House of Commons Debate—Review of patient safety across the health and care landscape (6 July 2026)

Summary

This article provides an overview of an Adjournment Debate in the House of Commons discussing the implementation of recommendations from the Review of patient safety across the health and care landscape. The debate focused on the proposed transfer of functions of the Health Services Safety Investigations Body (HSSIB) to the Care Quality Commission (CQC).

Content

What is an Adjournment Debate?

There is a 30 minute Adjournment Debate at the end of each day's sitting of the House of Commons. They provide an opportunity for an individual backbench MP to raise an issue and receive a response from the relevant Minister. Unlike many other debates, these take place without a question which the House of Commons must then make a decision on.

Review of patient safety across the health and care landscape

On 7 July 2025, the Department of Health and Social Care (DHSC) published the findings of the Review of patient safety across the health and care landscape in England, chaired by Dr Penny Dash.

The review looked at six specific organisations that were established to either assure—or contribute to improving—the safety of care, while also making reference to the wider landscape of organisations influencing quality of care. Its final report issued a number of recommendations, which included several proposed changes organisational changes:

• Transferring the functions of the HSSIB to the CQC.
• Closing Healthwatch England, moving its functions to a new directorate for patient experience in DHSC.
• Combining the statutory functions of Local Healthwatch relating to healthcare with involvement and engagement functions in Integrated Care Boards (ICBs), with social care functions transferred to local authorities.
• Transferring the hosting arrangement of the Patient Safety Commissioner for England to the Medicines and Healthcare products Regulatory Agency (MHRA).
• Closing the National Guardian’s Office, transferring its functions to NHS England.

Contributions from Bernard Jenkin MP

This debate was tabled by Sir Bernard Jenkin MP. He made a number of points concerning the transfer of the functions of the HSSIB to the CQC.

• He said that safety management is intrinsic to safety and public confidence in other safety-critical activities, such as aviation, but is alien to NHS culture. He asked without HSSIB, which independent body will promote a coherent understanding of safety system management in health, and who is to hold the NHS and Government to account for safety failures.
• He stated his view that neither the National Quality Board (NQB) nor the CQC should control investigations. He noted that the Air Accidents Investigation Branch cannot be prevented from making independent recommendations by the Civil Aviation Authority, the Transport Secretary or airlines themselves. He asked therefore why should the NQB, which will be subject to political direction, be allowed to decide what safety recommendations should be made and what should be investigated.
• He highlighted that the Dash Review incorrectly states that HSSIB was originally established to look at specific cases or incidents of severe harm, but it has since broadened its work into making more systemic recommendations. He noted that it was always intended by Parliament that HSSIB should make systemic recommendations arising from the investigation of specific incidents or groups of incidents.
• He questioned whether the CQC in its role as regulator and compliance enforcer could also be an independent investigator. He said that the Dash Review also says that the CQC internal successor should collaborate through the NQB to agree the scope of any investigations it carries out and agree the recommendations. He described this proposal as a direct attack on the independence of investigations.
• He stated that the Dash Review fails to look at the comparative cost of HSSIB investigations versus the cost of public inquiries. He noted that HSSIB at the moment only costs £6.3 million per year. He suggested that to save money the Secretary of State should request that HSSIB conducts far more investigations into matters which he thinks are important, provided that he also provides the funding for the necessary capacity.
• An example he gave was that HSSIB, has conducted eight investigations into mental health suicides since 2023. Each was completed in a few weeks or months, costing a total of £850,000. In comparison, he noted that the Lampard inquiry into the Essex partnership university trust, also investigating patient safety concerns in mental health, is expected to cost more than £5 million.

Contributions from other MPs

• Jeremy Hunt MP highlighted concerns that moving HSSIB into the CQC, which has a legal duty ot act on information it receives, creates a worry for people talking to HSSIB that the information that they give to it may no longer be protected as they currently are.
• Anna Dixon MP noted that recent inquiries into maternity services, infected blood and pelvic mesh underline that professionals and those working inside the NHS must be able to speak freely when things go wrong in order to learn lessons and that that this is only possible with an independent investigating organisation.
• James Naish MP stated his concerns about the abolition of Healthwatch. He noted that there is a strong desire to see independent patient voice maintained outside the system and that Healthwatch was established due to issues within health structures, including, notably, the Mid Staffordshire scandal.
• Jim Shannon MP emphasised the need for lessons learned on data collection, streamlined complaints and patient safety culture are shared with the Northern Ireland Assembly Minister, Mike Nesbitt, as health is a devolved matter.
• Rachael Maskell MP stated that there was a wider issue, which she felt that the Health Bill completely misses, around the accountability systems within the NHS. She stated that these reforms are not going to deliver accountability, but will weaken it, and as a result we will see more requests for investigations into patient safety.

Government response

Responding to this debate on the Government’s behalf, Preet Kaur Gill MP, Parliamentary Under-Secretary of State for Health Innovation and Safety, made the following points:

• 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 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.
• Dash reforms are not about saving money; they are about strengthening patient safety and patient voice across the system. She stated that 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.
• The NQB has been 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.
• The purpose of these reforms is not to weaken investigation, but to strengthen the link between investigation, learning and improvement.
• 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.
• The Health 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.

How to watch the debate

You can watch the full debate here and find the full transcript on Hansard at the bottom of this page.

Related reading

• Review of patient safety across the health and care landscape: Patient Safety Learning's response (15 July 2025)
• The future of the Health Services Safety Investigations Body: a recent discussion at the Patient Safety Management Network
• Is the patient voice fading? Reflections on patient safety in a changing NHS