We in the Treasury Front-Bench team are wondering when the third book in the trilogy will come along and what it might be called. We have a guess for the title of the next book. I thank him for his advice in his books and in his recent Financial Times article. On train drivers and their pay, I am proud to be part of a Government who have avoided strikes that impact on public spending.

Public sector productivity is improving, with the NHS delivering 3.5% productivity growth in 2025-26, beating its 2% target. The Government will continue to drive public sector efficiency so that taxpayers’ money delivers the best possible public services. In addition, we are investing in AI adoption across the public sector to help realise the overall target of £14 billion of efficiencies by 2028-29, as agreed at the last spending review.

The primary responsibility for the safety of care rests with each National Health Service provider and its board. We expect providers to work together to manage risks that arise across organisational boundaries and to ensure continuity and coordination of care for patients.

Quality and safety risks are managed in accordance with the National Quality Board’s national guidance on Quality Risk Response and Escalation, which details the structure for quality governance across the NHS system.

Integrated care boards are required to establish System Quality Groups, bringing together NHS organisations, NHS England regional representatives, local authorities, regulators, commissioners and other partners to oversee quality and patient safety across local systems. Where appropriate, System Quality Groups can escalate concerns to NHS England Regional Quality and Safety Teams or if necessary further still to NHS England's Executive Quality Group to enable coordinated action across regional boundaries.

People who are acutely unwell and in a mental health crisis often do go to accident and emergency (A&E), and in some cases, a Mental Health Act assessment may be needed. In some cases, often due to distress or delays, the person may try to leave A&E before the assessment can be completed. In these instances, there can be confusion and often a lack of confidence about whether or what legal powers are available to health professionals to hold someone in A&E to keep them safe until the assessment can be completed.

We accept that there may be a need to provide greater clarity on the powers which are available to health professionals to keep people safe in a mental health crisis. We have committed to a consultation exploring the powers available to different professionals in different situations and settings, in particular but not limited to consulting on the operation of sections 135 and 136 powers under the Mental Health Act. The consultation will seek views on powers and joint working approaches to ensure health and social care professionals and police have the appropriate powers to act in order to protect people from harm to themselves and to others when in a mental health crisis.

As part of this, we will look to understand how the current legal framework in emergency departments is applied, and identify solutions to the problems raised. We will seek to provide further guidance on the existing legal framework and the handover protocol between health and police in the next revision of the Code of Practice.

I thank the right hon. Gentleman for raising that important point. While I understand that the amendments he tabled will not be voted on today, they raise an important issue that I will continue to look further into. With the Hillsborough law now due to have its Commons stages completed today and then go over to the Lords, I very much hope that it will be in law as soon as possible, which means that we can apply the duty of candour to future maternity services reviews such as those in Leeds and Sussex. The situation that we had in Nottingham, where senior leadership refused to take part in the inquiry under way, was totally unacceptable and must never happen again.

There are no plans to convene a taskforce on medicine shortages.

There are around 14,000 licensed medicines and the overwhelming majority are in good supply. Medicine supply chains are complex, global and highly regulated and there are a number of reasons why supply can be disrupted. Many of these are not specific to the United Kingdom and outside of Government control, including manufacturing difficulties, access to raw materials, sudden demand spikes or distribution and regulatory issues.

To help manage these risks, the Department and NHS England are committed to strengthening long term supply chain resilience and continually improving how we prevent, mitigate, and manage supply issues to protect patients from shortages.

The Department, working closely with NHS England, is taking forward a range of actions to further strengthen our ability to anticipate, mitigate, and manage shortages. As part of that work, we continue to engage with industry, the Medicines and Healthcare products Regulatory Agency, and other colleagues across the supply chain. However, medicine shortages are a complex and global issue, and improving resilience requires action from all parts of the supply chain through a collaborative approach.

In August 2025, the Department published a policy paper, Managing a robust and resilient supply of medicines, which provides greater transparency of the supply chains we rely on, the actions we take to protect patients from medicines shortages when they occur, and the steps being taken to strengthen resilience. Later this year, we will publish an update on progress against those commitments and set out further actions to strengthen the resilience of our medicines supply chains. The paper is available at the following link:

https://www.gov.uk/government/publications/managing-a-robust-and-resilient-supply-of-medicines/managing-a-robust-and-resilient-supply-of-medicines

The Government recognises that corridor care is unacceptable and should not become a normal part of National Health Service care. The finding of the Healthcare Services Safety Investigation Body's report Patient care in temporary care environments reinforces the Government’s assessment that reducing overcrowding and improving patient flow across urgent and emergency care services are essential to improving patient safety, patient experience, and staff wellbeing.

The Government and NHS England are therefore taking action through delivery of the Urgent and Emergency Care Plan for 2025/26, backed by over £450 million of investment in urgent and emergency care capacity. This includes investment in Same Day Emergency Care services, urgent treatment centres, mental health crisis assessment centres, and ambulance services, helping more patients receive timely care in the most appropriate setting and reducing avoidable pressure on emergency departments.

NHS England has also published the Model Emergency Department and the Model Acute Pathway standards for the first 72 hours of care, which support earlier assessment, timely senior clinical review, faster clinical decision-making, and improved patient flow through hospitals, addressing many of the operational challenges highlighted in the report.

In addition, NHS England has introduced a national definition of corridor care, begun publishing validated corridor care data, and established targeted improvement support for trusts experiencing the highest levels of corridor care. Expert Getting It Right First Time teams are working with local NHS leaders to improve patient flow, strengthen discharge arrangements, and reduce overcrowding. Together these measures will strengthen oversight, improve transparency, and support local action to reduce corridor care.

We consulted on proposals to enable pharmacist flexibilities when dispensing medicines and have considered the responses to this consultation, with further information available at the following link:

https://www.gov.uk/government/consultations/enabling-pharmacist-flexibilities-when-dispensing-medicines/enabling-pharmacist-flexibilities-when-dispensing-medicines#how-to-respond

We will issue a formal consultation response in the coming months.

Cyber security is not just a technology risk. In 2024, a cyber-attack affecting Synnovis, a supplier of pathology services to the National Health Service, caused delays to over 11,000 out-patient and elective procedure appointments and, tragically, contributed to the death of a patient. We must see cyber security and resilience as a patient safety issue. Throughout the Synnovis incident, data was published on the NHS website, including on cancelled or delayed appointments.

Following the incident, the South East London Integrated Care System ran a patient safety investigation, which identified levels of patient harm seen during the Synnovis cyber-attack. Any new cases of patients coming to moderate harm or more as a result of the cyber incident would be reported through the quality reporting governance systems of the integrated care board as per NHS England reporting guidance.

Any national considerations are based on the reporting from affected trusts, which have been used to inform national processes. In addition, as competent authority under the Network and Information Systems Regulations, working on behalf of my Rt Hon. Friend, the Secretary of State for Health and Social Care, the Department has investigated the impact of the incident to understand the patient safety and service continuity impacts for operators of essential services.

Cyber incidents, including WannaCry in 2017, Advanced in 2022, and Synnovis in 2024, show that it is a matter of when, not if, the next cyber-attack on the NHS will take place. The impact of cyber incidents can be severe, including cancelled appointments, delays, or data breaches. Therefore, preparing for and responding to incidents is an important part of our programme. Following the Synnovis cyber-attack, the Department identified a set of lessons from the incident. These have been actioned and assigned to owners, with a large number completed and long-term improvements integrated into our ambitious Cyber Improvement Programme. The completed actions have included improvements made to the way in which patient harm is identified following a cyber incident. This aligns with other national incident processes.

I am sure that my ministerial colleagues with responsibility for Myanmar would like to follow up with the right hon. Gentleman on that issue. The challenge of misinformation and disinformation relates not only to Russia but to a whole series of contexts—and not just states. We also see it in non-state actors, including Daesh and other organisations. We are working very closely with partners to identify and tackle those networks.

The UK remains deeply concerned by reports of human rights violations in Myanmar, involving a range of armed actors, and we continue to push for accountability for such abuses, wherever they occur. In April, we co-sponsored the UN Human Rights Council resolution on the situation of human rights in Myanmar, condemning ongoing violations, particularly against ethnic minorities.

The UK has provided £900,000 to the Independent Investigative Mechanism for Myanmar since 2021 to support the collection, verification, and preservation of evidence for future prosecution, and established the Myanmar Witness programme to verify open-source evidence of human rights violations.

It has been the long-standing practice under successive governments not to comment on potential future sanctions designations, as doing so could reduce their impact, but we keep all measures to promote peace and accountability in Myanmar under regular review.

The UK remains deeply concerned by reports of human rights violations in Myanmar, involving a range of armed actors, and we continue to push for accountability for such abuses, wherever they occur. In April, we co-sponsored the UN Human Rights Council resolution on the situation of human rights in Myanmar, condemning ongoing violations, particularly against ethnic minorities.

The UK has provided £900,000 to the Independent Investigative Mechanism for Myanmar since 2021 to support the collection, verification, and preservation of evidence for future prosecution, and established the Myanmar Witness programme to verify open-source evidence of human rights violations.

It has been the long-standing practice under successive governments not to comment on potential future sanctions designations, as doing so could reduce their impact, but we keep all measures to promote peace and accountability in Myanmar under regular review.

The Ockenden review into maternity services at the Shrewsbury and Telford hospital trust identified 15 Immediate and Essential Actions. Following its publication, NHS England wrote to all trusts and systems asking them to deliver the actions and report to their public boards.

The Three-year delivery plan for maternity and neonatal services, developed in partnership with families and key stakeholders and published in 2023, brought together the immediate and essential actions from the Ockenden review with those from other reports and guidance. The National Health Service operational planning guidance in 2025/26 set out the expectation that trusts should implement the key actions from the plan. In accordance with the NHS operating framework, it is for integrated care boards to oversee local progress. The technical guidance which accompanied the plan sets out how NHS England has monitored progress of the three-year delivery plan implementation at a national level.

The national independent investigation into NHS maternity and neonatal care, led by Baroness Amos, will also help us understand the systemic issues behind why so many women, babies, and families experience unacceptable care. The investigation is bringing together the findings from past reviews, from local investigations of maternity and neonatal services in selected trusts, and evidence from families and staff into one clear national set of recommendations.

Following publication of Dr Bill Kirkup’s report, Reading the Signals: Maternity and Neonatal Services in East Kent, Dr Kirkup was appointed by the Department to develop concrete actions to implement the report’s recommendations. In this work, Dr Kirkup concluded that a national maternity plan was needed to oversee improvements in maternity and neonatal care.

The National Maternity and Neonatal Investigation, led by Baroness Amos, will also help us understand the systemic issues behind why so many women, babies, and families experience unacceptable care. The investigation is bringing together the findings from past reviews, including East Kent, from local investigations of maternity and neonatal services in selected trusts, and evidence from families and staff into one clear national set of recommendations.

The National Maternity and Neonatal Taskforce will address the investigation’s final recommendations, tackling the recurrent systemic issues identified in the interim report, and will hold the system to account for improving outcomes and experiences for women, babies, and families, and staff experiences.

One of the recommendations of the East Kent report was to introduce a Maternity Outcomes Signal System (MOSS), which was launched in November 2025. The system is now being used by maternity services across England. MOSS monitors outcomes in near-real time to identify potential declines in the safety of maternity services, prompting timely action to reduce harm.

Additionally, to improve representation of maternity services on trust boards, all boards are required to have a board level Maternity Safety Champion and quarterly reports to the board providing comprehensive assessment of maternity and neonatal quality and safety.

NHS England has developed a new, mandated, intensive improvement offer for the most challenged National Health Service providers, the National Provider Improvement Programme, which assesses trusts based on:

• effective board and organisational leadership;

• effective and insightful governance arrangements;

• engaged staff; and

• a shared approach to, and capability for, improvement.

Our 10-Year Health Plan committed to rolling out Fracture Liaison Services across every part of the country by 2030. Integrated care boards (ICBs) remain well-placed to make decisions according to local need. The Renewed Women’s Health Strategy sets an expectation that ICBs prioritise community-based models when commissioning new fracture prevention services.

All of the proposals relating to the findings of the Williams Review and the Mann Review contained within the Reforming the General Medical Council legislative framework consultation, published 24 March 2026, are currently open for public consultation. We welcome stakeholder views on the consultation and responses will be carefully considered to help inform future policy decisions.

All of the proposals relating to the findings of the Williams Review and the Mann Review contained within the Reforming the General Medical Council legislative framework consultation, published 24 March 2026, are currently open for public consultation. We welcome stakeholder views on the consultation and responses will be carefully considered to help inform future policy decisions.

I congratulate the right hon. Gentleman on running his fourth London marathon this week for a cancer charity. I know that cause is dear to his heart. He makes an important point. I understand why people are calling for immediate support, but the previous Government’s untargeted support—I understand why the former Chancellor did what he did—cost more than £100 billion in total, I think, and it meant that interest rates, inflation and taxes have ended up being higher than they needed to be. We managed to reduce Government borrowing by £20 billion last year. The budget deficit is below 5% for the first time since 2019. Sticking to fiscal responsibility is not just good for the public purse; it is also good for ordinary families and businesses. I am determined that we do not go back to the high inflation, high interest rates and high taxes that would be the inevitable result if we had an untargeted response to this conflict.

NHS England, with support from the Department, has developed an e-learning programme to support healthcare professionals in the care of people with myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), of all levels of severity. All four sessions of the e-learning programme are now available, with sessions one, two, and three having universal access, whilst the fourth session, which includes support and clinical management of severe ME/CFS, is only available to healthcare professionals. Further information can be found at the following link:

https://learninghub.nhs.uk/catalogue/mecfselearning?nodeId=7288

The Medical Schools Council will promote the e-learning programme to all United Kingdom medical schools and will encourage those medical schools to provide undergraduates with direct patient experience of ME/CFS.

Additionally, the National Institute for Health and Care Excellence (NICE) has developed guidance on the diagnosis and management of ME/CFS, including mental health support for people with ME/CFS and their families. NICE guidelines are evidence-based, informed by clinical expertise, and represent best practice, and although NICE guidelines are not mandatory, healthcare professionals are expected to take them fully into account.

There is so much evidence to underpin the importance of continuity of care. I do not want to get ahead of the recommendations of the Amos investigation, but there is much to commend what the right hon. Gentleman says. Even with the best planning, the challenge for maternity units is that they are often both elective and emergency, with women arriving when they are not necessarily expected to, so we have to bear those considerations in mind, but the idea of women and partners knowing the team that will be responsible for their care in advance is a compelling one.