The Committee consisted of the following Members:

Chairs: Sir Roger Gale, † Dr Rupa Huq, Emma Lewell, Sir Jeremy Wright

† Argar, Edward (Melton and Syston) (Con)

† Brackenridge, Sureena (Wolverhampton North East) (Lab)

† Chambers, Dr Danny (Winchester) (LD)

Daby, Janet (Lewisham East) (Lab)

† Foody, Emma (Cramlington and Killingworth) (Lab/Co-op)

† Irons, Natasha (Croydon East) (Lab)

† Johnson, Dr Caroline (Sleaford and North Hykeham) (Con)

† Joseph, Sojan (Ashford) (Lab)

† Kyrke-Smith, Laura (Aylesbury) (Lab)

† Morgan, Helen (North Shropshire) (LD)

† Prinsley, Dr Peter (Bury St Edmunds and Stowmarket) (Lab)

† Robertson, Dave (Lichfield) (Lab)

† Robertson, Joe (Isle of Wight East) (Con)

† Smyth, Karin (Minister for Secondary Care)

† Stafford, Gregory (Farnham and Bordon) (Con)

† Twist, Liz (Blaydon and Consett) (Lab)

White, Jo (Bassetlaw) (Lab)

Sanjana Balakrishnan, Rob Cope, Committee Clerks

† attended the Committee

Public Bill Committee

Thursday 16 July 2026

(Morning)

[Dr Rupa Huq in the Chair]

Health Bill

We resume line-by-line consideration of the Health Bill. The selection list for today’s sitting is available in the room. Proceedings must, so far as not previously concluded, be brought to a conclusion by 5 pm. Once again, I am happy to give a blanket dispensation for the removal of jackets. New Clause 31 ECG screenings “Within six months of the passage of this Act, the Secretary of State must conduct and publish a review into the use of ECG screenings to identify cardiac issues in persons over 14 years of age.”—(Dr Chambers.) This new clause would require the Secretary of State to conduct and publish a review into the use of ECG screenings to identify cardiac issues in persons over 14 years of age. Brought up, and read the First time.

I beg to move, That the clause be read a Second time. Twelve young people die every week from undiagnosed heart conditions. One of those was Clarissa Nicholls, who died just before her 21st birthday, while on a year abroad in France. Her mother and friends have campaigned tirelessly not only to provide electrocardiograms to young people, but to raise awareness about early detection of heart conditions. Finding a heart condition does not mean that exercise must stop or that life goes on hold; it just means that appropriate alterations can be made to keep a person safe, active and healthy. Such a scheme has been rolled out in Italy and has been hugely successful. The new clause would push the Government to look seriously at having ECGs for young people as an early identifier for potentially fatal conditions, so that we do not lose up to 12 young people a week due just to a lack of testing.

I thank the hon. Member for his speech. I would like to know whether he is aware of any evidence that mass screening of young people with ECGs will actually improve matters.

As that was a speech and not an intervention, we will take the Minister before the hon. Member for Winchester responds.

It is a pleasure to serve under your chairship, Dr Huq. The hon. Member for Winchester raises an important point. Cardiac issues are serious, and people too often lose their lives as a result of unidentified cardiac conditions. As we know, ECGs are used significantly across the whole of healthcare, from accident and emergency to new community diagnostic centres and beyond. They are important for investigating palpitations or unexpected syncope and for evaluating pacemaker function, and are an extremely useful diagnostic tool. However, as my hon. Friend the Member for Bury St Edmunds and Stowmarket suggested, there is no clear evidence that non-symptomatic population screening using standard ECGs would yield any useful health data or improve population outcomes. Clearly, the loss of life—particularly a young life, as in the case of the constituent the hon. Member for Winchester mentioned, although we have all seen or, sadly, experienced such cases—is an awful tragedy for those concerned, but we need to rely on evidence. The UK National Screening Committee, which is an independent scientific advisory body, advises all four nations and is considering the issue. The committee launched a three-month public consultation on 8 June to look at the evidence on screening for sudden cardiac death. Its draft recommendation is against screening, because ECGs, as well as other tests, are an unreliable tool for identifying significant cardiac issues in asymptomatic individuals. ECGs are useful tools in the diagnosis of symptomatic patients, and the UK National Screening Committee is in the process of reviewing ECG use for asymptomatic individuals. For those reasons, I ask the hon. Member to withdraw the new clause.

I thank the Minister for her comments. I beg to ask leave to withdraw the motion. Clause, by leave, withdrawn. New Clause 32 Review on deaths related to antimicrobial resistant infection “Within six months of the passage of this Act, the Secretary of State must conduct and publish a review into the number of yearly deaths in the UK which are related to antimicrobial resistant infection.”—(Dr Chambers.) This new clause would require the Secretary of State to conduct and publish a review into the number of yearly deaths in the UK which are related to antimicrobial resistant infection. Brought up, and read the First time.

I beg to move, That the clause be read a Second time. The new clause would require the Secretary of State to conduct and publish a review into the yearly number of deaths in the UK related to antimicrobial-resistant infections. I declare an interest as the secretary of the all-party parliamentary group on antimicrobial resistance. AMR is a major threat to public health globally and domestically, and it is already contributing to an estimated 35,200 deaths every year in the UK. AMR is a bit like a silent pandemic. It gets little media attention, but given the prediction that 39 million people worldwide will have died of AMR by 2040, it will eventually be pushed right up the political agenda. This is not simply a matter of people dying from infections that could not be treated; nearly all the advances in modern medicine over the last 50, 60 or 70 years would be null and void. It would be too risky for someone to have something like a hip replacement, because of the risk of getting an infection that could kill them; they would be better off living with a painful arthritic hip than taking the risk of dying from sepsis. It is the same with things like heart disease, while giving birth will once again become one of the most dangerous things a woman can do if we lose the impact and effectiveness of antibiotics. The Government invested more than £560 million in AMR programmes between 2020 and 2024, so it is reasonable that Parliament should receive an annual assessment of AMR-related deaths to ensure that that significant public investment is delivering results, represents value for money and is targeted where it can have the greatest impact. We cannot effectively tackle what we do not measure, and an annual review of deaths linked to AMR would provide a clear, consistent picture of the scale of the problem and enable Parliament and the public to track whether policies are working. Better data leads to better targeted interventions. We know that rapid diagnostic tests and different types of decontamination will be hugely important in tackling AMR, along with potential future technologies such as phage technology. Surveillance has already identified significant variations by age, deprivation and geography. Understanding where deaths are occurring, and in who, would help direct resources to the communities and services that are most affected. AMR threatens the effectiveness of modern medicine, including surgery, cancer treatment and routine healthcare. An annual review of AMR-related deaths would ensure that this growing public health threat receives the attention and urgency it deserves. The reason I am determined to push it up the agenda is that the national cancer plan does not specifically mention AMR or infection, but it is the second biggest cause of death in cancer patients. At the moment, it is not pushed up the political agenda enough.

I commend the hon. Member for outlining this important issue before the Committee and for his work on the APPG. AMR is recognised as a chronic risk in the Government’s national risk register. In 2022, it was estimated that 7,500 deaths per year can be directly attributed to AMR in the UK, with a further 35,000 deaths per year associated with AMR. It is a significant and growing issue that the Government take very seriously—I want to assure the hon. Member and the Committee of that. Through the delivery of the 2024 to 2029 UK AMR national action plan, the Government are already taking comprehensive action to tackle this threat and ultimately reduce the burden it places on individuals, families and the healthcare system. That is where that work is located. I am not convinced that a review of the number of deaths at this point, while important, would add significantly to our understanding of the impact and burden of AMR or to the action being taken to address it, which we do take seriously. The Government will continue to work with APPGs and with information around this issue through the action plan. For that reason, I ask the hon. Member to withdraw the new clause.

I thank the Minister for her comments. We understand that the Government take this matter very seriously, but we are working on estimated numbers of deaths for something that will eventually be killing more people than covid. We really need some tangible figures, so I will press the new clause to a Division. Question put, That the clause be read a Second time.

New Clause 36

Duty of NHS boards to report medical malpractice

“(1) A member of the board of directors of an NHS trust or an NHS foundation trust in England must report any evidence or reports they have seen of systemic medical malpractice within the trust to—

(a) the Care Quality Commission,

(b) the Department of Health and Social Care, and

(c) the Health Services Safety Investigations Body.

(2) The board of directors of an NHS trust or NHS foundation trust in England has a collective duty to—

(a) refer the trust to the Care Quality Commission, and

(b) alert the Department of Health and Social Care and the Health Services Safety Investigations Body, if staff employed by, or acting on behalf of, the trust raise concerns of systemic medical malpractice.

(3) In this section, “systemic medical malpractice” means an action or omission in the provision of health care that falls below the expected standard of care and indicates a widespread, patterned, or recurring failure within the systems, processes, or governance of the trust.”—(Helen Morgan.)

This new clause would introduce a mandatory individual duty for members of NHS and Foundation Trust boards to escalate evidence of systemic medical malpractice to the CQC, the Department of Health and Social Care, and the HSSIB. It also imposes a collective duty on the board to formally refer the trust to regulators if staff raise concerns regarding malpractice.

Brought up, and read the First time.

With this it will be convenient to discuss new clause 37—Powers for coroners and medical examiners to report suspected health system failings— “(1) The Secretary of State must, by regulations, establish a standard mechanism for coroners and medical examiners to refer cases where they suspect failings in the provision of health care. (2) A coroner or a medical examiner has a duty to report (a ‘duty to whistleblow’) using the mechanism established under subsection (1) if, in the course of their duties, they have reasonable grounds to suspect that a death or incident involved systemic failings in a health care setting. (3) A referral under this section must be directed to any or all of the following bodies, as the coroner or medical examiner considers appropriate, based on the nature of the suspected failing— (a) the chief officer of police for the relevant police area, (b) the Care Quality Commission, (c) the Department of Health and Social Care, and (d) the Health Services Safety Investigations Body. (4) Regulations under subsection (1) must specify— (a) the information to be included in a referral, (b) the timeframe within which a referral must be made following the formation of a suspicion, and (c) guidance on the criteria for determining to which of the bodies listed in subsection (3) the referral must be directed. (5) A disclosure made in fulfilment of the duty under subsection (2) is a protected disclosure for the purposes of Part 4A of the Employment Rights Act 1996 (protection for whistleblowing). (6) The duties imposed by this section are in addition to, and do not affect, a senior coroner’s duty to make a report under paragraph 7 of Schedule 5 to the Coroners and Justice Act 2009 (reports on action to prevent other deaths).” This new clause requires the Secretary of State to create a standardised framework for them to formally refer suspected health system failings (including systemic issues) directly to the police, the CQC, the Department of Health and Social Care, and the HSSIB, with a duty on coroners to participate. It provides legal protection for those making such referrals.

I thank the hon. Member for North Shropshire, who raises issues of patient safety diligently on behalf of her constituents and the wider system. I will take the time to answer some of the points about where the Government are. Obviously, we support prioritising patient safety, which along with service quality and experience is of the utmost importance. On new clause 36, trusts are already subject to regulatory and contractual requirements to report medical malpractice, which is why we do not think the new clause is necessary. For example, CQC regulations on safe care and treatment and on good governance are central to trust accountability for systemic malpractice. They require trusts to have effective systems to identify patterns of harm, manage risks and deliver system-wide improvements. Trusts are required to identify and report incidents leading to significant harm through the Learn from Patient Safety Events service, ensuring that the CQC is informed and enabling NHS England to identify trends and support learning and improvement. This information can be shared with and accessed by HSSIB and could in the future be shared with and accessed by the investigations arm of the CQC. The CQC regulation on duty of candour reinforces transparency through truthful accounts of what has happened when something goes wrong, including where harm reflects systemic issues. Under the patient safety incident response framework, trusts must undertake patient safety learning investigations into certain incidents to support learning and improvement. In parallel, the NHS provider licence requires NHS trust boards to maintain clear accountability for quality of care and reporting of safety information through effective governance systems. Where failures of governance occur, NHS England has the powers to intervene. Those powers will transfer to the Secretary of State as part of the Bill. The new clause would clearly duplicate current processes. Together, the existing mechanisms already help trusts to identify and address systemic issues locally, while enabling national aggregation to support system-wide learning. New clause 37 seeks to require the creation of a standardised framework for coroners and medical examiners to report health system failings. I take the opportunity to reassure the hon. Member for North Shropshire that regulations already require medical examiners to report serious concerns identified in respect of clinical governance, patient safety or public health surveillance, in accordance with local reporting arrangements. Existing regulations also require coroners, in the context of an investigation, to issue a report to a person, organisation, local authority, or Government Department or agency where the coroner believes they may have power to take relevant action to prevent future deaths. In September 2024, the Department of Health and Social Care introduced death certification reforms, putting in place regulations to provide greater safeguards for the public by ensuring independent scrutiny by medical examiners of all deaths not investigated by a coroner. These reforms, as set out in the Medical Certificate of Cause of Death Regulations 2024, which require an independent review to be carried out for all deaths in England, introduce a system whereby all deaths are subject to either a medical examiner’s independent scrutiny or a coroner’s investigation. Should the medical examiner detect concerns about care, they will refer such cases to established clinical governance review processes and bodies and notify the coroner or, if necessary, the police. The Notification of Deaths Regulations 2019 require all doctors, including medical examiners, to refer a death to a coroner if they believe that deficiency of care while undergoing treatment contributed to the death, making the death unnatural. Under the Coroners and Justice Act 2009, a coroner has a statutory duty to report issues to the appropriate bodies where they believe that action can be taken to mitigate or prevent the risk of future deaths, and both the report and responses to it are published by the chief coroner. When incidents and errors occur resulting in death or serious injury, it is important that we learn any lessons. The Government are committed to ensuring that the prevention of future deaths reports are taken seriously and lead to meaningful action. The Department is working across Government and with the chief coroner to identify ways to strengthen oversight and ensure that the right organisations are consistently notified of concerns, respond to them in a timely manner and drive appropriate action. Under the Medical Act 1983, the General Medical Council ensures that all doctors, including medical examiners, report suspected health system failings by speaking up. That is a mandatory professional obligation linked to a doctor’s licence to practise, embedding this whistleblowing requirement into the GMC’s core regulatory and fitness to practise frameworks. The GMC also enforces a professional duty of candour requiring all doctors to be open and honest with patients and official bodies when things go wrong and actively report adverse incidents so that systematic lessons can be learned. In summary, both new clauses duplicate requirements that already exist. Regulations, systems and processes are already in place to report suspected health system failings to the appropriate bodies. For that reason, I ask the hon. Member for North Shropshire to withdraw the new clause.

I beg to move, That the clause be read a Second time. This is a very straightforward new clause. The Secretary of State would be required to ensure that there are single-sex changing rooms, toilets and washing facilities for NHS staff and single-sex wards, toilets and washing facilities for NHS patients. The UK Supreme Court unanimously ruled that a woman is defined by biological sex in 2025, and the Minister herself said: “We are completely committed to single-sex spaces.” However, it appears that the Minister for Women and Equalities did not get that memo. Despite having apparently been sat on her desk since September, the new draft code from the Equality and Human Rights Commission was not laid before Parliament until 21 May. One week before that guidance was published, a female NHS England employee in Leeds won her claims of indirect sex discrimination and harassment over a policy allowing transgender colleagues to use toilets and changing rooms that correspond to their gender identity rather than their biological sex. On 28 June, after the draft code was laid, it was reported that West London NHS trust had told patients that they could use single-sex facilities based on gender identity. It has taken the current Health Secretary some time, but I understand that he has changed his mind on the issue and come to the same conclusion as others: that a woman is, in fact, a woman and that toilets and changing facilities must be protected. Will the Minister follow his lead and protect single-sex spaces in NHS trusts? The Supreme Court has ruled that a woman is defined by her biological sex. My party knows that. The Minister claims her party knows that too. It is time for her to show it by pulling the levers that only she can to ensure that patients and staff are protected right across our health service.

I am grateful to the hon. Member for bringing this discussion before the Committee. She is right that, following the For Women Scotland case at the Supreme Court in April 2025 and the recent laying of the Equality and Human Rights Commission’s updated code of practice on 21 May, ensuring the provision of single-sex facilities for patients and staff is a prominent issue. The Government welcomed the clarity provided by the Supreme Court judgment. The EHRC code of practice sets out how service providers may lawfully apply sex-based distinctions following the Supreme Court judgment. That guidance is applicable to services, public functions and associations and includes, but is not limited to, the services provided in the NHS. Following that, NHS England drafted the revised guidance, “Privacy, dignity and safety in hospital accommodation”, which will align with the legal position and the EHRC code of practice and replace existing guidance. I know that many colleagues are impatient to see the existing guidance replaced following the Supreme Court ruling. It was important to wait for the EHRC code of practice to be published so that it could be considered in any guidance. The code of practice was published on 21 May. Following the publication, NHS England reviewed the guidance to ensure that it was in line with the code. The code was subject to a 40-day laying period before Parliament, which ended on 9 July. The Government expect the code to come into force in early August. Guidance for the NHS will be published shortly afterwards. NHS England is also developing guidance on staff facilities, including changing rooms, toilets and washing facilities that should be used by trusts and ICBs. The provision of physical single-sex facilities for NHS staff is for NHS organisations to individually manage in line with their legal obligations. There is already legislation covering this issue, particularly the Workplace (Health, Safety and Welfare) Regulations 1992. Organisations should already be conducting assessments of their own estates and the needs of their workforce to decide what changes they need to make to comply with all legislative requirements. On mixed-sex accommodation and breaches, there is a long-standing policy of same-sex accommodation. Individuals should not have to share sleeping accommodation with patients of the opposite sex unless appropriate. In practice, the proposed amendment does not allow scope for mixed-sex accommodation where clinically appropriate—for example, intensive care unit facilities or where it is necessary for patient safety. For those reasons, I ask the hon. Member for Sleaford and North Hykeham to withdraw the new clause. Question put, That the clause be read a Second time.

New Clause 40

Public private partnerships

“(1) Within six months of the passage of this Act, the Secretary of State must publish a report explaining the business case for the use of public private partnership for Neighbourhood Health Centres.”

(2) The report under subsection (1) must be laid before both Houses of Parliament.”—(Dr Caroline Johnson.)

This new clause would require the Secretary of State to publish a report detailing the business case for the use of Public Private Partnership for Neighbourhood Health Centres.

Brought up, and read the First time.

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

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.

I agree with everything that the Minister has to say—what a surprise—but particularly the fact that when the new Government came in, they did something about these 40 “new” hospitals that were not full hospitals. The people of Bury St Edmunds were delighted to learn that their RAAC-affected hospital, which is tumbling down, will be one of the first to be reconstructed. We look forward to that and are grateful for the decisions made by the Government.

I thank my hon. Friend for that. Across the east of England, where we now have so many Labour MPs, everyone has been trying to rectify the mismanagement that local people have seen, particularly of the capital estate. I will not detain the Committee on the capital estate—one of my favourite subjects—for very long. The hon. Member for Sleaford and North Hykeham is aware that the decision on neighbourhood health centres was announced in the autumn. The decision-making process was supported by a business case to examine the feasibility of developing a new model, learning the lessons of the past on public-private partnerships specifically to build neighbourhood health centres as part of our 10-year plan. That informed the decision to proceed. The business case was a strategic outline case, the purpose of which was to scope and identify the preferred way forward for a new potential model, in line with the Treasury’s five case model. We are now working with the National Infrastructure and Service Transformation Authority to develop this further, and we expect a further round of market engagement in the autumn. I recognise the interest in making the business case available to both Houses, but that must be balanced with the need to develop an effective policy. Publication while policy development is ongoing would limit full, candid and proper deliberation. Civil servants and subject experts need to be able to engage in frank discussion of policy options to expose their merits, demerits and possible implications. Their candour in doing so would be affected by their assessment of whether the content of such discussions would be disclosed. We are committed to building neighbourhood health centres across the country. That is what patients and the public deserve. We will obviously be mindful of public money and subject to the usual processes of the House, including the Public Accounts Committee. We will learn those lessons. We are in full discussion with NISTA. For those reasons, we are committed to developing good estate across our country. That is what our constituents deserve. I therefore ask the hon. Member for Sleaford and North Hykeham to withdraw her new clause.

For the record, I am a member of the Royal College of Paediatrics and Child Health and work as a consultant paediatrician at North West Anglia NHS foundation trust, which will have a new hospital. I would like to press the new clause to a vote. Question put, That the clause be read a Second time.

New Clause 41

Use of private providers

“Within six months of the passage of this Act, the Secretary of State must make regulations which make provision for the use of private providers to improve NHS treatment access and reduce NHS treatment waiting times.”—(Dr Caroline Johnson.)

Brought up, and read the First time.

I beg to move, That the clause be read a Second time. This new clause asks the Government to use private providers to help get waiting lists down. We are told that waiting lists are falling, but the Government’s own figures show that waiting lists are higher than they were last month, and if we look at the group of people who are waiting for admission for a procedure or operation, they are higher than they were last month, last year or indeed at the general election in 2024. There were 76,250 women waiting for gynaecological treatment at the end of July ’24, when this Labour Government took office; that rose by more than 6,000 patients to 82,623 as of May 2026. Private providers have capacity that may be able to help with that. The deployment of private providers is about using all the resources and capacity on offer across the country to get waiting lists down. The NHS uses private providers to perform some surgeries and scans, mental health support, GPs and dentistry, but it is a sensible measure to ensure that all hands are on deck when it comes to treating patients. I look forward to hearing how the Minister can use private providers to get more patients seen more quickly as opposed to wiping them from waiting lists at record rates.

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.

If this is put on the statute book, will it not mean that the private sector can have more and more hospitals, when we should be using them only if the NHS does not have the capacity? The private sector should be the last resort rather than a first choice.

I am slightly confused, as I suspect other Committee members are, by the Opposition’s approach to the private sector, having had a discussion in relation to the previous new clause about not using the private sector and boosting work and employment opportunities in our country. They do have a slightly odd view with regard to this. As I said, our view is very pragmatic: it is to support the treatment of patients to get waiting lists down. That is what our constituents deserve. Where capacity can be used, we want to make sure that that choice is available.

I am confused by the Opposition referring in their new clause to a requirement to “make regulations” in this respect, as the private sector is already widely used to reduce waiting lists where appropriate. However, we must also be aware of the problem we have with overuse of private facilities. That can have an effect on the provision of NHS services, because the number of available staff is limited. I think particularly of ophthalmology services, as we have created a situation in which the overprovision of private services has disabled the provision of ophthalmology services.

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.

The previous use of private providers was to remove debt from the Government’s balance sheet. That is not the same as providing guidance and regulations on how to increase capacity and use the spare capacity of private providers to reduce waiting lists, which are currently rising. In response to the point made by the hon. Member for Bury St Edmunds and Stowmarket, the workforce plan is important. Despite that plan being “imminent” for several weeks now, it has not been published. I will press the new clause to a vote. Question put, That the clause be read a Second time.

New Clause 42

Funding for Care Quality Commission (CQC) investigations

“The Secretary of State has a duty to make provision for adequate funding and resources for patient safety investigations conducted by the CQC, including some initiated by the CQC themselves.”—(Dr Caroline Johnson.)

Brought up, and read the First time.

Question put, That the clause be read a Second time.

New Clause 44

Medical training places

“The Secretary of State must double the number of medical school training places to 15,000 by 2031-32.”—(Dr Caroline Johnson.)

This new clause would put a duty on the Secretary of State to double the number of medical school training places.

Brought up, and read the First time.

Question put, That the clause be read a Second time.

New Clause 45

Data collection: clinically trained staff

“(1) The Secretary of State must collect and publish data on the numbers and proportion of NHS staff are qualified to deliver nursing and clinical care who delivering nursing care, or clinical care of any kind, and those who are not.

(2) Information under subsection (1) must be collected according to HCAS pay scales.

(3) Information under subsection (1) must include numbers of nursing and midwifery staff.

(4) Information under subsection (1) must be published quarterly.

(5) The NHS and ICBs are under a duty to comply with any requests from the Secretary of State for data for this purpose.

(6) Information under subsection (1) must include the proportion of time spent delivering clinical care as a proportion of the individual’s total working hours.”—(Dr Caroline Johnson.)

This new clause would require the Secretary of State to collect and publish data on the numbers and proportion of clinically qualified staff who are delivering clinical care, broken down by HCAS pay band.

Brought up, and read the First time.

Question put, That the clause be read a Second time.

New Clause 46

Redundancies

“The Secretary of State must publish, within 12, 24, and 48 months of the passage of this Act, the number of persons—

(a) employed by the Department for Health and Social Care; and

(b) made redundant following the abolishment of NHS England under subsection (1) of this Act.”—(Dr Caroline Johnson.)

This new clause would require the Secretary of State to publish of the number of staff in the Department for Health and Social Care and the number of people made redundant following the abolishment of NHS England.

Brought up, and read the First time.

I beg to move, That the clause be read a Second time.

With this it will be convenient to discuss the following: New clause 75—Transition strategy for the abolition of NHS England— “(1) The Secretary of State must, before the abolition of NHS England takes effect, prepare and lay before Parliament a report setting out a transition strategy for the abolition of NHS England (the ‘strategy’). (2) The strategy must— (a) identify and map critical functions and areas of expertise currently exercised by NHS England, including clinical, operational, analytical and patient engagement capabilities; (b) assess the risk of loss of knowledge, skills and organisational capacity arising from the abolition of NHS England; (c) set out the steps the Secretary of State proposes to take to ensure the retention and effective transfer of such functions, expertise, knowledge and skills; and (d) assess the likely impact of the transition on the delivery of key health programmes and services, including cancer services. (3) The Secretary of State must, at intervals of not more than 12 months, lay before Parliament a report on the implementation of the transition strategy. (4) A report under subsection (3) must include— (a) progress on workforce retention; (b) arrangements for the transfer of knowledge, expertise and institutional capability; and (c) any identified gaps in capability and the steps being taken to address them.” This new clause would require the Secretary of State to prepare and lay before Parliament a formal transition strategy before the abolition of NHS England, setting out how critical functions and expertise will be identified, retained and transferred. It would also require the Secretary of State to report to Parliament at least annually on the implementation of that strategy. Amendment 37, in clause 71, page 48, line 28, at end insert— “(3A) The Secretary of State may not make regulations under subsection (3) commencing section (1) until the conditions in subsection (3B) are met. (3B) The conditions are that— (a) the Secretary of State has published a document setting out the operating model for the exercise of functions by the Department of Health and Social Care following the abolition of NHS England (the ‘operating model document’); and (b) the Secretary of State has published a plan for the management of personnel affected by the abolition of NHS England and the transfer of its functions to the Department of Health and Social Care (the ‘workforce transition plan’). (3C) The operating model document must include— (a) a description of how each of the functions exercised by NHS England is to be exercised following its abolition; (b) the governance and accountability arrangements for the exercise of those functions; (c) the organisational structure of the Department of Health and Social Care as it will operate following the abolition; and (d) the proposed timetable for the transition. (3D) The workforce transition plan must include— (a) an assessment of the number of personnel whose employment is affected by the abolition of NHS England; (b) the arrangements for the transfer, redeployment or redundancy of affected personnel; and (c) proposals for consultation with recognised trade unions and staff representative bodies in connection with the abolition. (3E) Regulations to commence section (1) are to be made by statutory instrument and may not be made unless a draft of the instrument has been laid before, and approved by a resolution of, each House of Parliament. (3F) Before laying a draft instrument under subsection (3E), the Secretary of State must allow a period of at least 60 days beginning with the date of publication of the operating model document and the workforce transition plan (whichever is the later) before the draft instrument is laid. (3G) A period during which Parliament is dissolved, prorogued or adjourned for more than four days are not to count towards the 60-day period in subsection (3F).” This amendment would prevent the abolition of NHS England before the production of an operating model for the merged DHSC/NHSE and associated plan to manage personnel. Amendment 38, in clause 71, page 48, line 28, at end insert— “(3A) The Secretary of State may not make regulations under subsection (3) commencing section (1) until the condition in subsection (3B) has been met. (3B) The condition is that the Secretary of State has published an impact assessment in respect of the abolition of NHS England that complies with subsection (3C) (a ‘qualifying impact assessment’). (3C) A qualifying impact assessment must include— (a) a quantified estimate, expressed in monetary terms, of the total transition costs of abolishing NHS England, including in particular— (i) redundancy costs; (ii) the costs of integrating data, digital and information technology systems; (iii) the costs of reorganising and rehousing staff and functions; and (iv) productivity losses during the transition period; (b) a quantified estimate, expressed in monetary terms, of the ongoing annual costs of the restructured Department of Health and Social Care following the abolition of NHS England, including any costs falling on integrated care boards as a result of the transfer of functions to them; (c) a quantified estimate, expressed in monetary terms, of the estimated annual savings arising from the abolition, including savings from the elimination of duplicated corporate functions and reduced administrative costs; (d) a quantified estimate, expressed in monetary terms, of the net present value of the abolition, being the difference between the total costs under paragraphs (a) and (b) and the total benefits under paragraph (c) over a period of not less than ten years; (e) a statement of the key assumptions underlying the estimates in paragraphs (a) to (d) and an assessment of the sensitivity of those estimates to changes in those assumptions; (f) an assessment of the risks to the delivery of the anticipated benefits, including the risk of disruption to NHS functions during the transition period; and (g) a statement of the methodology used to produce the estimates, including any data sources relied upon. (3D) Before publishing a qualifying impact assessment, the Secretary of State must submit it for independent scrutiny to the Regulatory Policy Committee (or any successor body) and must publish the Committee's opinion on the assessment alongside it. (3E) The Secretary of State must lay the qualifying impact assessment and the Committee's opinion before both Houses of Parliament. (3F) Regulations to commence section (1) are to be made by statutory instrument and may not be made unless a draft of the instrument has been laid before, and approved by a resolution of, each House of Parliament. (3G) A draft instrument under subsection (3F) may not be laid unless at least 60 sitting days have elapsed since the qualifying impact assessment was laid under subsection (3E).” This amendment requires the Secretary of State to publish, and submit to independent scrutiny, an impact assessment on the abolition of NHS England, containing quantified cost and benefit figures, before making regulations to abolish the body. Amendment 39, in clause 71, page 48, line 28, at end insert— “(3A) The Secretary of State may not make regulations under subsection (3) commencing section (1) until the condition in subsection (3B) is met. (3B) The condition is that the Secretary of State has published a plan setting out how health services provided by or under arrangements made by NHS bodies are to work alongside and be integrated with the social care system in England (the ‘health and social care integration plan’). (3C) Before preparing the health and social care integration plan, the Secretary of State must have regard to— (a) the recommendations made by the Independent Commission on Adult Social Care chaired by Baroness Casey of Blackstock (or any successor body undertaking that Commission’s work) in any report published by the Commission before the plan is laid; and (b) the need to reflect any such recommendations in the content of the plan so far as they are relevant to the interface between health services and adult social care. (3D) The health and social care integration plan must include— (a) a description of the structural and operational arrangements for joint working between NHS bodies and local authority social care services following the abolition of NHS England; (b) proposals for how the transfer of NHS England’s functions to the Secretary of State will affect the coordination of health and social care commissioning, including in particular the commissioning of services for people with complex needs spanning health and social care; (c) arrangements for reducing delayed discharges from hospital attributable to the absence of suitable social care provision; (d) proposals for how the funding flows between the NHS and the social care system, including NHS Continuing Healthcare, will be managed following the abolition; (e) the workforce implications for the health and social care sectors arising from the abolition and the steps to be taken to address them; and (f) a timetable for implementing the arrangements described in the plan. (3E) The Secretary of State must lay the health and social care integration plan before both Houses of Parliament. (3F) Regulations to commence section (1) are to be made by statutory instrument and may not be made unless a draft of the instrument has been laid before, and approved by a resolution of, each House of Parliament. (3G) A draft instrument under subsection (3F) may not be laid before either House of Parliament until at least 60 sitting days have elapsed since the health and social care integration plan was laid under subsection (3E). (3H) In this section— ‘NHS body’ has the same meaning as in the National Health Service Act 2006; ‘social care system’ means the system for the provision of care and support under the Care Act 2014 and services provided by local authorities in the exercise of their functions relating to adult social care.” This amendment requires the Secretary of State to publish and lay before Parliament a plan setting out how health services will work alongside the social care system following the abolition of NHS England before using their powers for its abolition. The plan must address joint commissioning, funding flows (including NHS Continuing Healthcare), delayed hospital discharges, and workforce.

New clause 46 would require the Secretary of State to publish the number of staff in the Department of Health and Social Care and the number of people made redundant following the abolition of NHS England. New clause 75 would require the Secretary of State to prepare and lay before Parliament a formal transition strategy. Amendment 37 would prevent the abolition of NHS England before the production of an operating model. Amendment 38 would require the Secretary of State to publish and submit to independent scrutiny an impact assessment on the abolition of NHS England containing quantified cost and benefit figures before making regulations to abolish it. Amendment 39 would require the Secretary of State to publish and lay before Parliament a plan setting out how health services will work alongside the social care system following the abolition of NHS England before using the powers in the Bill for abolition. The plan must address joint commissioning, funding flows, delayed hospital discharges and the workforce. The problem is essentially that Ministers marched off into a battle without a plan and continue to fight without one. In this Committee, we have heard consistently about the number of times that things have not been thoroughly planned out and properly considered, particularly in relation to social care. I know that Members on all sides of the House are concerned about how social care will interact with the health service under the proposed new regime. In March 2025, Ministers and officials were going to work to determine what was needed, and in March 2026, they were still progressing to develop the design—12 months later, there was a change in tense but still no proper plan. When putting the Bill before the House, the Government published an impact assessment, but where there should be numbers quantifying how much this is all going to cost us, there is simply “N/A”. How is that any way to conduct a reorganisation? That is why I tabled amendments 37, 38 and 39. They would apply the brakes until the operating model had been established by requiring the full publication of a proper impact assessment, a detailed plan of how the health service will work alongside social care, and the publication of redundancy figures. They would ensure that the Government have worked out what they are going to do before they get on and start doing it.

The Government of course recognise the importance of clarity and assurance as we undertake this significant transformation, including on how functions, governance and the workforce will operate in the future. That is essential for ensuring that our staff and other stakeholders understand the new role of the Department. On new clause 46, we recognise the importance of transparency around departmental workforce numbers and the impact of abolishing NHS England. The Government remain committed to significantly reducing headcount across NHS England and the Department of Health and Social Care, but I put on record my thanks to all the staff and talented professionals working in both organisations; this is a difficult time for them. However, this new clause is not necessary. Workforce information is already published both monthly and through the Department’s annual report and accounts, alongside wider Government transparency publications. Placing a further reporting requirement in legislation would risk duplicating existing transparency data, so it is unnecessary to include it in the Bill. On amendment 37, I reassure the Committee that we will consult on the proposed structure for the new Department of Health and Social Care, and that is also required under existing employment law. The structure will clearly explain what every part of the new Department will do and set out every post we think we need. The target operating model is an internal document that sets out the proposed purpose, role, governance and organisational structure of the future Department. It will be shared internally, following engagement with staff and stakeholders, including trade unions. The chair of NHS England, Dr Penny Dash, has committed to sharing it with the Health and Social Care Committee once it is finalised. The target operating model will be used to guide detailed organisational design and will iterate over time. The proposed design of the new organisation will be subject to consultation. The target operating model does not implement changes that remain subject to parliamentary approval through this Bill. On workforce transition, we will follow TUPE-like principles whether TUPE or any other transfer mechanism applies, in line with the Cabinet Office statement of practice on staff transfers in the public sector. That means that recognised trade unions will be formally consulted and engaged with on measures related to the transfer. No changes to contractual terms and conditions will be made without proper consultation and engagement. We are committed to maintaining an ongoing dialogue with trade unions and staff throughout this period of change, and we are updating them as often as possible. Where appropriate, we are also committed to working with staff networks on the changes, particularly on how we can best support staff. Given those commitments, I hope that the hon. Member for Sleaford and North Hykeham agrees that placing further requirements in the Bill would be disproportionate. On amendment 38, we agree that it is important to be transparent about the costs and benefits of this programme. The Department has been open about the initial estimate of around £1 billion of savings per year, and we published an impact assessment alongside the Bill. The detailed timing and scale of costs and savings from the programme depend on factors such as the take-up of voluntary exit and redundancy schemes, which are under way. We will continue to refine our assessment of costs and savings as the programme progresses and as we move towards the abolition of NHS England. We will continue to be open about those figures. The savings will support continued investment in frontline services. The timescales set out in the amendment would risk delaying the abolition of NHS England and, as a result, would delay the transfer of savings to frontline services and the stability and certainty we need for our staff. On amendment 39, the Government are committed to supporting the integration of health and social care so that people experience more joined-up, person-centred care. Key planning frameworks, including for the better care fund and for neighbourhood health, already stress the critical importance of strong join-up and integration. We expect those frameworks to continue to guide the health and care system following the abolition of NHS England. Most importantly of all, we are committed to developing neighbourhood health approaches as an essential part of reforming the health and care system. That approach will deliver more integrated services across health, local government and wider partners, including the voluntary and community sector. The Bill simplifies existing complex legal frameworks to make collaboration easier and emphasises the role of health and wellbeing boards as a focal point for that collaboration. However, partnership and collaboration take many forms depending on local circumstances, and they cannot simply be prescribed through a centrally developed plan. Instead, we should encourage areas to develop effective, productive relationships in the interests of the people they serve. We have discussed that in this Committee, and hon. Members from all parties have a key role to play there. Turning to new clause 75, we absolutely recognise the need to ensure that critical functions, expertise and organisational capability are identified, retained and effectively transferred during this period of change. That is essential to maintaining continuity of services and supporting the delivery of key health programmes, including vital services such as cancer care. I reassure the Committee that that work is already well under way. We are carefully mapping all areas of current activity across NHS England, assessing what capabilities we need to deliver them in future and putting processes in place to support the retention and transfer of expertise. This includes the phased approach we are taking to workforce changes, alongside a robust and consistently applied process for voluntary redundancies and voluntary exits, to minimise disruption and protect critical skills. We are also committed to ongoing monitoring and oversight through the transition, and as part of our programme of governance, there is ongoing consideration of skill retention, knowledge transfer and organisational capability, and we will take action where gaps are identified. As drafted, the new clause would introduce a new statutory requirement to produce and lay before Parliament a formal transition strategy before the abolition of NHS England and the implementation of transfer schemes, alongside new ongoing reporting obligations. While well-intentioned, it would add another unnecessary step into what is already a complex and carefully sequenced programme. It would reduce the flexibility needed to adapt workforce organisational decisions as the transformation progresses. For those reasons, the Government believe that the objectives of the new clause are already being delivered through existing programme arrangements, without the need to place further requirements in the Bill.

I listened carefully to what the Minister said, but I do not know where the Government have transparently published all these numbers and calculations. A lot of parliamentary questions have been asked on the detail of this transition, so I think it is important that the detail is published so we can see it, and that the detail is planned, before the abolition process takes place. I therefore want to press the new clause to a vote. Question put, That the clause be read a Second time.

New Clause 47

Fracture liaison services: rollout plan

“(1) The Secretary of State must, within 90 days of the day on which this Act is passed, publish a plan for securing the provision of fracture liaison services across England.

(2) A plan under subsection (1) must include—

(a) an assessment of current access to fracture liaison services in each integrated care board area;

(b) annual milestones for achieving universal access to fracture liaison services by 2030;

(c) the steps the Secretary of State intends to take to support integrated care boards to commission fracture liaison services;

(d) any proposed use of directions, guidance, financial assistance, incentives or other mechanisms to secure delivery;

(e) workforce, diagnostic, digital and data requirements for implementation; and

(f) arrangements for monitoring, publishing and reporting progress.

(3) The Secretary of State must lay a plan made under subsection (1) before both Houses of Parliament.

(4) The Secretary of State must, within 12 months of publishing a plan under subsection (1), and every 12 months thereafter until 2030, lay before Parliament a report on progress made against the milestones in the plan.

(5) In this section—

‘fracture liaison service’ means a service for the systematic identification, assessment, treatment and monitoring of people who have sustained a fragility fracture, for the purpose of reducing their risk of further fractures.”9—(Dr Caroline Johnson.)

This new clause would require the Secretary of State to plan to roll out fracture liaison services across England.

Brought up, and read the First time.

I beg to move, That the clause be read a Second time. The new clause would require the Secretary of State to publish a plan for securing the provision of universal fracture liaison services across England. As we get older, our bone density naturally decreases, increasing the risk of bone fractures and possibly osteoporosis, which affects 3.5 million people across the UK. Fracture liaison services identify people aged 50 or over who have broken a bone, and they provide treatment to reduce the risk of further debilitating fractures. Of those over 50, one in two women and one in five men will break a bone because of osteoporosis. Heartbreakingly, 2,000 people die each year from preventable fractures. When the former Secretary of State, the right hon. Member for Ilford North (Wes Streeting), claimed that delivering universal fracture liaison services would be one of his first priorities if elected to Government, many people hoped to see this happen, but it has not. The previous Conservative Government began rolling out fracture liaison services, and it is an indicator of just how little progress the current Government have made that 97% of today’s fracture liaison services were delivered by the Conservatives. What have the Labour Government been doing? What is more, one in two NHS trusts, following freedom of information requests, tell me that they have no fracture liaison service at all, which is quite literally an accident waiting to happen. I am very grateful to the Royal Osteoporosis Society for its campaigning on this issue. By its calculations, at the current rate of delivery, it will take 38 years for the Government to deliver universal fracture liaison services, which is obviously far too slow. We have tabled the new clause because the Government need a plan. The former puppeteer of this Government, Morgan McSweeney, made it clear that Labour did not have a plan for government. The new clause would require the Secretary of State to deliver a plan within 90 days, not just to secure the provision of universal fracture liaison services but to deliver on his predecessor’s very clear and very deliberate promise to do so. The Minister in the other place was asked whether an implementation plan for fracture liaison services was needed. The answer was, effectively, no. What is the view of the Minister before us in Committee? There are so many critical questions in this area that have no answers and that a plan would and should address. What are the Minister’s annual milestones for achieving universal access to fracture liaison services by 2030? How will the Minister’s plans to cut ICB budgets by 50% impact that key promise? An important question on the promise is whether the Minister’s plans to merge ICBs mean that fewer services will now be delivered. How will that impact patients? What extra workforce, diagnostic and NHS estates capacity is required to deliver it? Yet again, as so often with this Government, we are left with a headline-grabbing promise with no plan behind it. The consequence is that more than 40,000 people are predicted to die from hip fractures that could have been prevented through timely national implementation.

I am listening carefully to what the hon. Member, who is a medical colleague of mine, has to say. Although I think that a fracture liaison service is an excellent idea, there are many, many aspects of medical care that require careful attention, such as the management of people with hearing loss—my own field—or the assessment of people with chronic renal failure. Does the shadow Minister believe that all aspects of each individual disease category require some sort of primary legislation?

Not necessarily, no, but this one does, because the Government clearly made a promise before the election. The former Secretary of State was clear that it would be one of his first acts—that is what he said—and it has not happened, so in this case we need to hold the Government to account. It is our job to hold them to account on their promises, and I am afraid that they are failing on this one. To sum up, the Government need to get their act together, because otherwise more and more vulnerable people will come to unnecessary and potentially fatal harm. I look forward to hearing the Minister’s plans to accelerate the delivery of the Government’s promise—and fast.

It is a pleasure to serve under your chairmanship, Dr Huq. I welcome the Minister back from her son’s graduation —I hope it went well. I rise to state my support for new clause 47, which would require the Secretary of State to publish a clear roll-out plan for fracture liaison services across England and report annually to Parliament on progress towards universal coverage by 2030. It is not about creating a new target, because the target already exists: both this Government and the previous Government committed to achieving 100% fracture liaison service coverage by 2030. The question before us, as proposed by the shadow Minister, is simple: how will that promise be delivered, and how will Parliament know whether meaningful progress is being made? Fracture liaison services are one of the most evidence-based interventions in osteoporosis care. They systematically identify people aged over 50 who suffer a fragility fracture; assess their bone health; initiate treatment where appropriate; and monitor patients to reduce the risk of subsequent fractures. Given that around half of patients who sustain a hip fracture have previously broken another bone, those services represent a vital opportunity to intervene before a life-changing injury occurs. The human cost is considerable. Osteoporosis affects millions of people, particularly older women, and fragility fractures can result in a loss of independence, reduced mobility, social isolation and significant pressure on health and social care services. The National Institute for Health and Care Excellence estimates that around 180,000 fractures each year in England and Wales are attributable to osteoporosis. There is also a compelling economic case: the Royal Osteoporosis Society estimates that investing around £30 million in fracture liaison services could prevent approximately 74,000 fractures over five years, including 31,000 hip fractures, saving the NHS around £665 million and freeing up some 750,000 bed days. Few preventive interventions offer that combination of better patient outcomes and substantial savings for the NHS. The Government frequently point to their commitment to universal coverage by 2030, but as the shadow Minister pointed out, progress has been achingly slow. When the Secretary of State appeared before the Health and Social Care Committee last week, I questioned him on that issue directly. While he confirmed that the Department remains committed to meeting that 2030 target, which was first established by the previous Conservative Government, no plan—or indication of when a plan would come—was given. A commitment alone is not a delivery plan. There are also growing concerns that the Government have overstated the progress that has already been made. The Royal Osteoporosis Society has confirmed that more than 97% of the fracture liaison services counted by the current Government were already in place before the change of Government. So, rather than that representing any significant expansion in national coverage, this Government have gone slow. I think it is therefore very reasonable—to answer the question from the hon. Member for Bury St Edmunds and Stowmarket—for Parliament to be entitled to ask what additional progress has actually been made since the commitment was reaffirmed. New clause 47 would also require the Secretary of State to publish an assessment of access in every integrated care board area. It would also require annual milestones, because, at present, there is no publicly available timetable showing where the services will be established, or which areas will be prioritised or progressed between now and 2030. Crucially, the new clause would require the Government to set out how integrated care boards will actually be supported. Ministers rightly point out that fracture liaison services are commissioned locally by integrated care boards, but if the responsibility for delivery rests locally while responsibility for national targets rests with central Government, there clearly needs to be a well-thought-through national framework explaining how those boards will be supported through funding, guidance, workforce planning and accountability. This is, therefore, a straightforward request for transparency, accountability and, most importantly, delivery. If Ministers are committed to achieving this by 2030, they should have absolutely no objection to publishing a plan that shows how they intend to get there. For those reasons, I support the new clause.

I will partly agree with the Opposition to start off with: they are absolutely right that osteoporosis is a really important issue, particularly for older women. The hon. Member for Farnham and Bordon outlined some of the economic case, but crucially, it is a strong health issue. I worked and campaigned on this issue in opposition myself, because it predominantly affects older women. It also very much fits into our 10-year health plan regarding prevention. That is why we have also, for example, increased access to DEXA—dual-energy X-ray absorptiometry—scanners. It is rather disappointing, though, for a subject on which there is obviously so much agreement to be used as a political back-and-forth here today. Let me be clear. I think some of the comments show why some of this has got a bit confused, including for people who genuinely care about this rather than just wanting to make it a political issue. Again, it is entirely the Opposition’s job to oppose the Government, and I do not have any problem with that, but there is a serious issue here about how this is monitored. We are absolutely committed to having coverage across the country by 2030, as the Secretary of State has recently said. That is why we are rolling out more DEXA scanners and so on, but with the clustering of ICBs, 92% of the country is now covered across those clusters.

rose—

That is why it is important that we look at what is actually happening on the ground and how we are moving forward. We are committed to supporting this cohort, and particularly those patients for whom this condition is largely preventable. Care closer to home, based around our 10-year plan, is absolutely the right way to go about that.

Will the Minister give way?

I was going to outline the points, but I am happy to give way if the hon. Lady wants.

Can the Minister be clear on the point about ICBs? There is a concern that, where there are perhaps three ICBs, one of which has a service and two of which do not, and they merge together, the Government then say, “Aha! This ICB area now has coverage,” but that is for part of it, not all of it. What is important for a universal service is that it is available to all.

Again, the hon. Lady has intervened, but that is exactly my point. There is a danger here of the Conservative party focusing on a target or number and totally missing the point, which is to have good, locally available services accessible to this predominantly female and predominantly older population through our 10-year health plan. If one counts the new clustered ICBs in that target, 92% of areas are covered. We want to get to the heart of this issue. Integrated care boards are the commissioners of local health services and remain best placed to make decisions according to local need. Commissioning these services at a local rather than national level—which is the entire thrust of our 10-year health plan, and indeed this Bill—means that ICBs are best placed to commission holistic, integrated care that wraps around the patient’s need, where the patient is. We have been very clear in our 10-year health plan, and indeed in this Bill, that we are not expecting patients to fit in with models of care that have been devised over a period of time and in hospitals that are largely located far from their homes. We are looking at a close-to-home service and building models of care around peoples’ needs. A legislative requirement for a national implementation plan would cut across that responsibility, undermining local ability to tailor services to patient needs and causing confusion for delivery. That is why we do not think the new clause is necessary. The renewed women’s health strategy sets an expectation that ICBs prioritise community-based models when commissioning new fracture prevention services. The Department will continue to work closely with NHS England and ICBs to explore a range of options that provide better quality, and better access to, important preventive services. I therefore ask the shadow Minister to withdraw the motion.

I am afraid I am not reassured at all. The Minister seems to be saying that the ICBs will do it—the same ICBs where she is cutting their budgets, making them change the board and making them merge with each other all at the same time. The target is behind schedule and it is important that we hold the Government to account on it. Therefore, I will press new clause 47 to a vote. Question put, That the clause be read a Second time.

New Clause 48

Radiotherapy cancer treatment services

“(1) The Secretary of State must publish and maintain a national framework for improving access to radiotherapy services in England.

(2) The framework must include nationally agreed metrics against which integrated care boards must measure and report their investment in, and delivery of, radiotherapy services.

(3) The metrics must include provisions relating to—

(a) waiting times for radiotherapy, including time to definitive treatment;

(b) patient travel times to radiotherapy services, including defining an appropriate recommended travel time;

(c) the number of cancer patients receiving radiotherapy and the quality of such radiotherapy;

(d) the age, capability and replacement needs of radiotherapy equipment, including the proportion of linear accelerators that are more than 10 years old or otherwise beyond the recommended replacement age;

(e) access to modern radiotherapy techniques and technologies;

(f) radiotherapy capacity against population need and the projected increase in number of cancer patients;

(g) variation in access to radiotherapy services between integrated care board areas;

(h) provision of sustainable, flexible workforce that is equipped to harness advances in radiotherapy for patient benefit; and

(i) investment in radiotherapy services and the extent to which such investment reflects clinical need.

(4) Each integrated care board must publish an annual report on its performance against the metrics in the framework.

(5) Before publishing or revising the framework, the Secretary of State must consult persons with clinical, technical, operational and patient expertise in radiotherapy which the Secretary of State considers appropriate.

(6) The Secretary of State must lay before Parliament, at least once in each financial year, a report on the implementation of the framework.”—(Dr Caroline Johnson.)

This new clause would require the Secretary of State to publish and maintain a national framework for improving access to radiotherapy services in England.

Brought up, and read the First time.

I beg to move, That the clause be read a Second time.

With this it will be convenient to discuss the following: New clause 53—Cancer treatment: waiting times— “(1) Within six months beginning on the day on which this Act is passed, the Secretary of State must make provision for every patient to have access to cancer treatment within 62 days following referral. (2) The Secretary of State must establish a scheme to support NHS hospital trusts in meeting the requirement under subsection (1). (3) As part of the scheme, the Secretary of State must expand the capacity of the Medicines and Healthcare products Regulatory Agency. (4) The Secretary of State must make an annual statement to Parliament on progress on meeting the requirement under subsection (1). (5) Any statement made under subsection (4) should be made as close as reasonably practicable to 4 February.” This new clause gives patients a right to start cancer treatment within 62 days of referral and requires the Secretary of State to establish a scheme to deliver this. It also requires the Secretary of State to update the House on progress against the target on/around the time of World Cancer Day. New clause 54—Cancer Survival Research— “(1) Within 12 months beginning on the day on which this Act is passed, the Secretary of State must by regulations establish a Cancer Survival Research Programme. (2) Regulations under this section must— (a) require government co-ordination and funding for research into cancers with a five-year survival rate below 20%, and (b) establish a fellowship programme for foreign academics in cancer research. (3) Any programme established under paragraph 2(b) must make provision to waive visa fees for entry into the UK for participating academics. (4) Regulations under this section are subject to the affirmative procedure.” This new clause would require the Secretary of State to introduce regulations requiring the government to coordinate research into cancers with the lowest survival rate. New clause 65—National framework on radiotherapy treatment “(1) Within six months of the passage of this Act, Secretary of State must publish and maintain a national framework for improving access to radiotherapy services in England. (2) The framework must include minimum standards, established by the Secretary of State, against which— (a) integrated care boards must measure and report their investment in, and delivery of, radiotherapy services, and (b) the Secretary of State must assess the performance of integrated care boards. (3) The minimum standards under subsection (2) must include standards regarding— (a) waiting times for radiotherapy (including time to definitive treatment), (b) patient travel times to radiotherapy services, (c) the number of cancer patients receiving radiotherapy and the quality of such radiotherapy, (d) the age, capability and replacement needs of radiotherapy equipment, (e) access to modern radiotherapy techniques and technologies, (f) access to treatments recommended by the National Institute for Health and Care Excellence, (g) radiotherapy treatment capacity against current and projected population needs, (h) variation in access to radiotherapy services between integrated care board areas, (i) workforce capacity to deliver radiotherapy treatment, (j) the level of investment in radiotherapy services and the extent to which such investment reflects clinical need. (4) For the purposes of subsection (3)(d) the Secretary of State must set a maximum proportion of linear accelerators that are more than 10 years old or otherwise beyond the recommended replacement age. (5) Each integrated care board must publish an annual report on its performance against the minimum standards in the framework. (6) Where an integrated care board fails to meet at least one of minimum standards it must publish a remedial action plan setting out the steps it will take to achieve compliance. (7) Before publishing or revising the framework, the Secretary of State must consult all persons with clinical, technical, operational and patient expertise in radiotherapy the Secretary of State considers appropriate. (8) The Secretary of State must lay before Parliament, at least once in each financial year, a report on the implementation of the framework.” New clause 100—Single patient record: review of flagging for early cancer diagnosis— “(1) Within 12 months of the day on which this Act is passed, the Secretary of State must lay before both Houses of Parliament a report on the feasibility of using patient records held by the health service to indicate, to a person providing health care to a patient, cases in which a patient has presented symptoms on more than one occasion which may indicate the presence of cancer. (2) The report under subsection (1) must consider— (a) the potential for such indication to support early diagnosis of cancer in patients aged under 50 years of age, and (b) any implications of such an indication requirement for clinical responsibility and patient safety. (3) In preparing the report the Secretary of State must consult— (a) NICE, and (b) any other persons as the Secretary of State considers appropriate.” This new clause would require the Secretary of State to report on the feasibility of using patient records held by the health service to indicate, to a person providing health care to a patient, cases in which a patient has presented symptoms on more than one occasion which may indicate the presence of cancer.

New clause 48 would require the Secretary of State to “publish and maintain a national framework for improving access to radiotherapy services in England.” One in four people can expect to need radiotherapy in their lives. That is a lot of people who will need consultation, assessment, pre-treatment planning and treatment delivery. Data published a few years ago showed that Scotland, Wales and Northern Ireland have more linear accelerator machines per million people than in England. Can the Minister confirm whether that is still the case? Last year, Radiotherapy UK had research indicating that more than 60,000 cancer patients are not getting the radiotherapy they need and I know particular areas of the country are struggling. Can the Minister provide an update on the roll-out of the new LINAC machines at 28 hospitals, which she spoke about in May 2025? We were also told that by March 2027, up to 27,500 additional treatments will be delivered. Can the Minister share some information on how that will be achieved? The Labour Government have now been in power for two years. They have raised taxes by more than £60 billion and they do not have much to show for it. They have not produced a workforce plan. They have said that one will be imminent; can the Minister confirm whether it will be published today before we break for the recess? Is the intention to publish it during the recess or will we have to wait until the autumn? There is a 31% shortfall in clinical radiologists. New clause 48 essentially requires the publication and maintenance of “a national framework for improving access to radiotherapy services”. This Government have essentially shown that if a requirement is not in legislation, plans just get delayed, diminished and disowned, but patients cannot afford to wait any longer.

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.

If I heard the Minister correctly, she said that the ICBs would provide NICE-approved treatment, which they have to do within 90 days at the moment. At an earlier sitting, we debated an amendment tabled by the Minister that would enable the Secretary of State to delay the provision of NICE-approved treatment, which was agreed to. I am not quite sure how that is congruous, but in either case we would like to press new clause 48 to a vote. Question put, That the clause be read a Second time.

New Clause 49

Modern Service Framework for Respiratory Disease

“(1) The Secretary of State must, within 18 months of the date on which this Act is passed, publish a Modern Service Framework for Respiratory Disease (a ‘respiratory MSF’).

(2) The respiratory MSF must set out—

(a) an evidence-based description of high-quality, respiratory care across the health service in England over the period of ten years following publication;

(b) the interventions and service models to be implemented to improve outcomes for people with respiratory disease, including in particular—

(i) pulmonary rehabilitation;

(ii) supported self-management;

(iii) spirometry and diagnostic services;

(iv) early detection and lung cancer screening; and

(v) access to medicines, including biologics and antifibrotic treatments;

(c) the steps to be taken to reduce unwarranted variation in the quality of and access to respiratory care across integrated care board areas;

(d) the steps to be taken to reduce emergency hospital admissions attributable to respiratory disease;

(e) the workforce requirements for delivering high-quality respiratory care and the actions to be taken to meet those requirements;

(f) measurable outcomes and milestones against which progress in implementing the respiratory MSF will be assessed; and

(g) arrangements for monitoring and reporting on progress against those outcomes and milestones.

(3) In preparing the respiratory MSF the Secretary of State must consult—

(a) clinicians with expertise in respiratory medicine;

(b) patients and organisations representing the interests of people with respiratory disease;

(c) integrated care boards;

(d) NHS trusts and NHS foundation trusts providing respiratory services; and

(e) such other persons as the Secretary of State considers appropriate.

(4) The Secretary of State must lay the respiratory MSF before Parliament on the day on which it is published.

(5) The Secretary of State must publish an updated respiratory MSF, or a report on progress against it, at intervals of not more than three years following the initial publication under subsection (1).

(6) In this section—

‘Modern Service Framework’ means a framework setting out the evidence-based interventions, service models and outcomes for the provision of health services in relation to a particular condition or group of conditions, developed in partnership with clinicians, people with lived experience and system partners, consistent with the approach described in the NHS Medium Term Planning Framework or any successor document;

‘respiratory disease’ includes chronic obstructive pulmonary disease, asthma, bronchiectasis, interstitial lung disease, pulmonary hypertension, lung cancer, obstructive sleep apnoea and other conditions principally affecting the respiratory system.”—(Dr Caroline Johnson.)

This new clause requires the Secretary of State to publish a Modern Service Framework for Respiratory Disease within 18 months of Royal Assent, and to lay it before Parliament. It also requires updated frameworks or progress reports to be published at least every three years thereafter.

Brought up, and read the First time.

I beg to move, That the clause be read a Second time. I will be brief, because we have a lot to get through. The new clause would require the Government to produce a modern service framework for respiratory disease within 18 months and, in essence, to make a plan for providing and improving treatment for those with respiratory disease. The previous Government had a major conditions strategy, which looked at the six major causes of ill health, one of which was respiratory disease. This Government paused that when they came into office to consider their own plans, but have not responded with a plan for respiratory disease in any detail. The new clause would require them to do so.

I am grateful to the hon. Member for bringing another important disease to the attention of the Committee. I agree that modern service frameworks are important tools for improving patient care. They sit at the heart of our 10-year health plan, enabling a step change in both service quality and delivery. That is why we are prioritising making rapid progress on them. The first two MSFs, on sepsis and cardiovascular disease, will be published shortly, and a further four are in development. Given the momentum, it is clear that primary legislation is not needed to drive the development of MSFs; instead, we have established a robust, expert-led process.

I should declare that I am an officer of the all-party parliamentary group for respiratory health. Clearly, a modern service framework is important, certainly for a constituency such as mine in the north-east that has a lot of respiratory health problems, but as the Minister said, we need action rather than legislative change.

Like my hon. Friend’s constituency, my constituency of Bristol South has a large tobacco industry legacy, and it is crucial to address respiratory disease in a way that looks at the whole person.

Does the Minister agree that the single most effective thing that we have done for public health since we were elected is to get the Tobacco and Vapes Act 2026 passed? The gradual abolition of cigarette smoking will save more lives than anything else we could conceivably do in politics.

My hon. Friend tempts me to go down the path that we went down in another Committee. I recognise that the Tobacco and Vapes Bill took a long time to come through Parliament, despite having been started by the Conservatives under the right hon. Member for Richmond and Northallerton (Rishi Sunak). It faced a lot of opposition, but we are absolutely clear that that is the single most beneficial piece of work. The hon. Member for Sleaford and North Hykeham asked me about the future, in terms of vape shops and so on, and I have corresponded back to her on that issue. Instead of what is proposed in new clause 49, we have established a robust, expert-led process. The national quality board will assess all proposals for new MSFs against a clear set of criteria, ensuring that we prioritise those areas where an MSF will deliver the greatest impact for patients. Alongside developing the first wave of MSFs, we are further strengthening the process, including by setting out a clear and consistent approach for assessing future proposals. Embedding an MSF in respiratory health in primary legislation would risk limiting that flexibility, rather than strengthening our ability to improve care, as my hon. Friends the Members for Blaydon and Consett and for Bury St Edmunds and Stowmarket have outlined, by taking the action that is so necessary to help and support people with respiratory disease.

The Minister talks about momentum, but as I understand it, there is a severe mental illness MSF, for which timelines are to be published in due course; a sepsis MSF that was expected in the spring but is now anticipated in the summer; a frailty and dementia MSF expected sometime this year; a palliative care MSF that was published in June as an interim update, but will not be complete until the autumn; and a cardiovascular MSF. I do not see very much momentum there, given that the Government have been in office for two years.

It is a lot faster than the 14 years in which it was not done under the Conservatives.

Actually, there were plans, changes and improvements in respiratory care. One of the more obvious ones for lung cancer was the start of the lung cancer screening programme. I do not think the Government have the momentum and vigour that is required. Of course, they have also paused the long-term conditions strategy, which was already written and would have delivered. This is important, and we will press new clause 49 to a vote. Question put, That the clause be read a Second time.

New Clause 50

Delivery plans for transformative technology commitments

“(1) The Secretary of State must, within 12 months of the date on which this Act is passed, publish a delivery plan for each of the transformative technology commitments set out in subsection (2).

(2) The transformative technology commitments referred to in subsection (1) are the commitments made in the document entitled ‘Fit for the Future: the 10 Year Health Plan for England’ published in July 2025 (or any successor document) in respect of—

(a) data quality and interoperability, including—

(i) the development of the Health Data Research Service and,

(ii) the use of NHS data for research and innovation;

(b) artificial intelligence, including—

(i) the deployment of AI tools across NHS clinical and administrative functions,

(ii) the development of an AI strategic roadmap, and

(iii) the establishment of a regulatory framework for AI as a medical device.

(c) genomics and predictive analytics, including—

(i) the expansion of genomic testing, and

(ii) the use of predictive analytics for earlier diagnosis and personalised treatment;

(d) wearable technologies, including the commitment that wearables will become standard in preventative, chronic and post-acute NHS treatment;

(e) robotics, including—

(i) the expanded use of robotics in surgery,

(ii) continuous monitoring,

(iii) rehabilitation, and

(iv) prosthetics.

(3) Each delivery plan published under subsection (1) must include—

(a) a description of the specific commitments being delivered, with reference to the relevant passages of the 10 Year Health Plan;

(b) a timetable with milestones for delivery of each commitment;

(c) the funding allocated or to be allocated to support delivery, including the source of that funding;

(d) the NHS bodies, government departments and other organisations responsible for delivery of each element of the plan, and the accountability arrangements in place;

(e) the regulatory steps required to enable delivery, including any changes to the regulatory framework for medical devices, AI or data, and the proposed timetable for those steps;

(f) the workforce implications of delivery, including any training or upskilling requirements;

(g) the steps to be taken to ensure deployment of each technology across different regions and patient groups; and

(h) the metrics against which progress will be assessed and reported.

(4) The Secretary of State must lay each delivery plan before Parliament on the day on which it is published.

(5) The Secretary of State must publish, and lay before Parliament, an annual progress report on implementation of each delivery plan, including—

(a) progress against the milestones set out in the plan;

(b) any revisions to the timetable or funding and the reasons for those revisions;

(c) an assessment of equity of access to the technologies covered by the plan; and

(d) any new barriers to delivery identified and the steps being taken to address them.”—(Dr Caroline Johnson.)

This new clause would require the Secretary of State to publish a delivery plan for the transformative technological commitments set out in the 10 Year Health Plan.

Brought up, and read the First time.

I beg to move, That the clause be read a Second time. The new clause would require the Secretary of State to produce a delivery plan for the transformative technology commitments in the 10-year plan. The 10-year plan took a lot of people a year to write, and there is plenty of ambition in it, but so far the delivery is rather suspect. The Government are right to say that technology can be game-changing, but it is one thing to ask civil servants and special advisers to draw up a grand plan and a nice brochure, and another to actually deliver on those ambitions. The Labour party came into government without a plan, and we are about to have a new Prime Minister but we do not know what his plan is, or even if he has one, either. We have seen IT outages take down health systems, hospitals fail to communicate critical information after patients are discharged, and warm weather take down MRI scanners and radiotherapy machines. The new clause would require the Secretary of State to produce a delivery plan for the transformative technology commitments in the 10-year health plan, and would provide a clear road map for data quality and interoperability, artificial intelligence, genomics and predictive analytics, wearables, and robotics. Let us be clear: the Opposition support introducing new technology to make the NHS more efficient and improve patient care, but we need clarity from the Government on how they will do that. Ordered, That the debate be now adjourned.—(Emma Foody.)

Adjourned till this day at Two o’clock.