Preet Kaur Gill
MP for Birmingham Edgbaston · Labour (Co-op) · United Kingdom
“Gentleman will understand that this is an independent process, and it is not for the Government to comment on, nor intervene in, individual applications. I am aware that the right hon. Gentleman has also called for the inquiry to be paused or suspended while the CCRC is reviewing Miss Letby’s application.”
“The hon. Member makes some important, valid points. Of course, the Countess of Chester hospital will want to know the outcome of the inquiry. As she rightly says, the CQC has been in and has made lots of recommendations, especially because of the inadequate rating.”
“On top of their grief, they have been subject to a level of press scrutiny that would match anything we have faced as Members of this place. They have been left in limbo, waiting for answers.”
“In addition, we will legislate in this Parliament to enable the Health and Care Professions Council to begin to operate a statutory barring system for senior managers. The mechanism will enable the Health and Care Professions Council to prevent senior NHS leaders whose conduct is unacceptable from working again in senior roles.”
“The inquiry is now in the report-writing stage, and I have every confidence that the chair will consider all the evidence when drawing conclusions and writing her report and recommendations. I do not consider that there is a case to either amend or expand the terms of reference, based on the information currently available.”
“In March 2025, the chair refused the application and set out her reasons in detail. For transparency, that has been made available online. In her judgment, the chair considered, among other things, the question of fairness, and she was satisfied that the inquiry process had been fair and would not become unfair because there is a possibil…”
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“Friend that any suspension would create unnecessary delays and become a barrier to the families receiving the answers they deserve. There has been no new information that would make us think twice about this decision, nor change the terms of reference, and there is a strong public interest in the inquiry being concluded as soon as possible. That is why this Government shall not suspend the inquiry pending the outcome of Miss Letby’s application to the CCRC to review her convictions.”
“In March 2025, the chair refused the application and set out her reasons in detail. For transparency, that has been made available online. In her judgment, the chair considered, among other things, the question of fairness, and she was satisfied that the inquiry process had been fair and would not become unfair because there is a possibility that all the convictions were unsafe. My right hon. Friend the Member for Ilford North agreed with that reasoning. It would not be appropriate for the Government to speculate on the outcome of the CCRC’s determination, and we should take into account that the families have not supported any pause or suspension of the inquiry either. Even if, hypothetically, we did take that unprecedented step, I concur with my right hon.”
“Gentleman will understand that this is an independent process, and it is not for the Government to comment on, nor intervene in, individual applications. I am aware that the right hon. Gentleman has also called for the inquiry to be paused or suspended while the CCRC is reviewing Miss Letby’s application. An application was made by legal teams for Miss Letby and former executives at the trust to the inquiry chair to consider exercising her powers to pause the inquiry under section 17 of the Inquiries Act 2005. An application was made in parallel by the same legal teams to the then Secretary of State, my right hon. Friend the Member for Ilford North (Wes Streeting), to suspend the inquiry under section 13 of that Act. The basis for both applications was that the inquiry should be halted until the CCRC had determined Letby’s application.”
“The inquiry is now in the report-writing stage, and I have every confidence that the chair will consider all the evidence when drawing conclusions and writing her report and recommendations. I do not consider that there is a case to either amend or expand the terms of reference, based on the information currently available. There is a separate process going through the Criminal Cases Review Commission, which received a full application in relation to Miss Letby’s case in April 2025. The merits of the application are solely for the CCRC to consider and, if appropriate, to refer the case for further consideration to the Court of Appeal. An application to the CCRC does not in itself indicate that the convictions are, or are likely to be, unsafe. Again, the right hon.”
“Lucy Letby was found guilty by her peers, following two criminal trials. She is currently serving 15 whole-life sentences for murder and attempted murder, and her convictions were upheld by the Court of Appeal. This is an independent judicial process, and it is not for the Government to comment on judicial decisions or appeals. The right hon. Gentleman has called for the inquiry’s terms of reference to be amended or expanded to reflect the ongoing public debate around the safety of Miss Letby’s convictions, but the point of the inquiry is not to rehearse Lucy Letby’s trial; it is to focus on how people within the trust responded based on what they knew, or should have known, at the time of the events.”
“On top of their grief, they have been subject to a level of press scrutiny that would match anything we have faced as Members of this place. They have been left in limbo, waiting for answers. As someone who advocates for constituents at my own trust, I know that this will take an additional toll on their mental health, and all of us in this Chamber can agree that they deserve closure. The previous Government established the Thirlwall inquiry in October 2023 to examine the events at the Countess of Chester hospital NHS foundation trust. Its terms of reference are available online. Lady Justice Thirlwall’s recommendations will help us to understand what went so wrong at the Countess of Chester. Her inquiry has now finished hearing evidence, and the final report will be published at the earliest practical date.”
“It is an honour to respond for the Government in the last debate until September. I extend my thanks to you, Madam Deputy Speaker, as well as to the other Deputy Speakers and Mr Speaker, for your stewardship of this House, and to everyone who works here in Parliament and in our constituency offices. I also thank all our NHS staff, who are keeping the service going despite record demand over the summer. The right hon. Member for Goole and Pocklington (David Davis) has raised an extremely serious matter. I want to start by expressing my heartfelt sympathy to all the families who were affected by the terrible events at the Countess of Chester hospital—as a mother of two daughters, I cannot begin to imagine what they are going through.”
“There are well-established criminal processes and procedures for how expert evidence is used at criminal trials. In our democracy, there are also routes for people to challenge convictions if they protest their innocence—even for Lucy Letby. It is not for me or the Government to undermine those processes. Our attention should remain on the families and parents impacted by the case and on continuing to work towards providing answers and closure for them. That is what the Government are focused on, and we trust the Thirlwall inquiry to give us those answers. Question put and agreed to.”
“In addition, we will legislate in this Parliament to enable the Health and Care Professions Council to begin to operate a statutory barring system for senior managers. The mechanism will enable the Health and Care Professions Council to prevent senior NHS leaders whose conduct is unacceptable from working again in senior roles. The Government have also launched the maternity and neonatal taskforce, personally chaired by my right hon. Friend the Secretary of State, which will translate Baroness Amos’s recommendations into action. The right hon. Member for Goole and Pocklington has campaigned against Government overreach his entire career; I respect him for that. I know that he will agree with me that our democracy rests on a separation of powers, and I trust our independent judiciary to get on with the job.”
“Where the inquiry identifies lessons on safeguarding vulnerable patients or on how management responds to patient safety concerns, the Government will examine them rigorously and take forward all recommendations that are deliverable, justified and in the public interest. There is a huge amount of interest, inside and outside the Chamber, about the professional regulation of managers in the NHS. We all know that the NHS needs and deserves the best leaders. We are committed to supporting their development and professionalism, and to strengthening accountability where they fall short. Work is already under way to develop an NHS college of leadership and management to support and develop NHS leaders.”
“The hon. Member makes some important, valid points. Of course, the Countess of Chester hospital will want to know the outcome of the inquiry. As she rightly says, the CQC has been in and has made lots of recommendations, especially because of the inadequate rating. I have asked for a submission from the CQC to understand what progress has been made. I have been informed that there has been some progress, but equally there are lots of areas in which there has not been progress. I am making sure that I am receiving regular updates, because, as the hon. Lady rightly says, every parent wants to see change. In the end, this is about so many lives. Parents have had to go through such heartbreaking situations just to get to justice, and they do deserve disclosure. I therefore really do thank her for her intervention.”
“We know of the devastating impact of failures in maternity care and the courage of women, families and many members of staff. We will reform maternity and neonatal services, translating the recent recommendations of Baroness Amos and Donna Ockenden into a national action plan by the end of the year. We will create a statutory maternity and neonatal commissioner, we are extending Martha’s rule so that the concerns of families are listened to, and we are investing £186 million to improve maternity and neonatal estates.”
“I think we can all agree that the report’s findings were shocking, and our thoughts are with the women and families who have suffered life-changing loss or harm. Baroness Amos’s recommendations will shape a new national action plan by the end of the year, and those families will be at the heart of the taskforce that will help us to get this right. That will include defining the role of the maternity commissioner, who will help us to ensure that never again are women not listened to.”
“Of course we want to improve services throughout the country. We are modernising the regulatory framework for UK healthcare professionals, ensuring that we can improve consistency of approach and secure less burdensome regulation. The Secretary of State has met representatives of the General Medical Council and invited them to account for their response to some of the failings of care in Nottingham and beyond. As I have said, it is important for us to ensure that consistency of care is provided, throughout Blackpool and throughout the country.”
“Losing a child is devastating, and no one deserves to experience such losses alone. I know that my hon. Friend is a keen supporter of the charity Love, Jasmine in her constituency, which provides vital support to families who have suffered child loss. We are making sure that local NHS services provide easily accessible bereavement support, and local integrated care boards should make sure that service provision is tailored directly to the needs of grieving families in their communities.”
“I commend the work of Rob and Kathy Lapsley. Having been through a terrible loss themselves, they have provided support to parents across Merseyside who face such tragic circumstances. It is vital that bereavement support is available and offered with sensitivity, choice and respect for what each person needs. Integrated care boards must ensure that there is sufficient provision for bereavement, and that includes working with the voluntary community and social enterprise sector. We are investing £25 million to enhance bereavement facilities, and maternity and neonatal services. I thank my hon. Friend for championing the charity Love, Jasmine.”
“I absolutely agree; all parents should have choice and respect in what is a very sensitive and difficult time. As of January this year, all integrated care boards in England have indicated that trusts in their areas offer a bereavement service seven days a week across maternity settings, so that support is available when families need it most. I would be happy to talk to the hon. Lady if she has any further concerns.”
“Medicine supply chains are global in nature, but we are taking steps to strengthen resilience by exploring opportunities to diversify supply chains, reduce reliance on single sources and undertake targeted monitoring of vulnerable supply chains. We also hold stockpiles for pandemic and serious infectious disease scenarios, including of antibiotics.”
“I commend my hon. Friend for his campaigning in this area. He is absolutely right: where serious misconduct takes place, action must be taken. That is why our programme of regulatory reform will enable regulators, starting with the GMC, to act more swiftly. We are consulting on proposals that will give the GMC a duty to remove registrants convicted of murder, rape and many other sexual offences without going through a fitness-to-practise process.”
“Air ambulance charities are a lifeline to communities across the country, and I want to celebrate the extraordinary volunteers who keep these services flying. The Royal Devon and Exeter hospital near the hon. Member’s constituency has a state-of-the-art helipad funded by a £1 million donation from the HELP Appeal. The facility is fully equipped with advanced lighting to allow landings 24/7 and can accommodate the latest generation of larger air ambulance helicopters.”
“For too long, across too many parts of the system, we have seen the same pattern: harm happens; a review follows; lessons are identified; but the change patients were promised does not always follow quickly enough. This Government are determined to change that. Dr Penny Dash’s review was commissioned to consider whether the current landscape of organisations provides effective leadership, listening and regulation on patient safety and wider quality of care, and whether a different approach could deliver better outcomes for patients.”
“I thank the hon. Member for Harwich and North Essex (Sir Bernard Jenkin) for securing this important debate. He has long taken a serious interest in patient safety, including in the importance of independent investigation. I recognise the strength and sincerity of the points that he has raised and will try to answer all of his questions. At the heart of this debate is a simple question: when patients and families tell us something has gone wrong, does the system listen and learn, and, most importantly, does it change? Patients do not judge the system by the number of reports published, the number of organisations involved, or the number of recommendations written; they judge it by whether care becomes safer.”
“I thank my hon. Friend for putting that on the record. He will know that we are in Committee stage of the Health Bill and there will later be the opportunity to debate this issue on the Floor of the House.”
“Absolutely. I am very privileged to have patient safety in my brief. I know everybody across this House really cares about it, and I will make sure that officials do as the hon. Gentleman requests.”
“The Patient Safety Commissioner will continue to champion patient voice on medicines and medical devices and report directly to Parliament.”
“The Bill also allows for the investigation function to make recommendations to the CQC in its report, and the CQC would be legally required to respond to such recommendations. I hope that the hon. Member is assured that we will work carefully with colleagues, patients, staff and system leaders as these reforms are implemented. The same principle applies to patient voice. Patients do not share their experiences simply for the system to record them; they do so because they want to see things change. Listening matters, but acting on what we hear is what makes patients safer. That is why we are ensuring that patient experience is closer to where decisions are made, with commissioners and providers responsible not only for delivering services, but for listening and responding.”
“Gentleman asked if I could explain who will conduct future investigations into safety in the NHS if the Dash review is implemented. The investigation function in the CQC will have autonomy to launch investigations into any part of the health system and will be able to make recommendations on any part of the system, just as HSSIB does now. There will be no barrier to an investigator finding out that CQC inspections are causing unintended harm. If they are, and if the investigator feels that a recommendation for change should be made, they will make it. There will be no need for litigation through the courts, and insights gained from investigations will continue to inform recommendations concerning the Care Quality Commission’s regulatory functions.”
“The question before us is not whether investigations matter —of course they do—but how we ensure that investigations lead to action, because learning without implementation does not improve patient safety. The Dash review recommended transferring HSSIB’s functions to the Care Quality Commission, while maintaining a dedicated investigation capability. I understand why colleagues will want reassurance on that, because, as the hon. Member said, independence, transparency and trust are essential in patient safety investigations, but so is impact. The purpose of these reforms is not to weaken investigation, but to strengthen the link between investigation, learning and improvement. We need a clearer route from identifying problems to making recommendations and ensuring that someone owns delivery and that patients see change. The hon.”
“We had a constructive conversation earlier today. On his point about the accusations that HSSIB had expanded the scope of its work beyond its remit, he explained to me in detail how HSSIB’s inception came about. The Government have accepted the Dash recommendation that HSSIB’s role as a centre of excellence for investigation should continue, and clarified the remit of any future investigations. I think that the investigation function with the CQC will perform the role of a centre of excellence for investigations. HSSIB has developed important expertise in understanding why things go wrong and identifying system-wide learning, and I acknowledge that work.”
“No organisation, however established or well-intentioned, should believe that learning and improvement only apply elsewhere. That is why we are streamlining and strengthening the patient safety landscape. The hon. Member mentioned the National Quality Board. We have revitalised the board by giving it a stronger role in providing a single, authoritative view of quality across the system. That will help reduce duplication, bring greater clarity to recommendations and ensure that effort is focused where it has the greatest impact. All hon. Members recognise that we need fewer recommendations because we know that they disappear into the system. More recommendations are needed that are owned, tracked and delivered. I recognise the concerns raised by the hon. Member in respect of the Health Services Safety Investigations Body.”
“Let me be clear: the Dash reforms are not about saving money; they are about strengthening patient safety and patient voice across the system. The abolition of HSSIB and the transfer of its functions to the CQC play an important part in making the system of patient safety much more effective. Safety is the issue, not money. Accepting recommendations is the beginning, not the end. Patients who have suffered harm, families who have campaigned for years and staff who have spoken up do not want another report sitting on a shelf. They want evidence that the system can listen, learn and prevent harm from happening again. I want to be absolutely clear: every organisation in the system has a responsibility to meet that challenge. Patient safety cannot be something we support in principle but resist when it requires us to change.”
“That is why the Government have accepted all nine recommendations of the Dash review. The hon. Member asked how the CQC will provide the same confidence that the safe space is not being compromised. The criteria for disclosing protected information outside the investigative function are set out in the Bill. Those criteria set a high bar for any disclosure—as high as it is currently with HSSIB—and the CQC will publish further guidance setting out much more detail. As the Bill sets out, the CQC will appoint a responsible person who will decide whether the case matches the criteria and whether it warrants information sharing outside the safe space. That person is likely to be the CQC’s chief executive officer. The hon. Member asked why the Dash review and the Government have ignored the whole question of HSSIB’s value for money.”
“Member for Harwich and North Essex asked me about the expertise in HSSIB, the full-time job that it does and whether it could undertake investigations more cheaply and quickly than public inquiries. The investigation function within the CQC will be expert and full time, and it will be able to conduct investigations in the same cheap and quick way that HSSIB does now. In future, there will be the same opportunity to use the CQC investigation function instead of needing a public inquiry as there is currently with HSSIB. The review also found that too many recommendations are generated through reviews, inquiries and investigations, as the hon. Member said, without enough clarity on ownership, prioritisation, implementation and impact. This is the fundamental point: recommendations alone do not make patients safer; change does.”
“The problem is not that people working in patient safety lack commitment—we all know that there are dedicated people across the system doing important work every day—but that the system around them has become too cluttered, complex and difficult for patients, staff and leaders to navigate. We inherited a landscape with more than 70 routes for patients and service users to raise concerns or provide feedback, and around 40 public bodies with a formal role in quality and safety. That complexity does not automatically make patients safer. It can make responsibility unclear, create duplication and make it harder to ensure that learning leads to improvement. A cluttered landscape, as we would all agree, is not an effective landscape. The hon.”
“I thank my hon. Friend for her contribution—she is absolutely right. I take accountability very seriously and am going to talk about it in my remarks in this debate. Far too often, we see so many inquiries and so many recommendations but nobody taking responsibility for implementing the change. In the end, patients have to feel that things have changed, not that we are just having further reports and recommendations. The Penny Dash review examined six organisations that are overseen by the Department: the Care Quality Commission; the National Guardian’s Office; Healthwatch England and the local Healthwatch network; the Patient Safety Commissioner; the Health Services Safety Investigations Body; and the patient safety learning functions of NHS Resolution. The review’s conclusion was clear.”
“I am grateful to the hon. Member for his comments. I did recognise the reason for keeping the functions separate, but just because they are part of the CQC does not mean to say that they do not have their independence. I have pretty much set out the powers that they current have and what they will be able to do, but they do not prioritise investigating the situations that we spoke about, such as “never events”. It is not simply about the investigation; it is about how we get those “never events” to lead to learning and change in the system. How do we hold the system to account to ensure that the very thing that the regulator recommends is implemented? What that journey looks like for patients will be far more significant, as opposed to those bodies simply doing investigations that lead to further recommendations.”
“Concerns were also raised about the fact that the UK commitments are larger than the US commitments, but I do not agree. The UK has made policy changes to improve access for patients, while the US has committed to tariff protection for UK exports, which is significant given the scale of that market. The commitments deliver improved patient access in the UK and protection for UK exports.”
“It will make recommendations on pilot programmes as per the UK-US arrangement commitment, and I look forward to providing an update to the Committee on that in due course. I know there has been concern that these changes undermine NICE’s independence, but that is not the case—let me just be clear about that. NICE will continue to make its recommendations based on evidence, clinical effectiveness and value for money, free from political interference. The change will allow Ministers to set the overall threshold within which NICE operates, not to determine individual decisions. This will preserve NICE’s core role as an independent evaluator, while ensuring that the framework that it uses reflects how we value innovation and patient benefit.”
“The UK’s life sciences sector is one of our greatest national strengths. It saves lives, supports jobs and underpins innovation across our economy. I am proud that thanks to this arrangement, the United Kingdom will be the only country in the world to have secured a commitment to tariff-free access for pharmaceutical exports into the United States. The Chair of the Committee raised NICE and VPAG changes and rebates. My right hon. Friend the Member for Hayes and Harlington (John McDonnell) also raised a number of issues, as did my hon. Friend the Member for York Central (Rachael Maskell). I will address them now. The joint Government and industry taskforce has been discussing the options for continuing to evolve our system to ensure that we maximise benefits to patients and the economy.”
“I will try to answer all the questions that have been put to me in the short time I have. First, I am grateful for the contributions made by hon. Members, and I thank the Chair of the Health and Social Care Committee, the hon. Member for Oxford West and Abingdon (Layla Moran), for securing this debate. The UK-US pharmaceuticals arrangement is an important step forward for patient access to innovation and the future of our life sciences sector. This arrangement is fundamentally about patients by ensuring that they can benefit from life-changing medicines as they are developed, rather than see the UK being left behind. We have already seen the benefit from those changes, with NICE approving life-changing treatments such as vorasidenib, a brain cancer drug for patients as young as 12.”
“I look forward to engaging with the sector on the future of the voluntary scheme, with negotiations due to begin next year informed by the outcomes or interim findings from pilot programmes that were launched as early as this September.”
“I am trying to get through all these questions as quickly as I can. I will give way to the hon. Gentleman shortly. On the VPAG changes and rebates, alongside changes to NICE recommendations, the arrangement affects how pricing and repayment mechanisms operate through the voluntary scheme for branded medicines pricing, access and growth. To ensure predictability for the industry going forwards, given the unexpectedly high payment percentage for newer medicines for 2025, the Government have committed to ensuring that future VPAG rates do not exceed 15%. This will support life sciences investment and patient access to medicines while ensuring that the scheme can continue to work for both industry and the NHS, keeping the medicines budget sustainable.”
“That includes AstraZeneca’s recent announcement of a £300 million investment into R&D sites at Cambridge and Macclesfield. That demonstrates the confidence that this key sector has in the UK. Maintaining a strong commercial environment helps ensure continued investment and the development of new treatments. This is not separate from patient benefit. It enables the pipeline of the new medicines that NHS patients ultimately rely on.”
“We are committed to increasing spending on medicines as a proportion of NHS spend, ending the recent decline in the proportion of health spend dedicated to medicines and increasing spending on innovative medicines to 0.6% of GDP. The Chair of the Science, Innovation and Technology Committee, my hon. Friend the Member for Newcastle upon Tyne Central and West (Dame Chi Onwurah), and my hon. Friend the Member for North West Cambridgeshire (Sam Carling) raised a really important point. Life sciences is one of our most productive sectors. It underpins research and development, clinical trials and high-value manufacturing, and it supports jobs across the country. Over £1 billion in industry investment has already been secured since the announcement of this arrangement in December last year.”
“With respect, I am going to answer the questions that have been put to me by many hon. Members, and I am coming to the impact assessment. We have been clear that the estimated short-term impact is around £1 billion in England over the spending review period. Costs will increase over time as NICE approves more medicines, but precise long-term costs cannot be modelled as a single figure; they depend on future medicines, NICE approvals, uptake and wider commercial developments. Members mentioned a number of figures. I do not recognise the £9 billion and £14 billion figures for costs. Spending on innovative medicines increases year on year as new treatments become available, so underlining growth would be expected to continue regardless of this arrangement, and often the figures cited publicly do not take that into account.”
“I recognise the Committee’s request for the impact assessment, but the analysis is scenario-based, contains commercially sensitive assumptions and remains linked to live policy development. Officials should be able to produce confidential advice for Ministers to inform trade and other negotiations, and we will not apologise for maintaining such confidentially where doing so is in the national interest.”
“Finally, there have been searches of the Yellow Card database for any reports of the use of DES, although given the time that has passed, I am sure that the House will appreciate the significant challenges in relation to locating and retrieving records between the 1940s and the 1970s. In addition, my officials are working to explore what can be done through NHS digital processes in relation to missing or destroyed medical records. Let me again thank Members for raising this important issue, and pay tribute to all those affected by DES who have continued to campaign for recognition, support and answers.”
“They include searches of agency archives, both digital and hard-copy, for documentation relating to regulatory activity associated with the use of DES; visits to the National Archives to attempt to locate records from the 1970s, including discussions of DES by the Committee on Safety of Medicines, a predecessor of the Commission on Human Medicines; and locating previous editions of the “British National Formulary” and Association of the British Pharmaceutical Industry datasheets that may detail information on the use of DES. The MHRA also contacted the General Medical Council to establish whether any direct communications on DES had been sent by the GMC to healthcare professionals directly, but the GMC could find no records of communications.”
“I recognise the importance of trying to understand the scale of DES exposure and the number of people who may have been affected. The Medicines and Healthcare products Regulatory Agency has taken a number of steps to establish what regulatory action was taken by its predecessor in relation to the risk associated with DES.”
“There are also primary research studies that have not yet been incorporated in those reviews, and existing reviews have not fully considered psychosocial impacts. The newly commissioned review is intended to address those gaps. My hon. Friend asked about screening. The research ensures that any future policy on local treatment pathways, clinical guidance and potential screening arrangements is informed by the latest available evidence. It will also be important in guiding decisions on whether a lifelong screening protocol should be developed for people affected by DES. The women affected by it should, of course, be involved in this work, which is why we ensured that the university will engage with members of DES Justice UK so that it can learn from women—and some men—with lived experience of the effects.”