Caroline Johnson MP: speeches

Speeches

• 8 Sept 2026 · Health Bill · Hansard source

  More

  I am not sure why the hon. Member has reached that conclusion. I am saying that this is based on biology, and people who are trans require the same protections as people who are not—that is what I have said very clearly. The Darlington nurses were particularly brave in bringing their case forward. The cost was £187,000 in damages after an employment tribunal ruled in favour of them. That is a victory for dignity, for women and for common sense, but it is also a significant cost of public money to an NHS trust because it decided not to follow the law. That money could have been spent on patient care. What steps is the Minister taking to ensure that this guidance is fully and properly implemented across the NHS? How will she ensure that a repeat of the Darlington nurses case does not happen again, and what guidance has been given to NHS managers on how to handle this? The Minister for Women and Equalities did not help matters. She had the responsibility to sign off the Equality and Human Rights Commission’s draft code of practice to inform businesses, services and public bodies how to implement the Supreme Court’s guidance in law. But for over a year, the Government failed to lift a finger to enforce the law. For over a year, businesses, hospitals, service providers and public bodies were left waiting for the Government to tell them what the official guidance said. Now that it is here, we need to know how it is being implemented. How will the Minister ensure that this guidance is implemented universally in our NHS? How will the Government ensure that single-sex spaces are protected? What provision will they make for transgender individuals? What reassurance can the Minister give to women working in our NHS that they are safe? Our new clause 143 makes it clear that both staff and patients in the NHS must have access to single-sex spaces to protect their dignity and their privacy. I hope the Minister will be able to support this; I cannot see why she would not. The Government have also decided to abolish Healthwatch and reduce the number of local Healthwatch branches. Healthwatch England has been engaging with patients since 2013, with more than 150 operating in a hub-and-spoke model, but that is about to change. Why? One reason seems to be to avoid duplication. The Government are clearly not keen on lots of Healthwatch branches doing the same thing in different areas of the country and feel that some branches may operate better than others. They say that they want to bring feedback closer to decision makers, but is that a good idea? The Government could have chosen to improve Healthwatch as it stands. In 2023-24, more than 925,000 people used Healthwatch to get advice and information, and more than 300,000 shared their experiences to improve services. They could have increased awareness further and developed a clear feedback chain, but instead they have decided to abolish Healthwatch altogether. That is of grave concern. How can patients be expected to complain to the system about the system? The Prime Minister previously wrote: “People speak to Healthwatch because they are outside the system—they are impartial, trusted, and provide a safe space for concerns to be shared.” On that, he was right, and I ask the Minister to accept our amendment on this subject. We have tabled a number of other amendments, including one on fracture liaison services, one that would produce a modern service framework for musculoskeletal care and others on radiotherapy, respiratory health, brain injury and the Government’s new medical devices regulations. However, I appreciate that we are short of time, so I will just make two short comments, if I may, Madam Deputy Speaker, First, I of course agree with the intent of the Liberal Democrats’ amendment 140, but it requires the presence of HSSIB, and since the Government seem hellbent on removing that, I do not know how the amendment would work. New clause 81, a Back-Bench amendment that has been selected by Mr Speaker, relates to another really important issue. As a paediatrician, I see the importance of what it suggests. The regulations would need to be carefully drafted for those who have a brief illness, to define life-threatening illness more clearly and to avoid duplication of work, but in principle, it is an important amendment. I commend our amendments to the House.

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

  More

  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.

• 3 Sept 2026 · Vaccination Rates: England · Hansard source

  More

  It is a pleasure to serve under your chairmanship this afternoon, Mrs Barker. I congratulate the hon. Member for Uxbridge and South Ruislip (Danny Beales) on securing this important debate. Why do we vaccinate? As we have heard today, we vaccinate because it prevents illness, it reduces the severity of illnesses that do occur, and it reduces complications. I should declare an interest as a consultant paediatrician in the NHS, as a parent of three children between 11 and 19 and as someone who was a volunteer vaccinator for many months at the local vaccine centre during the covid-19 pandemic. Vaccines were first identified, or discovered, by Edward Jenner in 1796. He discovered the smallpox vaccine, which eliminated smallpox completely between 1958 and 1977. We have seen that happen with so many diseases. I have a list, but it is so long that I am not sure I have time to read it all out: diphtheria, tetanus, polio, haemophilus influenzae, pertussis, rotavirus, hepatitis B, tuberculosis, flu, respiratory syncytial virus, shingles, human papillomavirus, various strains of meningitis, rubella, mumps, coronavirus—I could go on. There are so many different things to which we now have vaccines that we did not have previously and that have reduced the incidence of death and serious illness in so many people. It is almost impossible to quantify how many lives have been saved. I want to focus on measles, which several hon. Members have mentioned. My great-uncle Leonard died of measles at the age of 15 months. Pre-vaccine, it was a common condition that killed many people. Thankfully, now it is not—and why? Because of vaccines. Vaccination rates have fallen, however, and we have lost our measles-free status. We need to make sure, as far as possible, that everyone gets the vaccine. The concept of herd immunity means that if some children cannot be vaccinated because of a personal health condition, they will be protected to an extent by the fact of a large proportion of the population having been vaccinated, and by the reduction of that disease within the community in some conditions. If vaccination rates fall, there is a risk to those people, as well as to those who have just decided not to have the vaccine. I would be interested to know how the Minister will focus on measles in particular. When we were in office, the Conservatives modernised the routine vaccination programme. In 2015, the UK became the first country to offer the Bexsero vaccine against meningitis B, which was given to babies aged eight to 16 weeks, followed by a booster around their first birthday. In 2017, we also switched to the hexavalent six-in-one routine vaccine programme so that babies could be protected against hepatitis B for the first time. Conservative Ministers expanded the HPV vaccination to boys, bringing the UK in line with other developed countries and preventing approximately 30,000 cases of cancer in males. The vaccine taskforce secured seven vaccines for the UK during the coronavirus pandemic, invested over £400 million in scaling up domestic manufacturing and mobilised more than 100,000 volunteers with sites right across the country. We also backed the Oxford-AstraZeneca vaccine with public funding and agreed a 10-year partnership with Moderna to invest in mRNA research and development. The previous Government supported vaccination in a number of ways; I look forward to hearing from the Minister what her Government will do to support it. I also want to talk about meningitis B, which is a horrible, rapid disease that affects patients very quickly. It is one of the diseases that is quite frightening to see as a paediatrician because of the speed at which a child goes from being well to being critically ill. We have all heard about putting the glass across the rash to see whether it disappears, but I have watched that rash appear on children with lightning speed. The disease kills, and it leaves many children with severe, lifelong disabilities. In 2015, the UK was first in the world to bring in a vaccine against meningitis for small children, but last year we saw meningitis B infections in groups of older children and young adults in Kent, Dorset and Reading. There were 21 cases in Kent and two deaths. The Government quickly brought in a local vaccine programme to treat people who might have been at risk, but there was also a stampede for private provision; Boots, Superdrug and other commercial ventures ran out of the vaccine within a few hours. The Government have decided to bring in a system under which people born between 1 September 2007 and 31 August 2008, and those who are starting university or further education colleges for the first time this year, will be able to get the vaccine. However, the JCVI has suggested that children who have been vaccinated with one dose should be given a booster at age 15. That means those who were born after 1 May 2015, so the Minister has a little while to manage that, but the JCVI has also recommended two doses for adolescents who did not get the first dose. The Government do not seem to have taken up that recommendation yet. Will they do so? When? A meningitis vaccine has also been brought in for men who have sex with men because, interestingly, it also has a 42% protective rate for gonococcal conditions. There was a record high of 85,000 cases in 2023. The vaccine has helped with those cases, but it would be beneficial to know when the Government will ensure that all our young children have the protection that they need against this frightening disease. Other things are slipping, too. The flu vaccination is highly effective at reducing seasonal hospital admissions. The WHO recognises that it is the most effective way to prevent infection and severe outcomes from flu, but coverage among the elderly and at-risk groups has declined in England. I would be interested to hear why the Minister thinks that is, what her research shows and what she is going to do about it. Respiratory syncytial virus affects not just children, but the elderly. The vaccine is incredibly effective in the elderly; last year, the JCVI recommended its extension to the over-80s. At the time, I asked Ministers whether the vaccine, having been recommended by the JCVI in the early summer, would be ready for last winter. My understanding, from what was said, was that they were going to work at pace. They reassured me that it would happen, but it did not. I believe that the vaccine will be available to older people this winter, but what is the Minister doing to make sure that they are aware of that so that they take it up? It will help to reduce admissions to hospital over the winter and reduce the pressure on A&Es and ambulance services, and it will mean that people are less unwell, which is obviously a good thing. Many hon. Members have talked about vaccine hesitancy. Polling by Ipsos found that more than two thirds of adults believed that it was “difficult for the public to spot misleading health information.” It also found that those in the most deprived areas were more likely to be affected. According to a UK Health Security Agency survey, last year 47% of parents who reported seeing concerning information about vaccines said that they had seen it on social media. As hon. Members have said, those sorts of message, such as the suggestion that cancer in the royal family was caused by vaccines, were platformed by a political party at a conference. It is important that we give responsible information about vaccines that we know to be true. We do not pretend that there are no risks. There is always a small risk to anything: we take a risk when we get up in the morning and come to work, and we take a risk every time we cross the road. Every aspect of our life contains risk, but we need to be honest with people and explain that the risks of vaccines are tiny and the risks of the disease are potentially much greater. That will mean that people can make informed decisions. When patients who have not been vaccinated come to clinic—we check with all children whether they have been vaccinated when they come for their first clinical appointment—they have very often refused once and not been asked again. The reason why has not been discussed. No one has asked them why they are worried about the vaccine; it has just been accepted at face value. Very often, when we talk to parents about it, they will then have their children vaccinated. We need to make sure that when unvaccinated children do present to medical services, we take the opportunity to try to get them vaccinated. I welcome the addition to the relationships, sex and health education curriculum of facts about vaccination and immunisation, but what is happening to provide public information to parents and other adults? It is said that vaccine uptake among ethnic minority groups is markedly lower. Does the Minister understand why? What is she doing to improve it? The Prime Minister has previously attested that Healthwatch is a key factor in engaging marginalised communities, but this Labour Government have placed it on the chopping block in the Health Bill, which is due back in the House next week. How does the Minister foresee that role being taken up by the patient experience body with which the Government intend to replace it? From April next year, integrated care boards instead of NHS England will be responsible for vaccinations. I understand that that is part of the Minister’s strategic commissioning vision, but will that additional responsibility be met with additional resources? How will the Government ensure that it does not cause further slippage in vaccinations? Finally, I want to mention the life sciences industry, which is struggling under this Government’s tax burden. Now that the Department for Science, Innovation and Technology has been abolished, what will the Minister do to ensure that the industry is given the support that it needs? Occasionally during my career, a parent of a critically ill child has looked me in the eye, often as the child is being put in an ambulance to an intensive care unit, and said, “If I’d given my child the vaccine, they wouldn’t be this ill, would they, Doctor?” There is trauma and grief for those parents, and a regret that is completely unnecessary and can be prevented. It is in the hands of the Minister and of this Government to do what they can to prevent it. I look forward to hearing what the Minister plans to do.

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

  More

  New clause 109, tabled in my name, is very simple, requiring hospice funding to be provided in three-year blocks. Hospices are struggling under the weight of the national insurance rise in the Government’s first Budget, so they would benefit greatly from having a bit more certainty over how much their funding will be from year to year. I am interested to hear the Minister’s response to the new clause.

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

  More

  I beg to move, That the clause be read a Second time. Under the Government’s preference-informed allocation scheme, when a doctor is applying for a foundation post, they are allocated randomly to a job. They get to express a preference, but there is no work they can do to make them more likely to get where they want to be; there are no certificates they can earn, there is no research they can do, and there are no exam results they can get that would improve their chances. That is fundamentally wrong. The Government say that many people get their first choice, which is true. That is great for them, but it is not great for the people who do not get their choice and have no control over their future. We had a very good debate on this subject, attended by many people in this room, in January, and there was widespread agreement on both sides of the House that it was the wrong thing to do. The Minister said at the time that the Government would keep the system under review. Has the Minister reviewed the system? Does she believe that we should prioritise medical graduates with the most relevant qualifications, clinical experience and skills? Does she think that doctors should have the opportunity to have control over where in the country they work and what jobs they do? Should doctors be able to work harder, aim for better results or do additional activities in order to get themselves the job they want, or does she think it should all be done by a computer? I would be interested to hear the Minister’s thoughts. The new clause makes clear our position that meritocracy should prevail and people should be rewarded for the work they do and the results they get, and that we should be hiring the best clinicians who apply for the jobs.

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

  More

  For generations, it has not needed to be the law: doctors did not go on strike, because they recognised what would happen to patients if they did. Now that we know that doctors will go on strike, the landscape has changed. Consultants—I should say that I am an NHS consultant—have just balloted to go on strike, which will be fundamentally unsafe. The Government have a duty to keep people safe; first and foremost, that is the Government’s job. Doctors going on strike is fundamentally unsafe and should not happen. I agree with the hon. Member for Bury St Edmunds and Stowmarket that morally it should not need to be the law, but I think the evidence suggests that it does. New clause 82 would make it “an offence for medical practitioners to undertake strike action”, and would provide for the Secretary of State to repeal any necessary clauses of other employment regulations in order to do so. New clause 81 concerns the minimum service levels provided across the NHS. There are staff who provide an important and valuable service but whose jobs may not be clinical; for example, services may be able to run with slightly fewer porters if they want to go on strike. I hope that no member of NHS staff would want to go on strike. I hope they would want to make sure that patients were getting care, and I hope they would recognise that, in a universal service, they are essentially causing harm to the patients around them, who are their friends, their neighbours, the people who live on their street and the people who would look after them. However, the evidence suggests that that is happening, so I am afraid that these new clauses are necessary. We need to put a minimum number of staff in place to support the doctors, and doctors should be at work to make sure that patients are safe.

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

  More

  I understand the Minister’s interest in the balance between trade unions and patient safety. My personal view is that we should focus on patient safety. I am aware—anecdotally, to be fair—of examples of individual clinicians who were asked during previous strikes to come off the picket line to help and did not. I am also aware of many instances in which clinicians did, so it works both ways, but ultimately the Government’s job is to protect patients and put patient safety first. I will therefore press the new clauses to a vote. Question put, That the clause be read a Second time.

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

  More

  It would amend the relevant part of the Medical Training (Prioritisation) Act 2026, so that when people are put forward for these jobs in the foundation programme, it should be done on the basis of merit. At the moment, as the hon. Member is aware, it is done on the basis of random allocation—preference-informed allocation—which I think is wrong. I would be interested to know the Minister’s thoughts on the subject.

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

  More

  I beg to move, That the clause be read a Second time. New clause 40 would require the Secretary of State to publish a report detailing the business case for the use of public-private partnerships for neighbourhood health centres. This goes back to the use of the private finance initiative in the past, particularly during the last Labour Government when Ministers were attracted by the prospect of off-balance sheet financing. Although the idea looked good on paper, it proved a disaster in practice. Before the 2008 financial crisis, private finance initiative interest rates were 2.5% to 4.4% higher than public sector borrowing rates. After the crisis, PFI projects increased their rates by 20% to 30%. In the interests of time, I will not rehash the story I told earlier in Committee about the problems with simple things such as putting a whiteboard up, but PFI did create operational problems, too. The previous Government rightly called time on PFI and announced in the 2018 Budget that it would not be used for future projects, which is why this Government’s plans are so peculiar. Labour Ministers have taken a trip to the graveyard of bad ideas, resurrected PFI and adorned it in new clothes: it is now PPP. The Government have tried to reassure the public that it is not a rehash of PFI, but the facts suggest otherwise. The funding of neighbourhood health centres is to be 80% through PPP. The Minister told the BBC we will be working with the private sector, particularly around construction and maintenance of many of the new centres. How is PPP different from PFI? The Minister has previously told this House that the new scheme will draw on lessons learnt in the past, so could she please say what those lessons are? If they have been learnt, why did 53 academics write a letter urging the Government to abandon the proposal? Why did dozens of Labour MPs sign an early-day motion expressing grave concerns? And why have the Treasury Committee, the Public Accounts Committee, the National Audit Office, the Institute for Public Policy Research and the Institute of Economic Affairs all cast doubt over the value of money for such schemes? No matter how Ministers dress things up, I am concerned. The Government need to publish a business case for the proposal to show how it will work in practice and demonstrate they have learnt lessons from the past. If they have, Members have no good reason to object to the amendment. It only asks Ministers to show their workings-out in full view of the House openly and transparently.

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

  More

  I will be relatively brief. New clause 15 would require the Secretary of State to lay before Parliament any trade negotiation requiring NHS spending or funding exceeding £100 million, in the form of regulations subject to the affirmative procedure. New clause 76 would require the arrangements between the United States and the United Kingdom on pharmaceutical pricing to be laid before the House to be voted on. A key concern is costing. There have been various estimates of the additional cost of medicines. The former Secretary of State, the right hon. Member for Ilford North (Wes Streeting), said that he would not change or cut the NHS budget to pay for that increased cost. Will the Minister tell us the estimated extra cost of medicines, and where that money will come from, if not from the DHSC budget?

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

  More

  As my hon. Friend the Member for Isle of Wight East just said, new clause 6 seeks in essence to ensure that we have good data security and control, with which I agree. Trust is important, data security is important and supporting research with anonymised data is a good thing to do. What would the new clause do? First, it would establish an independent body known as a sovereign health data trust. In essence, that is a group of people who have been put together. The new clause does not say how big the group would be—I do not know whether the hon. Member for North Shropshire had its size in mind—but it describes a group of people with “a diverse range of backgrounds…and…health data experts, clinicians and patient representatives.” Are the first group intended to be laypeople, rather than experts? What does the hon. Lady mean by a “diverse range of backgrounds”? Does that relate to protected characteristics, or is she looking for a farmer from Northumberland and a lawyer from Islington, because they have different backgrounds? It is not entirely clear what she means, so I would be grateful if she clarified that. Additionally, however big that group is, who would decide how it is composed and by what criteria? Who would be responsible? The sovereign health data trust would be charged with creating a health data charter. That leads me to my second question: what is a health data charter? In essence, a health data charter—as defined in the new clause—must “set out the fundamental principles and responsibilities for assessing whether a data sharing partnership is in the interest of the public and the NHS”, and, as my hon. Friend the for Isle of Wight East said, “include the primary goal of protecting people’s privacy and their data from exploitation, while promoting trust in data systems and the handling of health data”. That is important, because we have heard in the media several examples of data being put up for sale or leaked, and the problems caused by that. The charter must also “ensure patients have control of their data, including providing relevant opt-outs”. I am glad to see that bit about relevant opt-outs. We have talked about the importance of the record being shared not as a whole, but in pieces. Things such as obstetric or sexual health ought perhaps to be consented to separately. Patient control of the data is important. How would the hon. Member for North Shropshire deal with safeguarding issues in the control of data, particularly in relation to children? The new clause sets out that the charter must “provide that all health data is held anonymously and accessed through a trusted research environment”— which seems reasonable—and must “set out ways to retain and protect the value of health data in England, including providing measures to invest a share of the income generated from new medicines or treatments developed with that health data to be invested back into the NHS”. Earlier this week, the hon. Member for Lichfield and I discussed the important value of the NHS data—I think he said that it was the most valuable dataset in the world, and he might well be right. I was a bit confused by that part of the new clause, because we talked earlier this week about the Health Services Safety Investigations Body being able to sell time and training and share expertise, including with private sector organisations overseas. The Government changed that in the Bill, so that they would only be able to retain costs and not make any money for the Treasury. When we put amendment 56 to a vote, the Liberal Democrats abstained. I do not know what the difference is between using NHS data for research and the HSSIB using their expertise for training overseas organisations. I would be grateful to understand that. The charter must be “designed in such a way to render it interoperable with the European Health Data Space”. The European Health Data Space regulations were introduced in March 2025. We are in a transition period, and they will be implemented in 2027 and 2029. It should be interoperable in technical terms “through the promotion of Findable, Accessible, Interoperable and Reusable (FAIR) data principles”. What is the European Health Data Space? Essentially, it is a single patient record for Europe. Its instructions say member states may—I underline the word may—offer “an opt-out option for the cross-border exchange of electronic health data under EHDS.” I do not understand the Liberal Democrats’ argument for that, because they have made a strong argument throughout Committee stage that data needs to be shared carefully. They advanced some clauses that will ensure that data is held in the United Kingdom and that we use British tech where possible. New clause 6 would make us interoperable with the European system and presumably move us towards European systems.

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

  More

  I have sympathy with the principle behind amendment 58, in the name of the hon. Member for Wells and Mendip Hills. The hon. Member for North Shropshire is right to say that individuals with ME have not always received the best quality care. In many cases, ME is a debilitating and incredibly frustrating condition, and around 10% to 25% of sufferers have severe ME, meaning that they are housebound or bedbound. We know that some patients are sadly not believed by medical professionals. In 2021, NICE said that most medical students have little or no training on the condition. The Government have previously committed to increasing the uptake of ME modules among NHS professionals. What progress has been made on that in the last couple of years? The Government also committed in the ME/CFS action plan to develop and run a public awareness initiative, with implementation expected by May this year. Has the Department developed that initiative yet? If not, what is responsible for the delay? It is not marked as complete on the Government website. The amendment would put guidance for medical professionals into legislation, though, and my concerns about that are twofold. First, it may slow down improvements in the future. If individuals have to legally follow that guidance, how can they innovate and improve treatment without having to come back to Parliament for more primary legislation? That will take time and may mean that people with ME get worse rather than better care in the short term. The requirement would also limit clinical judgment. A patient may have a particular set of symptoms or conditions or be on a particular set of medications that mean that the doctor or clinician looking after them needs to vary from the guidance. NICE intends the guidance to be just that, guidance, not law, but if guidance becomes law, the doctor or clinician will not be able to vary from it. My concern is that the amendment would be overly restrictive. Although it is well-intentioned, and it is a good idea to ensure that guidance is followed where possible, it would be too rigid. I therefore do not support the amendment, while continuing to support the aim of better treatment. Clause 58 amends the Health and Social Care Act 2012 by inserting a new section 237(8A), which states: “Provision made under subsection (8)(b) may include provision about the period within which a recommendation is to be complied with (including provision for the period to be determined by NICE or the Secretary of State).” At the moment, NICE technology appraisals check the value of a product, whether a drug or a technology, then NICE makes a recommendation. It is then supposed to be the case that within 90 days or three months, ICBs ensure that those technologies are available, but we know that in the real world it can take longer—sometimes 12 to 24 months—for some things to become available. That could be because technology needs to be bought or training needs to take place. I understand why there could be variation and why the Government may want to consider varying the period, but it is not clear why they need to do so in legislation, because it is possible now to vary the period on an individual basis. For example, the Government imposed a five-year limit rather than a 90-day limit for the introduction of hybrid closed loop systems for diabetes, because that is a technology that requires proper training and they were never going to be rolled out in such a short period. The other product that notably has a longer time is tirzepatide, which is more commonly known as Mounjaro. I suspect that that is down to cost, but I am not certain. Why do the Government want to change the 90 days? The patient’s right to treatment with a NICE-approved product within 90 days will become a right to getting the product when the Secretary of State says so. That is not really a right at all, because it does not give patients any comfort and may mean that products are received later. The Government have put this power into the Bill, so they clearly intend to use it. Given that they have the power to vary on an individual basis, why do they need the power to vary on a blanket basis? Do they intend to extend the 90-day limit across the board? If so, by how much? There is no ceiling. The Committee received written evidence from Henry Burkitt from Oxygen Strategy, who made the point that there is no ceiling, no maximum time, no duty to consult and no necessity for the Secretary of State or NICE to give reasons why a delay has occurred. The life sciences industry talks about how it wants products to be rolled out. When it is investing and doing research in this country, it wants to see new products rolled out as quickly as possible once they have been approved, and the clause is a sign that roll-out might be delayed. I understand that the Government might want to be able to vary on certain products, but they already can; why do they want to vary on a more general basis? It is presumably to slow down roll-outs, but by how much?

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

  More

  The Minister talked about changing the time period in which proceedings can be effected from three to five years, but once the CQC is aware that an investigation could be brought and there is evidence that needs to be looked at, it will still get only 12 months. That has not been changed. I wonder what the rationale is for that. I am not criticising it; I am just asking the question. The other issue is that clause 63 is prospective, so if an offence were committed immediately after the Act was passed, for the first three years things would effectively be as they are now; the change from three years to five would be relevant only after three years. Clause 71(2) on commencement provides that clause 63 will not come into force until two months after the Act is passed. I just wonder in practical terms why, given that it will take three years to come into effect in any case, it will not come into force on the day the Act receives Royal Assent. The impact assessment talks about the CQC prosecuting two or three additional cases a year, and a cost of £4.3 million over 10 years with fines of £2.7 million over 10 years. Will the regulator keep the fines, or will they go back into the Treasury? Can the Minister guarantee that the additional funds that are estimated to be required for the additional cases under this new regulation will be provided so that the CQC can do the investigations that she is giving it the opportunity to do?

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

  More

  I rise to discuss new clauses 3 to 5 and 43, which I am sure that the Whips will not let me forget. I understand the sentiment behind the Liberal Democrat new clauses. The hon. Member for Winchester is keen to ensure that uses of NHS data are limited to uses for which people can consent, uses in relation to their care or specifically approved research. Having heard examples of this data being tracked or leaked by accident, the hon. Gentleman is keen to ensure that that does not happen. He is particularly concerned about the risk of that happening in another jurisdiction where we have less control of the system. I am not sure that the new clauses have been properly thought through, however. New clause 3 says: “Within six months of the passing of this Act, the Secretary of State must conduct and lay before Parliament a risk assessment of all contracts between NHS organisations and suppliers based outside of the UK.” That is “all contracts”. In subsection (2), it says that the Secretary of State must “pay particular regard” to contracts with technology companies, but not only to those. I am being a bit pedantic here, but has the hon. Member for Winchester considered the wording of “all contracts”? The NHS does not just provide drugs and medical technology; it provides bedding, blankets, pillows, bananas for people to eat at lunchtime, bedpans and loo roll. There is a whole range of things procured as supplies by the NHS that may or may not be procured from overseas. It would be cumbersome and completely unnecessary to include all of those. Even with the tech companies themselves, there is a risk for small contracts for small pieces of tech to create a huge amount of bureaucracy. I am not sure that it would specifically improve data quality or data protection. It is reasonable that the Minister would consider risk assessments, and I hope that she would automatically consider them before contracts that are particularly sensitive or contain patient data, but I am not sure that the new clause works. Moving on to new clauses 4 and 5, the hon. Member talked about Palantir. It may even have been his intention for these new clauses to target one specific American firm, but the actual impact would erect costly barriers to trade. The NHS contracts IT functions to firms based in other countries when the business case is strong. It uses Microsoft, an American company that offers software, cloud services and Outlook for emails; Oracle for standardising and automating financial processes; Sectra, a Swedish company, for transferring medical images and reports; and Dedalus, an Italian company, for migrating services to the cloud. To echo the point made by the hon. Member for Bury St Edmunds and Stowmarket, should the NHS prioritise a British company over an international company if the service has better functionality and a lower cost and is safe? The hon. Member for Winchester spoke about the vibrant life sciences and tech sector in this country, but if we close off our markets to those from overseas, will others not do the same? Would he want those life sciences companies to be unable to export? There is a barrier to free trade here.