Karin Smyth MP: speeches

Speeches

• 8 Sept 2026 · Health Bill · Hansard source

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  Absolutely, and I am committed to working with my hon. Friend and many other hon. Members across the House. I was pleased to meet my hon. Friend the Member for Manchester Withington (Jeff Smith) to discuss his amendments concerning medicines. I hope that I reassured him—from his speech, I think that I did—that the Government do support well-designed research into innovative treatments using controlled drugs, where this is conducted safely and appropriately. We also understand the complexities involved, including the need to minimise the risk of harm and misuse. That is why we are working across government to consider how to implement the recommendations from the Advisory Council on the Misuse of Drugs to reduce barriers to research with schedule 1 controlled drugs. I committed to write to my hon. Friend to set that out further; I will do. A number of hon. Members tabled amendments on issues with their local infrastructure. We have already published the capital plan and improved long-term capital planning to improve local infrastructure. I think that I have addressed most things—

• 8 Sept 2026 · Health Bill · Hansard source

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  We have genuinely had a wide-ranging and thoughtful debate, and I want to try to address all the points that have been raised. I think there is broad agreement across the House on the goals that we are seeking to achieve with the Bill: safer care, better outcomes and a stronger voice for patients. Every patient deserves safe and high-quality care, every community deserves to have its voice heard, and everyone should be able to access the care they need, when they need it. The question before us is how best to deliver those ambitions. In general, we do not believe that the current landscape works, and that better outcomes are always achieved through new reporting requirements, additional layers of statutory process or more bureaucracy. Instead, we are committed to devolving responsibility and to empowering leaders in the NHS, while also holding them directly accountable, so that the NHS is focused on delivery and improving care. I will begin with Healthwatch. I think there is broad consensus that we want to see patient voices heard strongly at every level of the healthcare system—it is something that all MPs feel strongly about, dealing with constituents as we do. Hearing the patient and user voice results in better decisions in a system that is designed around them—a system that is better able to correct when things go wrong. Our ambition is to ensure that insight and experience from patients, service users and communities is part of commissioning and service planning decisions, rather than being held at arm’s length and outsourced. Our ambition is that this is done effectively everywhere. It is about strengthening the power of patients’ voices inside the NHS, where decisions are taken, not silencing criticism of those decisions. Within our approach, integrated care boards and local authorities will be expected to engage with people in their areas and will have a statutory duty to obtain their views. That is a core part of the new strategic role of ICBs, and it involves transparency about what people have told the system, what the system has done in response and how learning is shared across partners. ICBs will be held to account if they do not demonstrate those elements. However, we have heard the strength of feeling in this place and in Committee, and as the Bill moves to the other place, I can commit to working closely with colleagues across this House and in the other place in order to review these provisions and ensure that our approach sufficiently empowers and devolves to local populations. We all want to ensure that the changes deliver for patients and service users, building public trust and ensuring that their voice is embedded in the care they receive.

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

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  I appreciate the intention behind new clause 87, but the Government cannot support it. The Medical Training (Prioritisation) Act is designed to support a sustainable medical workforce that can meet population health needs and deliver the best patient care while reducing the UK’s reliance on an unpredictable international labour market. By creating a clear pathway for medical school to speciality training, we also strengthen domestic talent and improve retention. What matters is where a doctor is trained, not where they were born. Data shows that domestic graduates are more likely to stay in the country they trained in than those trained internationally. Doctors trained primarily in the UK are also likely to be better equipped to deliver healthcare that is tailored to the UK’s population, because they have a stronger understanding of UK-specific epidemiology and NHS practice. In addition, the Government set UK medical school places based on future health system needs. Student intakes and graduate outputs of overseas campuses are not included in our domestic workforce planning. If we prioritised British citizens for foundation training regardless of where they studied, it would undermine our aim to build UK-trained capacity while ensuring that we do not provide more foundation programme places than we need. I would like to emphasise—this is an important point—that prioritisation does not mean exclusion. Non-prioritised applicants can still apply for the foundation programme and will be offered places if vacancies remain after prioritised applicants have received offers—I understand that is already happening for the 2026 recruitment round. For individuals who do not secure a foundation post this year, there remain alternative routes to pursuing a medical career in the UK. Those include obtaining GMC registration through the established pathways, such as completing an approved internship in the country where they trained and entering the UK healthcare system through a locally employed doctor role or other non-training posts. I ask the hon. Member for Sleaford and North Hykeham to withdraw the new clauses.

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

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  I thank my hon. Friend for her work on and commitment to this issue, as was highlighted by the shadow Minister. I thank her also for her work on the APPG and with organisations such as Headway, to which we pay tribute for its work supporting patients and the public, and for her work with Members of Parliament and the Government on getting this right, which is legion. My hon. Friend has made similar comments in the House. The Minister responsible is continuing to work on the action plan, which I will talk about as we continue our consideration. The new clause raises the issues of prevention, identification, acute treatment, rehabilitation, long-term support, care planning, workforce capability, data and research, all of which are being considered in the work being done across the eight Departments. The Government agree that there should be a plan, and the relevant Minister, to whom I will of course pass my hon. Friend’s comments, will be working on that. The question is whether the proposals in the new clause are best placed to ensure that any plan will be robust, sustainable and timely for the patients it is designed to serve. I say gently to the shadow Minister that I think they are not. First, setting an arbitrary 30-day timeline for publication risks causing either an unnecessary delay or a duplicate plan. Secondly, as I hope she will appreciate, we have engaged more widely than with just the three Departments named in the new clause. As I have said, as many as eight Departments are contributing, which reflects the wide range of areas that are impacted by brain injury. Let me give the shadow Minister the assurance that I believe she is seeking, as are others: a plan will be published as soon as possible. That plan is being developed with the breadth, rigor and pace that the issue demands and is receiving input from across the health system, as well as from other Departments responsible for supporting people with acquired brain injuries and sector-specific stakeholders and organisations. I hope that she will work with us to support the plan once it is published, in the interests of our constituents, who desperately require a new approach to ABI prevention, care and support. I ask her to withdraw the new clause.

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

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  That is why I was clear in outlining that ICBs have a duty to make sure that they are financially sustainable and that their planning and strategic commissioning meets the needs of their local population. They need to balance those requirements. Under the new clause, there is a risk that the Secretary of State, by setting blanket requirements, would contravene the level playing field provisions in clause 10 of the Bill. For those reasons, I ask the hon. Member for Sleaford and North Hykeham to withdraw the new clause.

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

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  Again, I am grateful to the hon. Member for Sleaford and North Hykeham for bringing this discussion before the Committee. This new clause would require the Secretary of State to make regulations about how the NHS uses private provision to support access to treatment and reduce lists. I understand the point that she is making, but I assure her that this is an unnecessary new clause. ICBs already can and do use private healthcare providers to offer patients treatment in their area and boost capacity to reduce lists. Our approach is pragmatic, not ideological: in the 10-year health plan, the Government committed to continuing to use private sector capacity where it is available; that is not because we favour the private sector but because we are committed to using capacity wherever it is available. Our priority is treating patients in a timely manner, not favouring one form of provider over another. Under existing legislation, patients must be offered a choice of provider for their first outpatient appointment, where the duty of choice applies. If a person’s needs are not met by local services or waiting times are high, they can use that choice to see an appropriately qualified provider. However, we must resist the temptation to apply a one-size-fits-all approach here. ICBs are responsible for the financial sustainability, planning and strategic commissioning of services for their local populations, so they are best placed to decide how private premises should be used to meet a population’s needs. For example, high waiting times, which we obviously inherited from the Conservatives, for a particular specialty may result not from a lack of capacity but from increased demand from GP referrals. The ICB must have the flexibility to improve how advice and guidance—referral support, for instance—is working for GPs, rather than being required to wastefully spend NHS funds on increasing capacity with the private sector.

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

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  Well, what was a disaster was the Tories’ management of the capital estate pre-1997 and post-2010, if the hon. Member for Sleaford and North Hykeham wants to talk about disasters on capital planning. I could talk about this for a very long time, but I know the Committee is keen to move forward, and I addressed some of these issues in debate on a previous amendment. I am very proud of, for example, Southmead hospital in Bristol, which is one of the finest examples of a hospital in the country and was built under a PFI scheme. I received treatment there a couple of years ago, in facilities that are good for staff to work and patients to be treated in. It replaced a hospital that was falling down and in shocking condition, despite the best efforts of staff. We can see similar examples across the country. Under the Tories’ management, and for some of the early PFI schemes under the last Labour Government, contracts were poorly negotiated. They had issues with, for example, management of inflation. We have learned lessons from that. The hon. Member for Sleaford and North Hykeham talked about some contracts, including one where, I think, her whiteboard was not working. We know what the lessons are to be learned from that, and we are doing exactly what a good Government do when they take charge—change it. In the 14 years that the Conservatives were in power, they could have started negotiating these contracts differently at any point, but they chose not to. They chose to let the estate atrophy and fall down. That is bad for patients and the public. That is why I was proud last week to launch the Government’s capital plan, building for the future, looking forward and giving nine years of certainty for estates across all our constituencies.

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

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  This is an important debate, as many of them are today. I understand that waiting for a cancer diagnosis, as I have had to do myself, is very stressful. The national cancer plan sets out how the Government will change that experience for patients and their families. Crucially, the plan is driven by evidence and shaped by the voices of more than 11,000 patients, charities and professionals who responded to our call for evidence. The plan covers the entirety of the pathway, from referral and diagnosis to treatment and ongoing care, as well as prevention and research and innovation, and tackles the key issues raised in the new clauses. Delivery of the plan will be monitored by the national cancer board, with an independent co-chair reporting to the Department. On new clauses 48 and 65, let me be clear that improving access to high-quality radiotherapy services is a priority for the Government, and one that we are already delivering. In May last year we announced the roll-out of new linear accelerator machines, we have committed to meeting all cancer waiting time targets by the end of this Parliament, and timely access to radiotherapy is central to the 31-day and 62-day treatment standards. We will go further by reviewing the targets, once they have been met, to consider whether they should be strengthened. That will include considering what data is needed to support improved performance. A separate statutory framework would duplicate the established performance regime. We are well aware that radiotherapy performance is below that of other treatment types, as the hon. Member for North Shropshire outlined. We are also aware of the serious variation between different parts of the country. We have at our disposal the Getting It Right First Time programme and national interventions to address those issues at a local level. The national cancer plan also tackles unwarranted variation through robust national data and oversight from the national cancer board, while ensuring that service configuration remains clinically led. We have committed to improving the productivity of radiotherapy services, including by using artificial intelligence to streamline treatment. We will make a £70 million investment in state-of-the-art radiotherapy machines by 2027 through a managed national replacement programme. Imposing fixed legislative limits on the age profile of equipment would reduce the flexibility required to manage that programme effectively. Additionally, the NHS is already under a clear statutory duty to fund NICE-recommended interventions, supported by national commissioning guidance. Additional minimum standards would duplicate those safeguards without improving outcomes. New clause 48 also suggests metrics to track radiotherapy performance. I assure the hon. Member for North Shropshire that high-quality and detailed data already helps us to understand emerging issues and to monitor performance. The National Disease Registration Service in NHS England collects diagnosis, treatment and outcome data on cancer patients in England. It routinely reports incidence, prevalence, survival, routes to diagnosis and treatment data on all cancers. NHS England also publishes monthly radiotherapy performance data. On workforce capacity, we are already seeing increases in key roles, including clinical oncology doctors and radiologists, and the Getting It Right First Time review of radiotherapy services will report later this year. The new clauses risk duplicating efforts already in train to improve the oversight of radiotherapy services, workforce, data quality and coverage, and would create additional bureaucracy and divert resources away from patient care. I turn to new clause 53. Improving performance against cancer waiting standards is a priority for this Government. We have made year-on-year progress with cancer waiting times, but we know that there is some way to go. Cancer incidence is about 15% higher than when the 62-day standard was last met, in late 2015. There are more than 200 distinct cancer types, and each is complex. The cancer waiting time targets, including the 62-day referral-to-treatment target, are not set at 100% for several reasons, including patient choice, clinical guidelines and the complexity of diagnosis and treatment planning. That means that not every patient can or should be treated within the waiting time standard. We therefore do not think the new clause is appropriate. Change, including improvements to the cancer pathway and to tackle variation in performance, cannot be delivered overnight. The national cancer plan sets out the concrete actions that we are taking to get there. We have already demonstrated our commitment to transforming diagnostic services by investing £2.3 billion in diagnostic capacity. That will support us in achieving the 62-day standard through faster diagnosis. We recognise that the provision of cancer services, including treatment, varies across the country. The national cancer plan addresses how to tackle that variation. To accelerate breakthroughs in cancer treatments, we will explore innovative procurement methods. That will aim to stimulate the development of new diagnostic tests, targeted therapies and more effective treatment for rare cancers, ensuring that the NHS remains at the forefront of medical innovation. We believe that new clause 54, in the name of the hon. Member for North Shropshire, is unnecessary because the Department already has the National Institute for Health and Care Research and the national cancer plan underpinning its cancer research strategy. The Department invests about £1.8 billion each year on research through the NIHR. Cancer is a major area of its spending, at £141.6 million in 2024-25, reflecting the fact that it is a high priority. The NIHR does not usually ringfence funds for research in specific conditions; it welcomes funding applications for research into any aspect of human health and care, including cancer. Research is funded through open and fair competition and peer review to ensure that the highest-quality proposals most likely to deliver real impact for patients are funded without imposing financial targets or limits. The national cancer plan is the first plan to have a dedicated chapter on rare cancers, which is important to many hon. Members across the House, including my hon. Friend the Member for Blaydon and Consett, who has done great work. The plan includes a commitment to make progress on rare cancers as one of six key research priorities to tackle stubbornly low survival rates. Our aim is to be in the top quartile across 28 countries for survival of 14 rare and less common cancers. Through the NIHR, the Department is the largest funder of clinical academic training. The NIHR plays a key role in attracting training and supporting the best clinical academic researchers, providing comprehensive research career pathways for clinicians across all career stages, from undergraduate level through to professional appointments. New clause 100 would require the Department to publish a report on the feasibility of using data in patient records to flag symptoms. I understand the concerns behind it. We fully support using the single patient record and other data to improve cancer care and diagnosis, but we have largely covered the issues raised by the new clause in the cancer plan. We understand that there are concerns in some areas. The Government have introduced Jess’s rule, which instructs GPs to rethink a diagnosis if a patient presents with the same symptoms. That followed a campaign on behalf of the family of Jessica Brady, who tragically died after symptoms of her cancer were not recognised. The single patient record will give clinicians timely access to a single trusted record, which is why it is such an important part of the Bill. We envisage that the Bill, together with the cancer plan, will enable more personalised insight into cancer risk, for example, through the NHS app. For those reasons, we do not think the new clause is necessary.

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

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  I thank my hon. Friend. That is indeed one of the ways in which, working through the DWP and across Government, we have sought to bring in, as my hon. Friend the Member for Blaydon and Consett said, practical measures to make carers visible and to support them. That is exactly the sort of thing we wanted to do and have done, and it does start to recognise the work that people do. Let me turn to new clause 17 and new clause 89, which my hon. Friend the Member for Blaydon and Consett talked about and which was tabled by my hon. Friend the Member for Shipley, whose expertise and commitment in this area are well known across the House. The new clauses look at the identification of, and provision of information to, unpaid carers. I agree on the importance of ensuring that carers are properly recorded and identified in the system and provided with relevant information and advice so that they can be better supported and involved in care decisions. However, we do not believe that explicit requirements to identify and record particular patient and carer groups are appropriate for legislation. We have made clear commitments in the NHS 10-year health plan and are taking practical steps to improve identification, support carers and involve them in care planning. If we need to mandate compliance, that is best done by including requirements in national NHS contracts or in statutory guidance or directions, where we can provide more detail and directly address barriers. Information about unpaid carers will be captured systematically to ensure that their responsibilities are recognised and supported, and developments such as the single patient record, which we have discussed in Committee, will make that easier in the future. That is a really important step forward. We are also looking to support general practice in better identifying and recording which of their patients are unpaid carers, to help ensure that those carers can get the support they need in the community. NHS England recently published guidance to support that, and work is ongoing to ensure more consistent coding of unpaid carers by general practitioners. We are also working to improve the quality of local authority data on unpaid carers. The Partners in Care and Health programme, launched with the Local Government Association, is working with local authorities to improve their data and address barriers to data sharing between local systems.

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

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  It is good to see you in the Chair, Dr Huq. I am grateful to the hon. Member for North Shropshire for tabling this new clause. I am sympathetic to its intentions: the security of data, the transparency of use and even realising the value of data. Its principles are in the interests of the public and the NHS, but we do not consider it necessary to achieve our aims. It would impose onerous operational requirements and could have a damaging impact on the ability of the NHS to function. There is also a significant overlap with the role of the independent national guardian and potentially that of the information commissioner. Once the functions of NHS England have transferred to the Secretary of State, the Secretary of State must have regard to the need to respect and promote the privacy of recipients of health services and of adult social care in England, which is in addition to the requirements already set out in UK GDPR. The Secretary of State will be able to issue guidance to the health and care sector relating to the processing of information to which NHS bodies must have regard. The Secretary of State will be under a duty to have regard to guidance given by the Health Research Authority on the disclosure of confidential information. The proposed trust functions would also encroach significantly on the operational role intended for the health data research service, and would place cumbersome constraints on vital data collecting and sharing within the NHS. The new clause would mean that all health data collections and data-sharing initiatives would have to be preceded by public consultation. That would capture any of the essential collections that NHS England undertakes, and indeed any collection by NHS organisations, not to mention the use of that data. The burden would be considerable, with very real consequences for the ability of the NHS to use that data to improve outcomes for patients. Likewise, I cannot see how requiring all health data to be held anonymously and accessed only through a trusted, secure research environment would be compatible with delivering direct care to a patient or using confidential patient information for planning and commissioning services or research. It seems that the new clause would prevent such uses. For those reasons, I ask the hon. Member to withdraw the motion.

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

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  I am happy to get back to the hon. Lady on that specific point, if that is the case. The charging framework is about recovering costs, not making a surplus, which is what the amendment would result in. If that is not the case, I will make sure that she receives a proper correction. The Government do not think that there is a good case for the amendment, because, as I have said, the aim of the provision is to provide for fair and transparent cost recovery, not to raise extra income beyond cost. I am not sure whether the hon. Lady is suggesting that it might be good for the commission to create additional funding, but if that is not clear, I am happy to get back to her on it. The provision makes the recovery of costs more predictable and consistent for those who have to pay them. That is usual for public bodies. New clause 42 relates to funding provisions for the CQC’s new investigation function. The Department already provides grant in aid to the CQC to provide adequate funding for investigations and special reviews; similarly, HSSIB’s budget is provided through grant in aid and is set each year. When the CQC takes on HSSIB’s functions, the funding streams will remain distinct, and the CQC will have to assure the Department that the amount allocated to the new investigation function is being used for that purpose. Funding decisions for the investigation function will continue to be captured in wider departmental budget-planning processes and considered centrally. That provides assurance that business and strategic priorities for the investigation functions can be met. Robust financial oversight will require the CQC to demonstrate that grant in aid is used appropriately, and solely to support the investigation function, without the need to prescribe funding arrangements in legislation. As there is already an operational mechanism for the Secretary of State to provide adequate funding and resources for investigations, the new clause is not needed. It would also be inappropriate to prescribe the form or level of funding in legislation. The new clause would reduce the Department’s ability to manage funding through the established spending review and estimates process; introduce unnecessary rigidity as the merged function evolves; and risk creating binding funding expectations that may not align with future fiscal constraints. A non-legislative approach ensures flexibility, scale and adaptive function while maintaining robust oversight. I agree with the intention behind amendment 5, tabled by the hon. Member for North Shropshire, which is, as I understand it, to ensure that the Health Services Safety Investigations Body functions that are transferred to the CQC retain a high level of operational independence and continue to command the confidence—the Committee heard that word a lot this morning; I completely agree on its importance—of patients and their families, healthcare professionals and the wider public. Similarly, I understand that the objective of the amendment is to maximise the perception—again, that is a word I am coming back to; I tried to address the issue earlier—of independence in the CQC. The Government have protected safe spaces in legislation, and we agree that operational independence of the investigation function is required, but our plans support and enable that. For that reason, we cannot support the amendment, which would impose a highly prescriptive governance structure on the CQC by requiring the creation of a separate statutory committee and setting out in primary legislation detailed requirements for its purpose, membership appointments and operational arrangements. While the Government fully agree that effective safety investigations must be conducted independently and objectively, we do not consider it necessary to put such detailed organisational arrangements in the Bill. The Bill already provides a clear legislative framework for the transfer of those functions and enables the CQC to discharge them appropriately, within its broader statutory responsibilities. Furthermore, the CQC already operates within a robust statutory framework and is capable of establishing governance arrangements that support the effective delivery of its functions, including appropriate safeguards to protect investigative independence and the handling of safe-space material. The amendment would reduce organisational flexibility by mandating a specific committee structure, and would constrain the CQC’s ability to adapt its governance arrangements over time in response to operational experience, changes in circumstances or future improvements in best practice. Under the amendment, governance arrangements would be fixed in statute, rather than having the capability to evolve as the organisation learns and develops. Those additional administrative and governance requirements would increase bureaucracy and complexity, which the Government are looking to reduce. I re-emphasise that, in addition, a statutory committee would weaken the important links between learning and the action that the transfer of this organisation is intended to support. One of the key benefits of bringing these functions into the CQC is the opportunity to strengthen strategic oversight and ensure that learning from investigations can more readily inform improvement activity across the system.