7 Jul 2026 · Health Bill (Thirteenth sitting) · Hansard source

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  Clause 64 abolishes Healthwatch England, which I believe is a mistake, and introduces schedule 9 to facilitate that. The impact assessment talks about the roles of local healthwatch and Healthwatch England, with local healthwatch obtaining views, making reports and recommendations, promoting and supporting public institutions, signposting to advice, and giving views to Healthwatch England nationally; and Healthwatch England then providing leadership, guidance and support to local healthwatch, escalation to the CQC, which we have heard a lot about already, and advice to the Secretary of State or NHS England. Members may be familiar with the term “nothing about us without us”—the idea that policies should not be decided and services should not be shaped without the participation of those who will use those services or be affected by the decisions that are made. As a medical practitioner, I believe that is an important principle. Patients must have a voice, because it is they who have the lived experience of their conditions and know their needs better than any civil servant in Whitehall. They know what is working and what needs to change. Let us look at the history of patient voice. In the two decades after the NHS’s inception, the provision of care was really quite paternalistic. Patients did not really have any role in shaping the services that they received. That changed in 1974 with the establishment of community health councils, made up of volunteers. They carried out research, conducted visits to inspect standards and represented communities when changes were proposed. They also helped the public with information about local services, including how to make complaints—very similar processes. The Labour Government abolished community health councils in 2003, although a cursory trip to Hansard reveals that the Government repeatedly stated before the publication of the NHS plan that at that point they envisaged no immediate changes to community health councils, but they did go on to do that. That is reminiscent of what we are discussing today, because abolishing Healthwatch was not in the Labour party manifesto. In 2003, the community health councils became patient and public involvement forums, and five years later they became local involvement networks. The names and structures have changed, but the principle of patients having an independent voice remained. Healthwatch is the latest iteration. To be precise, Healthwatch England was established initially as a committee of the Care Quality Commission in 2013. It operates a hub-and-spoke model with more than 150 local healthwatches spread across local authority areas. Healthwatches play a vital role in exposing problems in the health service. Indeed, even the King’s Speech contained a reference to Healthwatch England. According to Healthwatch England’s May 2025 report, “nearly one in four…adults have noticed inaccuracies or missing details in their medical records”, such as inaccurate personal details and inaccurate records of medicines, diagnoses, treatments and conditions. I note that the Minister herself has relied on Healthwatch when bringing problems facing her constituents to the House. She said: “In a recent Adjournment debate about Bristol and the south-west, I raised the issue of a pregnant constituent who was unable to access care at that critical time. This is the No. 1 issue raised by Healthwatch. Patients are struggling.” —[ Official Report, 10 February 2022; Vol. 708, c. 484WH.] So Healthwatch is valuable. I invite Members to look at the impact that Healthwatch had in 2023-24. More than 925,000 people used their local healthwatch to get advice and information about their health and care. More than 329,000 people shared their experiences to help improve services. Healthwatch England helped to secure changes to Royal Mail so that NHS letters are delivered to patients on time. It also led new NHS guidance so that patients commencing cancer treatment have priority access to NHS dentists. A piece of Healthwatch research indicated that millions of eligible adults may be missing out on social care. Recently, my local branch, Healthwatch Lincolnshire, produced a report on the challenges facing carers nationally. Healthwatch has influenced the future of attention deficit and hyperactivity disorder care, encouraged the uptake of cervical cancer screening and so much more. That is why the public and health experts are alarmed by the Government’s plans. As for HSSIB, the success of Healthwatch is due to its independence, but the Government want to do away with that. Their policy paper commits to replacing Healthwatch with a new patient experience directorate, which will sit inside the Minister’s Department. Instead of having organisations embedded in communities sitting on local health and wellbeing boards, the public will need to interface with the Minister’s Department. How can she guarantee the independence, and the perception of independence, of the new directorate? How can she be sure the public will trust it? I remind Members of what Councillor Dr Wendy Taylor of the Local Government Association said: “The current proposals to disband Healthwatch and allow health and social care services to gather and respond to feedback, rather than being challenged by an independent voice, risks organisations being seen to mark their own homework.” When Healthwatch conducts surveys, it often solicits information that proves problematic for the Government of the day. How can the public have confidence that the new directorate’s process will do the same? What will stop the Secretary of State deciding what questions get asked and what data gets published? From my reading of the Bill, the answer is nothing. The Government have made it clear that, alongside the new directorate, ICBs will take over several patient voice functions. I appreciate that this strays slightly into the subject of the next group of provisions, Ms Lewell, but it is difficult to separate Healthwatch from local healthwatches. The Patients Association has warned: “Splitting local Healthwatch between ICBs and local authorities risks creating a patchwork of accountability with no single body responsible for ensuring patients are heard”. If responsibility to deliver those functions is shared between different parts of the health system, who becomes accountable if it is not funded? Who is accountable if people fall through the cracks? If accountability is divided, it often means that accountability is somewhat diminished. Members also need to ask whether it is financially feasible for ICBs to deliver patient voice. In its evidence, the Health Foundation wrote: “Moving the NHS functions of local HealthWatch organisations into newly enlarged ICB footprints could also result in the loss of a more nuanced local understanding of the public’s priorities and needs, with particular implications for seldom heard or more vulnerable communities.” We know that ICBs are under financial pressure because of decisions by the Labour Government; they have had to slash operating costs by 50%, and many are pencilling in cuts to frontline services. Against that backdrop, how can they afford to deliver patient voice functions? Ms Lewell, your guess is as good as mine. We have not heard about any additional funding from the Government for the purpose of patient voice. Healthwatch England was provided £3.3 million in 2025-26, and local healthwatch £14.1 million. How much of that money will be redirected to the patient experience directorate and the ICBs? I tabled a written question about the benefits to the public purse of abolishing Healthwatch. The Minister’s response was as follows: “The potential savings from abolishing Healthwatch England and Local Healthwatch are dependent future policy decisions regarding the approach taken to collecting user experiences post-abolition.” She set out an intention for “future policy decisions”, but there was, and still is, an absence of a plan. That is something we have heard again and again in relation to health, in Committee and throughout the two years that this Government have been in power: the absence of a plan for how things will be achieved. They have lofty aims, and understandable and sometimes really good goals, but no understanding of how they are going to get there. It is not just the Opposition who are concerned; I will give some examples of Government Members who are, too. The hon. Member for Birmingham Erdington (Paulette Hamilton) said: “One of my biggest concerns about the Bill is the reduction in independent patient representation, including the abolition of Healthwatch structures.” —[ Official Report , 1 June 2026; Vol. 786, c. 921.] The hon. Member for York Central (Rachael Maskell) said: “Replacing Healthwatch will mean that, ultimately, patients will not have confidence in the commissioners.” —[ Official Report , 9 June 2026; Vol. 787, c. 136.] The hon. Member for Blaydon and Consett said: “I understand that the Government’s real intention, through the Bill, is to strengthen the patient voice and the ability to raise issues, but there is real concern that an organisation inside the Department of Health and Social Care will not provide that independence. Will the Minister commit to looking again at how that independence can be built in and…with the ability to pull the levers”? —[ Official Report , 1 June 2026; Vol. 786, c. 944.] We have also heard concerns from the Health and Social Care Committee. But the Member that the Minister may be most interested in is the right hon. Member for Makerfield (Andy Burnham). He wrote to the former Secretary of State last year saying: “People speak to Healthwatch because they are outside the system—they are impartial, trusted, and provide a safe space for concerns to be shared.” Does the Minister agree? If so, why does she want to remove the independence of patient voice? The right hon. Member for Makerfield also said: “The independence of resident and patient voice is a necessity. Without it, we risk losing the trust of the public, the richness of lived experience, and the ability to challenge and improve the system from within, particularly during this time of significant system reform”. My plea to the Minister is this: think again about the importance of the independence of patient voice. People will give their views when they think they can do so independently and safely—a principle that was echoed in the debate this morning. Removing the independence does not seem necessary, and I do not understand why the Minister thinks that it will improve patient care and thereby patient safety. It is clear that Members not only on the Opposition Benches, but right across the Government Benches—in fact, potentially the new Prime Minister from next week or the week after—may think the same. I encourage the Minister to reconsider this step.

• 7 Jul 2026 · Health Bill (Thirteenth sitting) · Hansard source

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  As I understand it, the objectives of the Bill are to replace the local healthwatch with a less independent, internalised gatherer of patient experience feedback. The objectives appear to be featuring feedback more centrally in strategic decision making, getting people into the room and simplifying the patient landscape. There are things that I do not understand about that. If the problem is that those who commission or deliver the services are not listening adequately to the people who gather the patient experience information, why not invite the independent individual who has gathered that information into the room? Why ask someone in the room to gather the information and risk the independence? Why not compel more listening? The Minister talked about who is accountable for action. My understanding is that it is the healthwatches’ job to gather the patient experience and present it to Healthwatch England and the decision makers. It is not their job, as I understand it, to make decisions on how care is delivered or to deliver that care differently. Does the Minister intend that to change? The Minister also talked about strengthening the impact of Healthwatch, but I do not understand how this change will do that. We have heard how its independence allows Healthwatch to go on telly, talk to Members of Parliament, Select Committees, radio stations and others, and publicise its findings. If it is within the Department, will it be able to do so as freely? I suggest that it will not. The other thing that I do not really understand—perhaps the Minister can help us with this—is the organisation. At the moment, it is done in local authority areas. It will now become the job of the local authority and the ICB to commission feedback, but we have already heard how the 50% cuts to ICB budgets have led to ICBs merging into larger conglomerates. Those do not necessarily overlap with the strategic mayoral authorities in the way the Minister eventually wants. What geography does the Minister want the feedback to be gathered over? How does she see that working? Will it require further restructuring? The hon. Member for Lichfield talked about the importance of localism and how different areas of his constituency have different health needs. How does the Minister think that that will work under her new plans? The Minister said that one benefit of the new process is reaching vulnerable individuals, but what is to stop Healthwatch doing that? Ultimately, if we have Healthwatch doing things now that are independent and respected across the House—I am sure your local healthwatch is also excellent, Ms Lewell; Lincolnshire’s certainly is—why not strengthen that voice? Why not say to those who are providing that service, “We’re going to give you more resources,” or “We’re going to ask you to deliver it in a slightly different way,” or “We’re going to ask you to focus on particular populations,” or even, “We’re going to invite you into the room with the ICBs so that they can hear you and listen carefully”? Why not compel those making the decisions and delivering the services to listen to Healthwatch, rather than replacing it? It was not Healthwatch’s job to listen to them, but to gather the information and present it, and that is what it has done. Can the Minister explain how removing its independence is going to help? I simply do not understand it.

• 7 Jul 2026 · Health Bill (Thirteenth sitting) · Hansard source

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  Is there not a third issue: that the local authority and the ICB will no longer have congruent areas and will therefore look at different populations?