Dr Caroline Johnson
MP for Sleaford and North Hykeham · Conservative · United Kingdom
“So someone was watching to make sure he was safe, and I am so glad that was the case, but it is so very rapid, as others hon. Members have testified. There is no single test. There is no single thing we can monitor or measure that helps.”
“I want to mention group B streptococcal infection, which I have seen in paediatric practice, particularly in babies. It is a common bacteria that lives harmlessly in the gut or lower reproductive tract, but there is a risk that it can enter the bloodstream, causing neonatal sepsis when passed to newborns.”
“The Joint Committee on Vaccination and Immunisation met in July 2026 and suggested an increase in the vaccination schedule for those young people.”
“I remember sitting in this Chamber a little over two years ago—I am sure you were there too, Madam Deputy Speaker—when the then Member for South Thanet, now Lord Mackinlay, received a rare standing ovation from the House and from the Gallery as he returned to Parliament following his remarkable recovery from sepsis.”
“That was a good start, but of course, as always with medicine, there is more to do, and it was pleasing to see the previous Starmer Government build on this work by introducing the modern service framework for sepsis. We have modern service frameworks for other diseases, and it seems good to have one for sepsis specifically.”
“I remember seeing a patient whose mum had got up in the middle of the night to use the bathroom—not something she did normally, and she was not quite sure why she had on that particular night—and when she was walking back along the landing, she thought, “It’s a bit cold—I’ll just check.” She checked her son had his blankets on and was war…”
The complete record
Every one of 604 lines we hold for Dr Caroline Johnson, in date order, each linked to its source. Free to read, in full, without an account. Page 12 of 13.
“I beg to move amendment 47, in clause 11, page 8, leave out lines 15 to 30. This amendment prevents the Secretary of State from removing the Chief Executive of an integrated care board.”
“After listening to remarks this morning, I have no doubt that Members are clued up on the importance of innovation to the health service, but a problem—a philosophical contradiction—at the heart of the Government’s reform programme and the Bill is that Ministers talk about decentralisation while these provisions constitute a recentralisation of power.”
“469.] That was repeated in the Government publications that accompanied the Bill: “Empowering ICBs as strategic commissioners will support putting patients at the centre of care by devolving decisions to a local level where different services can better integrate… Reforms to the NHS FT model will give providers more flexibility to design and deliver healthcare around local needs.” Between the announcement of the abolition of NHS England and the publication of the Bill, Ministers articulated a vision for a more decentralised system. There is expert consensus that decentralisation boosts performance, reduces health disparities and fosters innovation.”
“Clause 11 is particularly interesting. In August 2025, Alan Milburn was asked about the abolition of NHS England on the Health Foundation podcast. He said that the Government wanted to see a model that was “more delegated…more devolved” and “more diverse”, which necessitated the centre being smaller. Considering that he is a former Labour Health Secretary and a non-executive director at the Department of Health and Social Care, I do not doubt his understanding of what the Government wanted to achieve. When the former Health Secretary, the right hon. Member for Ilford North (Wes Streeting), announced the 10-year plan to the House, he also talked about dissolving power. He spoke of a “brave new world of devolution of power, resources and control”. —[ Official Report , 3 July 2025; Vol. 770, c.”
“Again, as a paediatrician, I am used to providing supportive treatment for conditions such as respiratory viruses and gastroenteritis, which generally get better on their own, but I am not used to giving powerful drugs to children that can cause permanent long-term damage for subjective, self-resolving difficulties during adolescence.”
“The International Classification of Diseases states that it is “characterised by a marked and persistent incongruence between an individual’s experienced gender and the assigned sex, which often leads to a desire to ‘transition’”. We know that gender incongruence is a condition that is subjective. It is based on how someone tells us they feel. There are no blood tests and no lab markers that can be used to diagnose it. As a paediatrician myself, I understand that how patients feel, particularly in relation to their mental health, is very important. We know from the Cass review that the vast majority of children with gender incongruence will get better on their own.”
“Rather, we are being asked to consider the Pathways trial: whether it meets ethical tests, what it does, the cohort, the protocol and the consent. I will go through each of those points in turn. The Pathways trial is part of a group of studies run by King’s College London and funded by the Government. So what does it do and why are we so concerned? The trial will take 226 children who are physically healthy—who are developing normally—and inject them with powerful drugs to delay that normal development in a way that may weaken their bones, affect their ability to think, damage their sexual function, and leave them unable to have children of their own. We are told that the purpose of this is to treat a diagnosis of gender incongruence. So what is gender incongruence?”
“Member for Canterbury (Rosie Duffield) was treated when she raised concerns. As adults and as elected Members of this House, we have a duty to safeguard children in our country. That means protecting them from adults who—with whatever motivation, good or bad—could do them harm. As a children’s doctor, I have recruited patients for trials, and I have cared for children and babies participating in clinical trials. I recognise the value of a well-designed clinical trial in improving clinical care, but today the House is not being asked to consider the principle of performing clinical trials in general, or on children in particular—I hope we can all agree that a well-designed trial can improve care.”
“I beg to move, That this House calls on the Government to take steps to prevent the PATHWAYS clinical trial into the effect of puberty suppressing hormones on children with gender incongruence. Before I start, I declare an interest as an NHS consultant paediatrician, a member of the Royal College of Paediatrics and Child Health, and a member of the British Medical Association. It is also important for us to recognise at the beginning of this debate that we are talking about the protection of children—vulnerable children who are troubled, and who need our care and compassion and the very best quality of healthcare. The healthcare of children distressed about their gender is an area in which attempts have been made to shut down debate with threats and accusations of transphobia; we saw the way that the hon.”
“This is not a form of gene therapy. It is a medication that is a GnRH analogue, and what it essentially does is delay puberty. It was designed as a drug to treat children who go into puberty much earlier than they would be expected to, and to delay it until, as it were, the right time. The effects of the use of puberty blockers in older children and for a much longer period, at an age when they ought to have started puberty, are not fully understood.”
“Even if the Secretary of State thinks the principle of the trial is right, he must surely agree that it is unnecessary and unethically broad. For example, if someone was designing a trial to treat children with a specific form of cancer, the children who would be entered into the trial would have that specific form of cancer. We would not include children with any disease, because that would make the results unreliable in terms of benefit to the target group and children would be unnecessarily put at risk of receiving experimental drugs that they did not need. The same applies to this trial. The Cass report tells us that many of the children in the proposed trial will get better on their own. The Secretary of State said yesterday that “we are talking about a very small subset of a very small group.” —[ Official Report , 22 June 2026; Vol.”
“Does the Secretary of State think that the long-term damage to many is worth it for the cosmetic benefit of a few? The Medicines for Human Use (Clinical Trials) Regulations 2004 specify that “anticipated benefits” must justify the risk. This is an ethical rather than a medical question. Does the Secretary of State think that the benefits justify the risk? I regret that we have ended up discussing the details of a clinical trial in the Chamber—the reality is that things should be done impartially by scientists in most cases—but with this topic we have seen the quashing of open debate, which is why we have ended up where we are. I will move on to the point made by my hon. Friend the Member for Farnham and Bordon (Gregory Stafford).”
“Will the Secretary of State tell us whether he is aware of new evidence allowing clinicians to work out confidently which children will persist with the trans identity at 11 and which will not? We need to think about the risk involved in the treatment, and whether it is worth the benefits that they will purportedly receive. The trial researchers suggest that they will take a wide approach to looking at potential benefits, that they will look at quality of life and body satisfaction, and that there must be a reasonable prospect of benefit; but how can they know whether there is a reasonable prospect of benefit when they do not know whether or not the condition will persist? Some have suggested that giving puberty blockers will help the few adults who retain their trans identity into adulthood to pass as the opposite sex.”
“My hon. Friend raises a very good point, and I will come to the data linkage study shortly. What we do know from the Cass review is that the vast majority of children who went on to puberty blockers in adolescence went on to receive cross-sex hormones, which are known to have permanent effects. One fact that is crucially important is that it is not possible for clinicians to confidently determine which children with gender incongruence will persist with the trans identity into adulthood, and which will not. How can the clinicians possibly know that they are not injecting potentially dangerous drugs into children whose incongruence will resolve itself? The answer is that they cannot.”
“Well, one of the things with doctors is that if you ask two doctors, you might get two different opinions. I completely respect Baroness Cass. She has been president of the Royal College of Paediatrics and Child Health, of which I am a member, and she has done great work on the report that we commissioned in the last Parliament. I know she is concerned that people may obtain these drugs illegally if they are not provided, but I do not share that concern. Personally, I think the important thing is whether the people obtaining such drugs legally are using them in a way that is safe, and I am not convinced that that is the case.”
“Why is he letting this trial, which he has expressed reservations about, go ahead in the knowledge that it is unnecessarily broad and in advance of the data linkage study?”
“The Tavistock was a travesty, but it means that the Government could analyse the data from the outcomes of those children. They could establish the outcomes as children went into adulthood, and Baroness Cass tried to do this using the data linkage study. Shockingly, six out of seven adult gender clinics refused to provide the Government with the data. Even when a specific piece of legislation was passed by the previous Government to clarify that it was legal to provide the information to this trial, the gender clinics still did not provide it. I understand that NHS England is working on the data linkage study, but I ask the Secretary of State why it is taking so long. Is the abolition of NHS England causing delay?”
“I am sorry, but I just do not support that. We would not give children cocaine on the basis that they wanted it and would get it illegally otherwise. These are not sweeties; they are powerful drugs and need to be treated with respect. Even if we accept the premise that a very small number of people might benefit from treatment, how could clinicians decide which children to treat? On what ethical or moral code would we want to inject powerful drugs into children who are likely to have a self-limiting illness and therefore do not need it? That is what the Government have chosen to do, and it is not necessary. Following on from the point made by my hon. Friend the Member for Farnham and Bordon, they have this data already.”
“How can a child of 11 understand what it means to lose sexual function, to be unable to have children when they are older, to have difficulties in thinking and to have weak bones? Remember that this Government think that 14-year-olds are not old enough to watch social media, but they think 11-year-olds are capable of understanding this.”
“They have a higher risk to fertility because sperm and eggs have not yet fully developed at Tanner stage 2, but this Government have chosen to include children of 11 or 12. Some will wonder why it is 11 for girls and 12 for boys—indeed, I was asked that question yesterday—but as a paediatrician I am aware that puberty starts earlier in girls than in boys. It is somewhat ironic that a trial based on the premise that girls could be boys recognises this biology, but I am glad that in this respect it does. However, that means some of the participants will be primary school-aged children with the merest form of puberty. How can they possibly meet the eligibility criteria, which includes “sufficient understanding of the treatment advantages and disadvantages, including discussion of fertility preservation”?”
“The hon. Gentleman is exactly right, and he expresses my point succinctly. Why is the Secretary of State going ahead with a trial—experimenting on more children unnecessarily—when he has the data to analyse already? Why has he chosen to fund this trial? Is he worried about the children who will be put on a medical pathway that may lead to cross-sex hormones and a lifetime of medicalisation when they would have got better by themselves anyway? I want to talk about the age of these young people. The Medicines and Healthcare products Regulatory Agency warned in February that the youngest patients are at the greatest risk, and may end up on puberty blockers for a much longer period.”
“and hon. Members will be asked to vote to consider their approval or disapproval of the trial. I urge them to look at their conscience, read the trial protocol—it is online—and remember that these are vulnerable children who deserve the best care. One day, the children caught in the middle of this debate will be adults. It is our responsibility to ensure that when they look back on their one childhood, their one adolescence and their one chance to enjoy growing up, they must know that every decision was made with the utmost care, caution and respect for their future. The power to make that happen is in our hands today. I urge hon. Members to protect children’s futures.”
“(This is when they put their mouth or tongue on your penis/vagina or you put your mouth or tongue on their penis/vagina)”. Let us be clear: if that is happening to a 12-year-old, that is sexual abuse and the police should be called. Is the Secretary of State content for the Government to be asking these questions of such young children? Can he believe that they will be paid £20 for completing their questionnaires, alongside £30 for completing the assessment of cognitive ability and £15 for completing physical and height assessments, in addition to travel expenses? There will be lots of talk this week about the Prime Minister’s legacy. Putting children as young as 11 on puberty blockers, with irreversible life-changing consequences, would be the most disturbing final chapter in what has been a troubled book of leadership. Today, right hon.”
“I want to discuss sexual function, because yesterday the Secretary of State said that the trial would involve the completion of a number of questionnaires, and one of my hon. Friends raised the question about what happens to children’s sexual function in the long term. What is sexual function? It is desire, arousal and orgasm. The trial organisers are clearly concerned about this, because they put into the trial the ALSPAC—Avon longitudinal study of parents and children—romantic relationships questionnaire. I read the questionnaire on the Health Research Authority website, and children from the age of 12 and over will be asked these questions, one of which is: “In the last year have you had oral sex with another person?”
“We are told that it is a randomised controlled trial—as a doctor, I am familiar with that term—but in this case it is a bit of a fudge. Yes, this Government-sponsored trial will randomise which children get the drugs now and which get them in a year’s time, but the comparison group that does not receive puberty blockers—300 children from the Horizon Intensive trial, with whom the trial will seek to compare—may not be considered a reliable comparison, because the group is a different group with different eligibility criteria. When the results of this trial are published, this fact is bound to be used by people who dispute or disagree with the findings. The Secretary of State said this trial will resolve the dispute over the issue, but that is one of the reasons why I think it will not.”
“Members’ attention to the next part of the quote: “There is no age appropriate way to explain to many of these children what losing their fertility or full sexual function may mean to them in later years.” Yet, as Secretary of State confirmed yesterday, the children must consent or assent to being in this trial. Another question that he did not answer yesterday is why the Government did not heed the MHRA recommendation for a minimum of 14 years. Having established that the Government are going to put a group of physically healthy children with a self-resolving condition at a risk they may not fully understand, the remaining question is why they would they want to do this. The trial itself has an interesting design.”
“I thank the hon. Gentleman for his intervention on devolution, and I am sure the Secretary of State was listening and considering what he has said. To go back to the age of the young people, I am reminded of the judgment in Bell v . Tavistock, which says: “We do not think that the answer to this case is simply to give the child more, and more detailed, information. The issue in our view is that in many cases, however much information the child is given as to long-term consequences, s/he will not be able to weigh up the implications of the treatment to a sufficient degree.” I draw right hon. and hon.”
“The Secretary of State has said that the criteria will stop short-term harm, and that should mean that long-term harm will not occur or go unnoticed, but history is littered with examples of things that do not cause short-term harm but do cause long-term damage. He also suggested that the trial will resolve the dispute, but sadly, I do not think that will be the case, because, first, a single trial rarely resolves a dispute; and, secondly, the comparison group, who are not getting the puberty blockers, are not randomised and are an intrinsically different population. This is bound to be highlighted once the result is published. In medicine, we have a founding principle: primum non nocere—first, do no harm. I ask the Health Secretary to please cancel this trial before vulnerable children suffer unnecessary, irreversible harm on his watch.”
“The Secretary of State said that “when it comes to eligibility, we are talking about a very small subset of a very small group.” Even if we were to accept the premise that a very small number might benefit from treatment, how could the clinicians identify which those children might be? A study of clinical outcomes from kids treated at the Tavistock is due to be completed next year. That could help, so why is the Secretary of State not waiting until that report is completed before conducting an experiment on an unnecessarily broad group of children? Has evidence come to light since the Cass review that helps clinicians confidently work out which 11-year-olds will become adults with gender dysphoria and which will not?”
“In the trial, the outcome is a short to medium-term effect on quality of life and body satisfaction. Does the Secretary of State believe this is proportionate to the risks of these medications? Is there any evidence suggesting that puberty blockers are safer than they were thought to be in 2024, when the Government banned them, following the expert advice from the Commission on Human Medicines? Some have suggested that the drugs help adults to pass as the opposite sex. Is the long-term damage really worth it for the cosmetic benefit of a few? And it is just a few, because we know that the vast majority will be better without any treatment.”
“The MHRA warned in February that the youngest patients are at greatest risk; they may end up on puberty blockers for a much longer period, and face a higher risk to fertility, because sperm and eggs have not yet fully developed at Tanner stage 2. I am reminded of this point in the judgment in Bell v. Tavistock: “There is no age appropriate way to explain to many of these children what losing their fertility or full sexual function may mean to them in later years.” Yet as the Secretary of State confirmed, the children must consent or assent to being in the trial. Why did the Government not heed the MHRA’s recommendation of a minimum age of 14 years? This Labour Government think that 14 is too young to watch social media. Why do they think 11 is old enough for this trial? What is the goal of the treatment?”
“We have seen tragedy occur when fears of accusations of racism limited mental health treatment. We have seen profound suffering when fear of accusations of Islamophobia limited inquiries into the grooming gangs. The healthcare of children distressed about their gender is another topic where there have been attempts to shut down debate with threats and accusations of transphobia. Such attempts were reported in relation to the Tavistock. When considering treatments for life, with lifelong implications, we have a duty to be careful and sensible, so I ask the Secretary of State: why are this Government funding a trial that will cause harm to physically healthy children? These children may be 11 years old, at Tanner stage 2. Some of them are primary school children with only minimal signs of puberty. This is far too young.”
“Again, this is not unusual in paediatrics. It is really common for children to be admitted to hospital for supported care for things like gastroenteritis and respiratory viruses. Puberty blockers are powerful drugs. This is a powerful treatment with significant long-term consequences. Again, this is not new to paediatrics. Some chemotherapy, for example, has substantial short and long-term consequences. But what is unusual and, I think, toxic is the combination of all three. Medicine is about balancing risk. Where else would we give powerful drugs with potentially serious long-term consequences for a subjective condition that is likely to get better on its own? I understand that this trial has been approved, but time and again we have seen and heard how fear and hostility can distort priorities.”
“I declare an interest as an NHS consultant paediatrician and a member of the Royal College of Paediatrics and Child Health. What does this trial do? Put simply, it takes physically healthy children with normal pubertal development and subjects them to powerful drugs that may weaken their bones, affect their ability to think, damage sexual function and make them unable to have children of their own. Serious stuff—and for what? To treat a diagnosis of gender incongruence that will probably resolve without treatment. Let us look at this carefully. Gender incongruence is a subjective condition; it is how someone says they feel. There are no lab markers and no scans. That, of course, is not necessarily unusual. In fact, it is common in mental health conditions. Gender incongruence is often self-resolving; it gets better on its own.”
“It said: “For the first time the NHS and the private sector will work more closely together not just to build new hospitals but to provide NHS patients with the operations they need.” When GP fundholding went, the Government introduced primary care groups, which meant that GPs, nurses and other staff came together to commission for local populations. Those groups then evolved into primary care trusts, which by 2002 were responsible for spending 80% of the annual NHS budget—a budget that is now distributed by NHS England.”
“They were saying one thing but, to some extent, doing another. There are similarities with this Bill: we have talked about decentralising power but, as we heard in evidence on Tuesday, many people feel it is more of a centralising Bill than a decentralising Bill. It was clear that the new public management approach had been adopted across the political divide. The NHS plan promised patients more choice about how to access the NHS—a good thing. It promised a system of inspection, accountability and far greater local autonomy.”
“GP fundholding was established, enabling larger practices to receive budgets to buy secondary care on behalf of their patients, but that was short lived and was shelved in 1999. When new Labour came to power in the late ’90s, one might have thought that things might swing back the other way, but in some respects the trajectory was similar. Initially, the Labour Government talked critically about the internal market. In 1998 the then Health Secretary told Members that the Government were “sweeping away the internal market” —[ Official Report , 1 July 1998; Vol. 315, c. 314.] and the NHS plan published in 2000 claimed that “the internal market introduced competition but failed to bring improvements.” However, the policy choices of that Government furthered, rather than dismantled, the marketised aspects of the health service.”
“In theory, if elements of the state could operate more like the private sector, perhaps Ministers could achieve both cost savings and better outcomes. In 1991 the Government introduced market logic into the health service. They created an internal market by splitting the purchasers—mainly, at that time, the district health authorities—from the providers, which were the hospitals. The Secretary of State gained the power to create NHS trusts—hospitals with the freedom to acquire, hold and dispose of assets; make bids for capital directly to the NHS management executive, in the way they might for NHS England; borrow money within limits; develop their own management structure; and employ their own staff with their own terms of employment. Within three years, almost all providers had become trusts.”
“Previously, people had been happy just to get a health service, which they had not had access to before, but that changed and people wanted choice. We now see the benefits of giving patients choice, and we will hear about how the Government’s changes through the Bill will apparently improve patient choice. Of course, individuals have different values and preferences and live their lives in different ways, which makes it impossible for there to be a single public interest for the Government to pursue. Against that backdrop, the new public management approach to Government administration emerged, advocating for the introduction of market mechanisms and performance metrics—we have heard about the targets that NHS England follows—in public institutions.”
“In the 1980s, Ministers recognised that the system had become very bureaucratic—perhaps similarly to today—and in 1982, area health authorities and district management committees were scrapped in favour of new district health authorities, with the aim of reducing what was in effect a three-layer structure to two layers. The thinking was that the new district health authorities would be closer to local populations, but primary care was left mostly unchanged. Once again, there are parallels with what is happening now. From its inception to the end of the 1980s, the NHS had gone through several waves of rationalisation, but the model remained that of a centrally planned public service. However, during that time, there was an intellectual change—the concept of choice.”
“The main objective at that time was to create a unified, integrated system. Community health services previously operated by councils moved into NHS control. These functions were put under the control of new area health authorities, which took control of most NHS hospitals. Some larger area health authorities had their own distinct management teams, which managed services on the ground—we can look at the current process and ask how it is similar and how it is different. The majority of teaching hospitals lost independent governance, in the way that we, too, are seeing that go back and forth. Above the new area health authorities sat regional health authorities, which were responsible for planning and allocating financial resources. Their members were appointed by the Secretary of State.”
“Those boards implemented Government policies and oversaw the budget. Meanwhile, teaching hospitals kept more independence, directed by their own boards of governors. Councils, operating as local health authorities, had a duty to provide several personal health services including health centres, maternity care, home nursing, immunisation and ambulance services—some of those are now provided by NHS England. They also had substantial powers to prevent illness and to care for the disabled. Independent practitioners—GPs, dentists, pharmacists and opticians— delivered services to local communities under contract from the health service. Now they deliver under contract from NHS England and the ICBs. The health service underwent significant reorganisation in 1974, not long before I was born.”
“In the aftermath of the second world war, the national health service created a state monopoly provider. The Minister of Health had a duty to provide a comprehensive health service free for all at the point of use and a bureaucracy was created to manage it. There was a tripartite split between hospital services, local authority services and independent practitioner services. The hospitals provided secondary care for those with serious disease and those requiring emergency response. The NHS also took over many cottage hospitals in rural areas that had previously been run by GPs, and larger hospitals that used to be run by local authorities and the voluntary sector. At that time, hospital staff were managed by hospital management committees appointed by regional hospital boards.”
“This Government have decided, in pursuit of better outcomes and cost savings, once again to reorganise the health service, and they seek to do so with this Bill and particularly clause 1. Clause 1 formally abolishes NHS England. The clause may have very few words, but they represent one of the biggest changes to our health service in decades. Abolishing NHS England is not just a decision about organisational structure or trimming bureaucracy, but a break with the direction of travel the health service has been on since its inception. Prior to the creation of the NHS in 1948, health services were fragmented: some people used contributory workplace schemes, people who could afford it paid out of pocket, and everyone else relied on very limited state and voluntary provision or went without.”
“The NHS constitution says that health services should “improve, prevent, diagnose and treat both physical and mental health problems with equal regard”, yet in my work as a doctor—and I worked across several hospitals during my training—the gap between the vision of what should be delivered and the reality of what is being delivered has become apparent to me. The answer frequently given seems to be top-down reorganisation. As I will talk about in a minute, such top-down reorganisation has been done so many times but does not seem necessarily to have delivered in practice what it promised. Indeed, to an extent, we seem to be changing things from how they were to how they are to how they were, backwards and forwards.”
“It is a pleasure to serve under your chairmanship, Sir Jeremy. First, I declare a number of interests. I am a consultant paediatrician working in the NHS, a member of the British Medical Association and a member of the Royal College of Paediatrics and Child Health. Like the Minister for Secondary Care, I got into politics after working in the health service. I am sure she agrees that what you see when working in the health service stays with you when working in the House, and that it benefits the House to have people who have done all different jobs working here.”
“In response, the Minister for Secondary Care wrote: “Work is progressing at pace to develop the design and operating model for the new integrated organisation, and to plan for the smooth transfer of people, functions, and responsibilities.” One does not need to enlist the services of Hercule Poirot to see that, one year later, that work has not been done. The Government have no comprehensive plan for how they will abolish NHS England. They can write a line in the Bill to abolish it, but how that will happen, to which clauses 2 and 3 relate, is, as yet, really uncertain.”
“In March 2025, Lord Scriven tabled a question about the legislation required to abolish NHS England. In her response, the Health Minister in the other place, Baroness Merron, wrote: “Ministers and senior Department officials will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to determine the structure and requirements needed to support the creation of a new centre for health and care.” One year later, in March 2026, the Liberal Democrat health spokeswoman, the hon. Member for North Shropshire, tabled a question asking what functions had been transferred over since the announcement was made.”
“We have been told that this will save money—£1 billion a year, I believe—but no sums have been produced for us to scrutinise to explain where that will come from. Indeed, when asking questions about where it might come from, it has been quite difficult to establish that. We have heard that the redundancy package will be worth £1.1 billion to £1.3 billion. It does not seem clear exactly where that will come from or how it will benefit patients. It is also not clear how many of those staff will end up re-employed by the new organisation, having received redundancy from the first, and what effect that will have on the country’s finances. More than a year on from the Government’s announcement that they will abolish NHS England, how much progress have Ministers made?”
“Lord Darzi’s independent investigation said that, taken together, there are nearly 80 people employed in regulatory and headquarters functions for each NHS provider trust. Can the Minister say how many people will be in such roles once the abolition of NHS England is complete? Can she talk about how abolishing NHS England will review the volume of paperwork on patient safety, some of which is helpful for patient safety and some of which is not. That was identified by Dr Dash in her report. I remind Members that abolishing NHS England is not a prerequisite of undertaking a robust cost-benefit analysis before introducing changes. We have had difficulty in getting answers on numbers.”