Caroline Johnson MP: speeches

Speeches

• 15 Sept 2026 · Sepsis Awareness Month · Hansard source

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  It is clearly important that young people are aware of the signs of infection, particularly such a serious infection, so I agree with the hon. Member about that. I am interested in what the Minister is doing to try to prevent these infections by ensuring that the right people have the right vaccines. The Government are changing the way in which vaccines are being commissioned from NHS England, which they are abolishing. [ Interruption. ] Madam Deputy Speaker seems to have a cough, so I will finish my speech. The integrated care boards are going to be responsible for vaccinations. How is that change going to impact vaccines, particularly for students who live in one place and go to university in another? To sum up, the Government’s ambition to reduce sepsis and sepsis deaths should be welcomed, and it is good to have the modern service framework in place. However, I am sure that charities such as the UK Sepsis Trust and families affected by sepsis would be most grateful if the Minister could provide further clarity on the Government’s road map and the funding required to reach this important destination.

• 15 Sept 2026 · Sepsis Awareness Month · Hansard source

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  I start by declaring my interest as an NHS consultant paediatrician, a member of the Royal College of Paediatrics and Child Health, a member of the British Medical Association and a mother of three children. I congratulate my hon. Friend the Member for Kingswinford and South Staffordshire (Mike Wood) on securing this debate, alongside the hon. Members for Dartford (Jim Dickson) and for Ashfield (Lee Anderson). In particular, I thank my hon. Friend for his speech, which was hugely moving. I cannot believe that it has been such a long time since his illness happened, but it is great to see him looking so well today. I express my condolences to the hon. Member for Carlisle (Ms Minns) and thank her for the brave speech that she gave. I remember sitting in this Chamber a little over two years ago—I am sure you were there too, Madam Deputy Speaker—when the then Member for South Thanet, now Lord Mackinlay, received a rare standing ovation from the House and from the Gallery as he returned to Parliament following his remarkable recovery from sepsis. His journey has been incredible, and his story has brought renewed attention to a disease that kills nearly 50,000 people every year. For context, that is around the same number of people who die from bowel, breast and prostate cancer combined. However, with attention to prevention, early identification of infection, early diagnosis, better treatments and the avoidance of antimicrobial resistance, we can reduce that number and save people’s lives. As I said, raising awareness of sepsis and how suddenly it can change someone’s condition is vital, and the previous Conservative Government got the ball rolling in that regard. My right hon. Friend the Member for Godalming and Ash (Sir Jeremy Hunt) adopted the UK Sepsis Trust’s “Just ask ‘Could it be sepsis?’” campaign in 2016 when he was Health Secretary. The Conservatives also backed sepsis research with more than £1 billion through the National Institute for Health and Care Research. Research is important, because it will help us to improve diagnosis and treatment and to better understand why some people get an infection and it makes them a little bit ill, but some people get an infection and it turns into sepsis. That was a good start, but of course, as always with medicine, there is more to do, and it was pleasing to see the previous Starmer Government build on this work by introducing the modern service framework for sepsis. We have modern service frameworks for other diseases, and it seems good to have one for sepsis specifically. The guiding light of this framework is the Government’s ambition to reduce sepsis deaths by 25% by 2035, with which I think we could all agree. But simply saying it will not deliver it; it has to have a plan, and the plan has to be deliverable and funded. What funding have the Government committed to implement that framework? As we know, early diagnosis is paramount, but sepsis is notoriously difficult to diagnose and very rapid. I remember seeing a patient whose mum had got up in the middle of the night to use the bathroom—not something she did normally, and she was not quite sure why she had on that particular night—and when she was walking back along the landing, she thought, “It’s a bit cold—I’ll just check.” She checked her son had his blankets on and was warm, but as she did so, just in the light from the landing she spotted a little mark on the little boy’s leg. She turned the light on, and saw that he was developing the rash, which does not blanch, that goes with meningococcal sepsis. She brought him in, and he survived and he went home well, but I shudder to think what would have happened if she had waited till she woke up routinely at 7 o’clock in the morning. So someone was watching to make sure he was safe, and I am so glad that was the case, but it is so very rapid, as others hon. Members have testified. There is no single test. There is no single thing we can monitor or measure that helps. Flu-like symptoms mimic many other common illnesses, and on top of that, as we have heard, diagnosis and treatment are absolutely time-critical. The UK Sepsis Trust has developed the sepsis six—oxygen, cultures, antibiotics, fluids, lactate management and urinary output monitoring—and all these should be carried out within the first hour. The Government’s MSF commits to rapid diagnostic tools and more advanced genomic sequencing. What infrastructure and workforce investment is required by the Government to set this up, and over what timeframe do they envisage that it will be achieved? Talking about the workforce, the Government decided to ditch the previous Government’s NHS workforce plan to create their own, which is of course their right. However, their replacement was originally due to be published in early 2025 and was most recently promised as “imminent” just before the summer recess, but we are now well into September 2026 and there is still no plan. The Minister in the other place was asked for more details about the workforce plan, but her written answer simply stated that the Government “will provide an update on the 10 Year Workforce Plan in due course.” Could the Minister please update us on when this plan is going to be published, preferably with a date rather than an expression of “soon” or “imminent”? I want to mention group B streptococcal infection, which I have seen in paediatric practice, particularly in babies. It is a common bacteria that lives harmlessly in the gut or lower reproductive tract, but there is a risk that it can enter the bloodstream, causing neonatal sepsis when passed to newborns. The GBS3 trial is looking to prevent and reduce the impact of group B strep, and the Government’s framework commits to supporting that. Could the Minister tell us more about how the Government plan to do that? I also want to talk about prevention, which the Government have said is one of their big shifts in medicine. Some sepsis can be prevented or reduced, and research has shown that, for example, if ibuprofen is given to children with chickenpox, it increases the likelihood of their developing sepsis. We know that completing the antibiotic course is important. We also know that handwashing technique is important, and that keeping things clean is important, particularly in preventing the sepsis that is acquired in hospitals. Management of chronic disease reduces the risk, too, and then there is vaccination. Meningitis B is possibly one of the most scary infections and conditions that one sees as a doctor, because it progresses so quickly—and it can cause brain damage, amputations and death—but there is a highly effective vaccine, which was introduced for infants born from the middle of 2015 onwards. However, as the outbreak in Kent, Dorset and Berkshire showed last year, when three young people died, it can still come back in older children. The Joint Committee on Vaccination and Immunisation met in July 2026 and suggested an increase in the vaccination schedule for those young people. It recommended that young children who had had one dose of vaccine should have another at age 15; that those who had not had the vaccine should have two doses; and that older people starting university should have a catch-up. Very shortly, it will be freshers week, and around 580,000 young people will head off to university for the first time with great excitement. University students are seven times more likely to get invasive meningococcal sepsis than people who do not go to university, and the Government have only managed to vaccinate 246,000 of those young people—something that the UK Health Security Agency issued a document about last week. It said that last year, 97% of invasive meningococcal disease in 15 to 24-year-olds was caused by meningitis B, so I will ask the Minister some questions that I asked her during last week’s vaccine debate and have not yet received an answer to. When is she going to review and respond to the requests for vaccines for younger children who have not had them yet—the doses at 15 and the two doses for those who have not had a dose yet? What is she doing to increase awareness among people starting university in the next week or so?

• 8 Sept 2026 · Health Bill · Hansard source

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  I absolutely do. The Government have said that the CQC is not fit for purpose, yet they are now asking it to do things it did not do before, including not only HSSIB but event healthcare management, as the hon. Lady will be aware. It is absolutely right that the Government pause and think this one through again. One of our other amendments concerns puberty blockers. One of the first rules of medicine is primum non nocere—first, do no harm—and yet here we have a Labour Government sponsoring a £10.6 million trial to put 226 physically healthy children as young as 11 on puberty-blocking drugs. That was said to make the former Secretary of State, the right hon. Member for Ealing North (James Murray), “uneasy”. Why was he uneasy? Perhaps because these are powerful drugs that could cause serious long-term harm, because most children get better by themselves, because we cannot reliably identify which children will persist with a trans identity and which will not, because the huge increase in girls experiencing gender dysphoria has not been adequately explained or because the Tavistock data has not yet been reviewed in the data linkage study. There are many reasons for concern, but I am aware that we are short of time. It is difficult for a clinician to tell which children’s symptoms will self-resolve and which will not. As a result, we risk putting a large number of children on puberty blockers to assess the effects on, as the former Health Secretary put it, a “very small subset of a very small group”. —[ Official Report , 22 June 2026; Vol. 788, c. 56.] That means the results of the investigation may be unreliable, and it could cause unnecessary harm to children, so why are the Government not ensuring that the data linkage study is, at the very least, done first?

• 8 Sept 2026 · Health Bill · Hansard source

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  As always, my right hon. Friend is absolutely right. HSSIB has recently produced a report, which it would benefit the Government to listen to. The House will be aware that the advice and guidance service provides GPs with specialist advice, which sometimes avoids referrals. However, Ministers have made it mandatory to ask for advice before certain types of referrals, and set an aim for one in four referrals to be diverted back. The Government said that they were not rationing care or meddling with waiting lists—that there was nothing to see here, and that the Opposition were spreading misinformation—but HSSIB has published an interim report linking this process to delays in patient care, including cancer diagnoses. New clause 141 asks the Government to suspend the new process until they have properly considered it.

• 8 Sept 2026 · Health Bill · Hansard source

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  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.

• 8 Sept 2026 · Health Bill · Hansard source

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  Absolutely; my hon. Friend has obviously read my speech. What would happen if the new unit identified the CQC itself as the problem? Ministers have not provided good answers to these questions. To be honest, they cannot, because the Government cannot have their cake and eat it. Either HSSIB remains independent or it is folded into the CQC and loses its independence. The Government are either decluttering the landscape by removing an organisation or simply hiding it inside another organisation, to the detriment of both. We have tabled amendment 1 to protect HSSIB, and I urge the Government to support it in the interests of patient safety.

• 8 Sept 2026 · Health Bill · Hansard source

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  As is now routine, I 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. Yesterday the Government voted not to introduce a backstop to decide on the Hughes report. I submitted a written question that also had a deadline of last night to ask when they were going to respond, and they have not answered that either. Taking their time about something is one thing, but for the Government to completely ignore victims, refusing to give an answer and refusing to provide a backstop or a deadline, is frankly shameful. Patient safety is really important, and one key element to improving it is striking a good balance between accountability and blame. If we do not hold people accountable for their actions, they may not be as careful, but if they feel that their superiors are looking to find fault, they will be defensive and may cover things up. That makes it hard to get to the root cause and prevent mistakes from happening again. The Health Services Safety Investigations Body, or HSSIB, was set up with this problem in mind. Like the Air Accidents Investigation Branch, it has a safe space. This means that people are not held legally responsible for what they reveal to that team. They can then get to the bottom of why things are going wrong and find system errors. People come forward because they know and trust that HSSIB is independent, but this Labour Government want to change that. The Health Bill will abolish HSSIB and transfer all its functions to the Care Quality Commission—the body responsible for regulating health and social care. This is the same CQC that, according to Ministers, is not fit for purpose. Why are the Government doing this? Ministers cite a review by Dr Penny Dash that said that the patient safety landscape was “cluttered” and “fragmented”, but too many different organisations are producing too many recommendations. That report was narrow in scope, and the clutter is not caused by HSSIB. In recent years, 30 public inquiries produced 1,400 recommendations, but HSSIB produced just 56. The Government have suggested that moving HSSIB into the CQC can improve the quality of care and safety, but it is not clear how. People come forward to HSSIB precisely because it is a safe space, and this Government are removing the confidence in that safe space. For the new set-up to work, frontline workers will need to believe that the new unit in the CQC is independent, despite the law making it clear that it is not. The Government’s impact assessment says that the national quality board will provide clear direction to the new investigations unit, but the national quality board is tied to the NHS, so how does that square with the new unit staying independent? The impact assessment also says that the vast majority of investigations are expected to be directed by the Health Secretary. How can we be sure that the new unit will have the power and resources to look at things that might be politically difficult for the Government? How will the people in charge of the CQC balance the responsibility of investigating with the responsibility of maintaining that safe space?

• 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.

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

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  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

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  I echo the Minister’s thanks to the Clerks, House staff and others, as well as members of the Committee. Leaving aside the heat, I have also enjoyed our exchanges. I hope that the Minister has a good recess and that she does well in the upcoming reshuffle.

• 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. In their final months in office, the last Labour Government introduced the Equality Act 2010. That consolidated several pieces of anti-discrimination legislation, which was welcome, but it also introduced a new public sector equality duty, requiring public authorities to have “due regard” to preventing unlawful discrimination and fostering equality of opportunity between groups. The public sector equality duty also requires authorities “to…encourage persons who share a relevant protected characteristic to participate in public life or in any other activity in which participation by such persons is disproportionately low.” Unfortunately, that has become a vehicle for social engineering. It was designed, I believe, to improve equality of opportunity, but it is being used to gerrymander equality of outcome instead. That can mean discrimination—against different groups of people, but discrimination nevertheless. That is clinically objectionable, because it means that health and social care staff may be recruited for reasons other than their clinical abilities, which are what we need and are most important. We have parts of the health service spending their time working on cultural learning classes and pushing paper around, rather than on patient care. We must get the health service back to basic healthcare, ensuring that it delivers the very best healthcare, free at the point of use, to all individuals based on their clinical need, not their ability to pay. We need to focus on clinical need and the best possible staff, not on trying to gerrymander some sort of social engineering.

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

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  If the hon. Gentleman reads new clauses 81 and 82 together, he will see that one of them would require doctors not to go on strike, because they are involved in the clinical decision making across the piece, while the other would make provision for staff across the NHS to be on minimum service level provision. That is something that I maintained under the previous Government as well: I do not think that doctors should go on strike, in the same way that the police and the military do not go on strike. Medical professionals are key to the functioning of a hospital in a way that means they should not go on strike. Other staff within the hospital provide an extremely valuable and important service, but often several individuals provide that service, so it might be possible to say, “We can have three here rather than five today and still deliver most of the service.” Fundamentally, I do not think that it is morally right for doctors to go on strike, because in effect they are saying to people, “We know you’ve been waiting for your knee replacement for a year and we know your knee hurts, but we’re not going to do your knee replacement today, because we’re going to go on strike for more cash.” I just do not think that that is right. [Interruption.] I will take an intervention from my hon. Friend the Member for Farnham and Bordon.

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

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  The Government’s 10-year health plan says that reducing hospital admissions is a key goal for the neighbourhood health service. These new clauses could help, because they would require the Secretary of State to support self-care and health literacy in neighbourhood health plans and to conduct a safe and proportionate reclassification of some medicines. Pressure on GPs continues to grow, with the total number of GP appointments reaching almost 377 million in 2025. The new clauses are designed to relieve pressure on the healthcare system and allow people to take back control of their healthcare. There are medicines that could be considered for reclassification from prescription-only to being available from pharmacists without a prescription, in the way that medication for migraines, for example, previously had to be prescribed but can now be bought with supervision from a chemist. How might measures to increase self-care or pharmacy care square with the Secretary of State’s duty to improve health inequalities outlined in the Bill? In addition, the new clauses might help neighbourhood health centres in rural communities to increase availability of medicines closer to people’s homes. I will stop there, because I know that we are running short of time. The principle is to give people the ability to take control of their own healthcare and to more easily access medications that are currently under a higher classification, where it is safe to do so.

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

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  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

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  I think we are all getting busier. As such, it is harder for clinicians in primary care to phone the consultant and speak to them, because both are busy and potentially seeing patients. I am not criticising the ability to have an advice and guidance service, because it is helpful. We do the same with specialists in tertiary centres, for example. One might send them a message asking a question. Advice and guidance is a good principle. My concern is that it would remove the ability for consultants to refer directly, introducing an unnecessary delay in the system. Are we questioning the judgment of clinicians? Why do we want to reduce the number of patients who get put on the list by a quarter? I recognise, as I am sure the hon. Member for Bury St Edmunds and Stowmarket does, that sometimes referrals could be better directed. There is a mechanism already for doing that, but new clause 86 reflects the fact that general practitioners should still be able to refer patients using their clinical judgment to a consultant. That may be someone who the patient has chosen to see or who the GP believes is right for the patient’s condition.

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

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  The Minister will remember the evidence given earlier in Committee by my right hon. Friend the Member for Godalming and Ash, in our first sitting. As our longest-serving Health Secretary, my right hon. Friend focused much of his tenure on patient safety, and yet, as he made clear: “We are the world champion at doing inquiries and reports. Unfortunately we are also the world champion at allowing those reports to gather dust without anything actually happening.” —[ Official Report, Health Public Bill Committee, 16 June 2026; c. 30, Q52.] One clear example of that so far is the Hughes report. Twenty-nine months ago, Professor Henrietta Hughes published a report outlining redress for thousands of victims of the pelvic mesh and sodium valproate scandal. Time and time again, I and other hon. and right hon. Members have asked this Government when they plan to respond. Every time, the answer is, “Soon”, “At the earliest opportunity”, or, “We’re working on it”, but warm words are not enough to secure patient safety. Can the Minister confirm when she intends to publish the Government response to the Hughes report? Many patient safety recommendations prompt questions about the effectiveness of the Care Quality Commission, the national care regulator. The former Health Secretary claimed that it was not fit for purpose, and yet the Government have decided to bring HSSIB—Health Services Safety Investigations Body—within the CQC, as well as to add other measures, including events management. We need urgent steps taken to revive the CQC to ensure that it is fit for purpose to uphold patient safety. I will keep my remarks brief, because we have a lot to get through, but the Government need to respond to the Hughes report. Too many people, predominantly women, but men also, are waiting for the answers. They want to know what the Government are going to do. This Government have been in office for more than two years, with the report published shortly before that. Those people need an answer. In future, new clause 85 would mean that that delay cannot happen again, because the Government would have to respond to any future reports on patient safety issues within a set timeframe of six months, to ensure that we cannot have situations where people are waiting far too long for the answers that they need and deserve.

• 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.

• 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. New clause 66 relates to the prescription of puberty blocker drugs, also known as GnRH agonists. A first rule of medicine is “Primum non nocere”—first do no harm. That is what this clause seeks: to make sure that harm does not come unnecessarily to children. It is required because the Government are sponsoring a £10.6 million trial to put 226 physically healthy children on puberty-blocking drugs. That is being done despite the fact that the Health Secretary claims he feels “uncomfortable and uneasy” at the prospect. There are lots of questions that need to be answered. The minimum age for this trial is 11 years old for girls and 12 years old for boys, despite the Medicines and Healthcare products Regulatory Agency having recommended a much older group. When my hon. Friend the Member for Fylde (Mr Snowden) asked why in a written question, the Minister gave a holding answer. Is that because the Government do not know or because they do not want to say? I am not convinced that the trial will produce the answers the Government want. Apparently, they are asking the question of whether puberty blockers benefit children who have questions over their gender and who will later go on to have a trans identity in adulthood. The challenge is that we do not know which of the children who have challenges with their gender during puberty will go on to have such an identity in adulthood, so we are essentially doing a trial on a large number of children to see whether puberty blockers are beneficial for a small group, or, as it was described by the Secretary of State, “a very small subset of a very small group”. —[ Official Report , 22 June 2026; Vol. 788, c. 56.] The Government have data that they could use in a data linkage study to try to narrow that field down, but for some reason they are choosing to do this trial before that. I do not understand why; perhaps the Minister can explain. I do not want to detain the Committee too long on this issue—I could talk for some time—because we have had Opposition day debates in the House on it, but we have seen unease from both sides of the House. The Minister will be aware that there was a vote on the trial at the end of the recent Opposition day debate, and there were a large number of abstentions, as well as three votes against, from her party, as well as many votes against from ours. Puberty blockers carry risks that may or may not be reversible: there are concerns about bone density, cognitive damage and fertility loss, all for children who should be enjoying their childhood. The new clause would prevent a trial from taking place without votes in the Houses of Parliament. I appreciate that we would not normally seek to have votes in the Houses of Parliament on a clinical trial, because it would slow clinical trials down, but I think this topic in particular has unfortunately become so polarised that it is very difficult to see how it can be processed properly. Ultimately, the Government have responsibility for what goes on in this country. If the Government want to pay for the trial, then it is the Government’s trial, and the Government should bring it before the House for us to decide as parliamentarians whether it is the right thing to do. I think it is absolutely not. I think we are putting children at risk of permanent harm. We do not know that these children are going to benefit. We do not even know if they are in the pool of children who would, in the long term, have a trans identity, and the Government are not even waiting to see whether they can find out using the data linkage study. It is wrong, and we need to do what we can to try to prevent it.

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

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  The Minister says that if doctors want to go on strike, that is a failure of the system. The consultants have just balloted to go on strike. What failure in the system does she think has caused that?

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

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  Under the previous Conservative Government, the NHS constitution was updated with a commitment to guarantee that “those in the armed forces, reservists, their families and veterans are not disadvantaged in accessing health services in the area they reside.” The previous Government also introduced the veterans’ strategy action plan, committing NHS England to providing millions of pounds for specialised support services. Ministers also introduced a single point for veterans to access mental health services and support. The previous Conservative Government also created an armed forces covenant duty. Today, we need to see the principles the covenant brought to life at all levels of Government. Only last week, I received an email from a constituent who has moved around because of her husband’s service in the armed forces and who was struggling to access specialist services for her child’s health as a result. That is why we need new clause 112, which would require the Health Secretary to report on how they are meeting the duties under the covenant. Members will know that I am cautious about mandating any more paperwork, but veterans are being let down. We need some accountability. That report would hopefully achieve that, so I commend the new clause to the Committee.

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

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  New clauses 81 and 82 stand in my name. As a doctor, I felt deeply uncomfortable with the morality of going on strike, with doctors leaving their patients to suffer in order to get more money for themselves. That is one of the reasons why the previous Government introduced minimum service legislation to ban strikes in essential services. We are clear that we would not allow doctors to go on strike, just as the police and the military cannot. These are key services and key people for the functioning of our country. Unfortunately, on 6 August, one month after entering office, this Government announced that they would repeal the minimum service legislation, leaving the safety of patients at the behest of union barons. Despite resident doctors having a 28.9% pay rise, we have seen damaging strike action across the NHS: the Minister wrote that the strike action has cost £1 billion since July 2024. The latest round of strikes in April 2026 led to the cancellation of almost 50,000 appointments, on this Government’s watch. Those are all patients who are waiting.

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

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  If they are, they can use the advice and guidance service. The point is that when a general practitioner wants to refer his or her patient to a consultant on the basis of their clinical need, they should be able to. That is the purpose of the new clause.

• 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.