Monday 1st June 2026
(1 week, 2 days ago)
Commons ChamberHealth Bill 2026-27 View all Health Bill 2026-27 Debates Read Hansard Text Watch Debate
The Secretary of State for Health and Social Care (James Murray)
I beg to move, That the Bill be now read a Second time.
Madam Deputy Speaker, if you were to ask anyone in Britain what they think about the NHS, I bet they would give you an answer without hesitation. No one would be lost for words, because everyone has an opinion. Regardless of whether they tell you a story about how the NHS has helped them or their family in their moment of need, or whether they share a view on how they would change it for the better, everyone cares about the NHS. The NHS matters deeply to people right across our country because of how deeply it touches all our lives.
For my part, the NHS came to my rescue when I was diagnosed 18 years ago with a serious and rare neurological condition that threatened my ability to run, to write and to talk. After the best care I could have hoped for from my brilliant consultant and his team at the National Hospital for Neurology and Neurosurgery in Queen Square, and from other teams across the NHS, I am now symptom free. It is only thanks to the support of those people working in our health service, and to the faith of the Prime Minister in appointing me to this role, that I am able to stand here today as the Secretary of State for Health and Social Care and set out what this critical Bill will mean for the future of our NHS.
Like me, everyone across Britain will have their own story of the NHS, or a view to share about its future. It is an achievement that we all share together, and one that is personal for us all. My predecessor as Health Secretary, my right hon. Friend the Member for Ilford North (Wes Streeting), has spoken movingly about the importance of the NHS to him. He explained how it saved his life when he was diagnosed with kidney cancer at the age of 38 and how, amidst all his worries, the one thing he never had to worry about was how much the treatment might cost. Let me pay tribute to my right hon. Friend for what he did in the role as a great champion of patients everywhere, and as someone with a huge passion for building a modern NHS—something we can see in this Bill, which he and my hon. Friend the Member for Bristol South (Karin Smyth) put so much energy into.
As a former Chief Secretary to the Treasury and Exchequer Secretary, I have been incredibly proud to support my right hon. Friend the Chancellor in her determination to take the right decisions on the public finances to enable record investment in our national health service. Thanks to that investment, the changes that this Labour Government have begun to make, the leadership at the Department for Health and Social Care and NHS England, and the incredible work of frontline staff across the NHS, in just under two years we have seen: over half a million fewer people on the waiting list; 2,000 more GPs; 8,500 more mental health workers; four in five patients being seen within four hours in A&E; over 100 community diagnostic centres now open in evenings and at weekends; and over 240,000 more people getting their cancer tests on time. That is the difference that this Labour Government are making: an NHS in which more patients get the treatment they need when they need it, and in which taxpayers get better value for money.
Tim Farron (Westmorland and Lonsdale) (LD)
The Secretary of State mentions some achievements and the progress being made within the NHS. May I bring him back to the issue of cancer treatment? According to OECD figures, 53% of cancer patients should receive radiotherapy as their primary treatment. In the UK, the figure is only 35%. In Cumbria and Lancashire, it is only 29%. This is delaying treatment, delaying cures and preventing people from living long lives. Will he take a personal interest in correcting the commissioning so that every single part of this country has access to radiotherapy close to where people live, so that they can be cured with the most up-to-date technology?
James Murray
The hon. Gentleman is absolutely right to draw attention to the importance of having the right approach to cancer, and our national cancer plan sets out what we as a Government are doing to achieve that. He is also right to point to the regional variation in different parts of the country, and to say how important it is not just to raise standards across the country but to ensure that the increase in standards is evenly distributed, so that all areas improve. One of my roles as Secretary of State is to ensure that we not only deliver our national cancer plan but support local areas so that they have the right services.
Catherine West (Hornsey and Friern Barnet) (Lab)
I congratulate the Secretary of State on his excellent speech, and I thank him and my hon. Friend the Member for Bristol South (Karin Smyth) for their work in developing the Bill. Healthwatch Haringey plays an enormously important role in being a champion for the ecosystem within a locality. The Local Government Association is very concerned about some of the discussions. Will he reassure me that as the Bill passes through the House, how we do the NHS, as well as what we do, will be an integral part, so that everybody can feel included in the NHS?
James Murray
I reassure my hon. Friend that what the Bill seeks to achieve, through local health watches across the country, is to bring the voice of patients closer to the people who plan and deliver services. Too often, we have not seen action following feedback. We need to ensure that such feedback is integrated into the planning and delivery of services, so that patient voices are heard.
I have set out some of this Labour Government’s achievements less than two years into office, which shows that decline is not inevitable. Our determination to deliver on what people voted for is making a real difference. We have started to make progress, and we are building an NHS that is fit for the future.
Labour’s choice in government has been, and will always be, to strengthen and improve the NHS as a service that is universal and publicly funded, with use based on need, not on ability to pay. That choice is backed by people across Britain, yet for the first time in a generation, some Members of this House are openly calling for the NHS’s founding principles to be abandoned. The hon. Member for Clacton (Nigel Farage), who I note is not in his place—[Interruption.] He never is—good point. Time and again, he has made it clear that he would tear the principles of the NHS to shreds and bring in an insurance-based system that would benefit only his friends in finance. Be in no doubt: Reform would sell our health service to the highest bidder. That would be a devastating mistake, and we must not let it happen.
Instead of turning our backs on the principles on which the NHS was founded, as some Opposition Members would have us do, I will fight every day as Health and Social Care Secretary to build the modern health service that our country demands and that patients deserve.
Calum Miller (Bicester and Woodstock) (LD)
I welcome the Secretary of State to his place. He has spoken about two themes: the scale of ambition of this Bill, and the need for the patient voice to be heard at the heart of it, given how much all our constituents care about the NHS. In the case of Healthwatch, can he reassure the House that bringing the scrutiny of local voices up to the level of the Secretary of State will not diminish the independence of the local healthwatch organisations that, in Oxfordshire and elsewhere, do so much to promote the patient voice and to hold the NHS to account for its services?
James Murray
I thank the hon. Gentleman for his words about my taking on this post. I can reassure him that, as I will come to in my speech, the Bill sets out to integrate the national Healthwatch into the Department of Health and Social Care through a new patient experience directorate and to integrate local healthwatch organisations into integrated care boards and local authorities, which are responsible for delivering health and care at local level. This measure is about making sure that patient voices at national and local level are closer to those deciding on and delivering services, so that those voices are heard.
Sarah Coombes (West Bromwich) (Lab)
Will the Secretary of State confirm that the heart of this Bill is about modernising the NHS and reducing inequalities across this country, and that since my constituency has the third lowest healthy life expectancy in the UK—it is shocking—my constituents will benefit from this Bill and all the action on inequality that it is intended to deliver?
James Murray
My hon. Friend is absolutely right that this Bill is about modernising the NHS. As a Labour Government, our priority is to boost investment and to modernise the NHS for the future. It is exactly that combination of investment and reform that will deliver the health service that her constituents need and deserve.
Several hon. Members rose—
James Murray
I will give way one more time, and then I will make some progress.
Jim Shannon (Strangford) (DUP)
I welcome the Secretary of State to his place and I wish him well in the role he now takes on. I am very pleased that he has experienced the NHS at its best, and I am glad to hear that.
The Government have called for a duty of candour, so they must ensure that that is still possible, but the decision to scrap independent bodies such as Healthwatch and the Health Services Safety Investigations Body risks silencing the patient voice, so there is a need to be careful. Will the Secretary of State assure us that the Government have taken that on board in this Bill?
James Murray
The hon. Gentleman raises questions relating to Healthwatch and to HSSIB being integrated into the Care Quality Commission. I will set out more detail in a few moments about those decisions, but fundamentally they derive from conclusions arrived at by Dr Penny Dash, whose review of the patient safety landscape found that it was too full of different organisations, and that their impact on the services provided to patients was unclear. We are seeking through this Bill to simplify that landscape, make sure that patients’ voices are heard closer to decision makers and improve the NHS for everyone across the country.
For me, the way to build on the progress of the past two years is not just to maintain the improvement in performance that we have seen, but to accelerate our fundamental transformation and modernisation of the NHS. As Health Secretary, I am absolutely focused on delivery and putting the values that we in the Labour party all share into action. Crucially, I am determined to make sure that we benefit from the fullest possible use of technology, digitisation and artificial intelligence to renew the NHS for the future.
The changes in technology, digitisation and AI are not an add-on to the NHS’s core business. With a determined focus on driving innovation at every level and the confidence to reimagine our approach to the nation’s health for the modern world, they offer us the chance to transform the way the entire NHS works. They will improve the speed of diagnosis, helping people to get the right treatment much more quickly than they do today.
Kim Johnson (Liverpool Riverside) (Lab)
Will my right hon. Friend give way?
James Murray
I am going to make some progress, if I may.
These changes will streamline tasks for NHS staff, freeing them from admin and bureaucracy to focus their energy on caring for patients. They will transform the experience we all have as patients, giving us control and reducing our anxiety over the care we receive. They will reduce the costs of delivering healthcare, so that more of the money we spend goes to the frontline, where it belongs. That is the future we must build, and the road to that future runs through this Bill.
For many years, patient groups have warned about the pitfalls and shortcomings of fragmented information systems in the NHS, and they are absolutely right. Right now, information in the NHS tends to follow the institution, not the individual. That is why we all know the familiar frustration of having to repeat the same story over and over, every time we see a new nurse, doctor or consultant. The reason for this is that too often no one, including the patient themselves, can see a full summary of a patient’s medical record in one place. Those patchy care records are not just an inconvenience or a source of anxiety and distress; they can also be a risk to patient safety.
Ben Obese-Jecty (Huntingdon) (Con)
I welcome the Secretary of State to his place. Hinchingbrooke hospital in my constituency is one of the new hospitals to be built as part of the new hospital programme—it is in wave zero—but it currently does not have an electronic patient record system, so we have the fragmented patient history that he has just mentioned. It desperately needs to increase its rating on the HIMSS—Healthcare Information and Management Systems Society—scale as a new hospital, but it does not have the funding required to install a patient record system. Will he guarantee that the hospital will receive the funding required to deliver a new electronic patient record system?
James Murray
I am happy to look into the specific circumstances the hon. Gentleman refers to and get back to him. More widely, however, the investment is secured across the Government for implementing the single patient record system. That will mean that, rather than data being transferred from where it exists at the moment to a new system, it will remain where it is—in GP surgeries, hospitals and so on—but it will be linked up so that one person, including the patient, can see all that data from the middle of the network of information.
Several hon. Members rose—
Sarah Champion (Rotherham) (Lab)
Specifically on the single patient record, the explanatory notes say that it will
“allow patient information to be shared with patients and their relevant health and social care providers (such as GPs, hospital doctors, social care workers and others involved in their direct care)”.
By my maths, that is probably a couple of million people, so could the Secretary of State please talk about how safeguards will be implemented, particularly for children’s care data?
James Murray
I thank my hon. Friend for raising the very important question of data privacy and security. I will address that in a moment, because I am going to set out some of the protections in our approach to the single patient record, and I think that will exactly answer the questions she raises.
I will make progress, because I am conscious of time. As I have said, the patchy records are not just an annoyance or a source of anxiety or distress; they can also be a risk to patient safety. In other areas of our lives, getting information wrong or not having it immediately available may be an inconvenience; in a health service, the consequences can be profound. What happens to the patient who is rushed to accident and emergency and has complex conditions that require multiple medications, if the emergency team have no way of knowing that? What happens to the dementia patient who cannot keep track of all the different documents from all the different specialists in all the different providers? In today’s NHS, the GP or practice nurse at the clinic, the paramedics stepping through the front door and the consultant at the bedside are doing everything they can to try to solve a puzzle, but without all the pieces. This Bill will change that. It will do so by introducing a new approach—the single patient record—and that is nothing short of a game changer.
Dame Chi Onwurah (Newcastle upon Tyne Central and West) (Lab)
I congratulate my right hon. Friend on his new position.
On Wednesday, my Science, Innovation and Technology Committee will publish our report on the Government’s digital ambitions. My right hon. Friend will not be surprised to know that we will be raising serious concerns about data management, data hygiene and vendor lock-in. Many projects such as the single patient record have failed over the last 20 years. Will he confirm to me that he will ensure that patients can control when and how their data is seen, that he will be building on existing records such as the great north care record, and that this will be treated as critical national and sovereign infrastructure, not subject to capture by a single provider such as Palantir?
James Murray
I thank my hon. Friend for her intervention. She is absolutely right to underscore the importance of data security and data privacy. That is essential in building trust in what we are seeking to do.
To be clear, the single patient record, as I was just saying a moment ago in response to the hon. Member for Huntingdon (Ben Obese-Jecty), does not move data from one system to another; it preserves the data where it is, and builds links between systems so that one person, whether a clinician or a patient, can see all the data at once. The data will still be governed by the same privacy policies on a GP system, in a hospital trust system and so on. When linked together through the single patient record, it will be governed by the highest levels of security: only authorised individuals will be able to access the data, there will be an audit trail of anyone who has accessed it, and the cyber-security protection will be the strongest available.
Kim Johnson
I really appreciate the Secretary of State giving way on that point. This morning on Radio 4, he failed to rule out Palantir being awarded the single patient record. We know that the £330 million offered to it for the current federated data has been highly criticised by unions and the British Medical Association. What assurances can he give us that patient safety will be free from abuse and misuse?
James Murray
As my hon. Friend will have heard, as she listened to the rest of my interview on Radio 4 this morning, the situation with the single patient record is very different from that of the federated data platform, because it is likely that we will let a series of contracts to de-risk the delivery of the single patient record. The situation with Palantir is that the contract for the federated data platform is, as I am sure she knows, being reviewed ahead of a potential break clause in 2027, but the situation with the single patient record is a very different set-up. As I have said a couple of times now, information is stored on individual systems—in GPs, hospitals and so on. The single patient record links them up and will be delivered through a range of different contracts to make sure that the system works in the interests of clinicians and patients.
Jeremy Corbyn (Islington North) (Ind)
Will the Secretary of State give way?
James Murray
I am going to make some progress.
The single patient record will mean that wherever a patient is being treated, even if they are not at their local GP or are in a hospital they have never been to before, those caring for them will have access to all the accurate, relevant, up-to-date information they need. Through this new approach, we will bring together people’s health and social care records digitally, securely and conveniently, and make them available to patients on the NHS app.
A number of Members have raised questions about data privacy, so let me be very clear on that point. Patients rightly expect their highly personal and sensitive medical details to be protected, and they will be. Under our plans, strict safeguards, strong cyber-security and clear controls on who can read information will be backed by an audit trail of who has accessed what. The single patient record will also be subject to existing forms of scrutiny and oversight in the NHS, from data protection officers to legislative safeguards. Where the single patient record is being used for research or planning, it will be treated the same as all other sensitive health data, subject to the same legal protections, ethical approvals and governance.
Dr Luke Evans (Hinckley and Bosworth) (Con)
The Secretary of State is making himself the data controller of all the data that will be in place. What impact does that have on the sections he has just talked about?
James Murray
When the data is held by a GP surgery or an NHS hospital trust, for instance, the relevant bodies will remain the information controllers. Where that information is then shared through the single patient record, the Department of Health and the Secretary of State will take on a role as data controller as well. That will all be governed in the way that data protection currently applies across the NHS, through existing forms of data security. Fundamentally, it will reorientate the NHS to be a service that revolves around patients, rather than patients having to revolve around the NHS.
Ms Julie Minns (Carlisle) (Lab)
Just before my right hon. Friend moves away from the single patient record, may I highlight the challenge remaining in cross-border communities such as mine in Cumbria? My constituents in Carlisle often register with a GP across the border in Scotland. Unfortunately, at present that means that their single patient record will not necessarily flow with them. Will he work at pace with his colleagues in Scotland —and Wales; I can see my hon. Friend the Member for Clwyd East (Becky Gittins) nodding in front of me—to ensure that we get this right for anyone, regardless of where they live?
James Murray
My hon. Friend is absolutely right that the single patient record applies to the NHS in England, but my colleagues in the ministerial team have regular conversations with our counterparts in Scotland and in other devolved Governments to ensure that we are working on such cross-border issues wherever we can.
Becky Gittins (Clwyd East) (Lab)
Does the Secretary of State agree that the introduction of the single patient record will be a huge step forward in the safe treatment of people with allergies? Will he join me in calling on the new Minister in the Plaid Cymru Government in Wales to follow our lead for the betterment of allergy care for people in Wales?
James Murray
I very much join my hon. Friend in urging the new Health Minister in Wales to follow our lead by introducing a way for patients to access the data and, crucially, for clinicians to be able to see all a patient’s data when making those decisions. With complex cases, where people see multiple nurses, doctors, consultants and so on, it can be crucial that clinicians see all the relevant information when making choices on how to treat their patients. I thank my hon. Friend very much for her question.
Madam Deputy Speaker, I should make some progress, as I know that many Members wish to speak this evening. I am getting a nod from you that that is the right thing to do.
As I have set out how the single patient record will help to improve patient safety, I also want to be clear that no Government should ever pretend that things do not go wrong. When they do, it is crucial that the right systems are in place to hold people accountable, and to ensure that we learn from mistakes in order to prevent them from happening again. As I mentioned earlier, Dr Penny Dash conducted an independent review into the patient safety landscape. What she found was a confusing landscape of multiple, overlapping organisations that are responsible for patient safety in the NHS, making it harder for staff and organisations to do the right thing. That is why the Bill simplifies the patient safety landscape, streamlining and consolidating functions to make the system more effective and efficient, and to restore patient confidence.
Tom Gordon (Harrogate and Knaresborough) (LD)
Will the Secretary of State give way on that point?
James Murray
I am going to make some progress.
Following Dr Dash’s recommendations, the Bill will embed the mission and functions of the Health Services Safety Investigations Body into the Care Quality Commission to establish a clearer link between investigating safety concerns and increasing the quality of care. We will ensure that we protect the principle of a safe space for people to share their concerns. To ensure that patients are heard at every stage, from commissioning to delivery, we will make sure that patient feedback is embedded alongside decision makers at every level.
Sir Bernard Jenkin (Harwich and North Essex) (Con)
I am most grateful to the Secretary of State for giving way, and I congratulate him on his appointment. He has inherited this policy—it is not his own. I assure him that the abolition of the Health Services Safety Investigations Body is a dreadful mistake, because which other investigative function in the healthcare system is completely unconflicted in what it does? By abolishing HSSIB he is taking its functions into the CQC, which is a regulator and compliance enforcer, not an investigator, so that there is no longer any independent, unconflicted body conducting healthcare investigations. Has he consulted the royal colleges about this? I have not spoken to a single royal college that is in favour of the abolition of HSSIB.
James Murray
As I made clear, we will protect the principle of a safe space for people to share their concerns. The investigatory function will remain protected within the CQC. The benefit of embedding the HSSIB in the CQC will be to establish that clearer link between investigating safety concerns and increasing the quality of care. That is something on which we can all agree.
James Murray
I am going to make some progress, because, Madam Deputy Speaker, you have asked me and looked at me several times, suggesting that that is what I should do.
I mentioned the changes that the Bill makes to HSSIB and the CQC, but the functions of Healthwatch England—I spoke about that earlier—will move to a new patient experience directorate within the Department of Health and Social Care. The functions of local healthwatch groups will be incorporated into ICBs and local authorities. That approach brings the voices of patients closer to decision makers, so that people have a direct impact on the services they receive. Of course, the changes will neither fix everything at the stroke of a pen, nor take effect overnight, but rather than the voices of patients being kept at arm’s length, the Bill puts them where they should be: right at the heart of the NHS.
Vikki Slade (Mid Dorset and North Poole) (LD)
The Secretary of State has not talked about the role of the governors of hospital trusts, which also appear to be abolished by the Bill. With the creation of mega-ICBs, the removal of healthwatch, and the removal of governors, I am worried that the voice of the local community is reducing rather than increasing.
James Murray
The principle behind the changes to local healthwatch organisations is to bring the voice of patients closer to those who are planning and delivering services. Whether through ICBs or local authorities for health and care, it is an important principle to ensure that feedback is followed by action, and that people can have an influence on the design and delivery of health and social care at an earlier stage in the process.
James Murray
I am going to make some progress, because I need to update the House on the important measures in the Bill to abolish NHS England. Those critical measures will reduce bureaucracy so that more energy, time and funding in the NHS can be focused on the frontline, helping patients. The Bill will abolish the world’s largest quango by merging NHS England into the Department of Health and Social Care and the wider NHS system.
Gregory Stafford (Farnham and Bordon) (Con)
I have asked this question both as a member of the Health and Social Care Committee and on the Floor of the House to the Secretary of State’s predecessor. Given that the new Secretary of State is a numbers man, I hope that he can answer it where his predecessor could not. How much in redundancy payments will this measure cost the British taxpayer, and can he confirm that no person currently employed by NHS England will be fired, paid a redundancy fee, and then rehired by the Department of Health and Social Care?
James Murray
As the hon. Gentleman will appreciate, we are going through that process with the workforces at NHS England and the Department of Health and Social Care. Crucially, however, by 2028, across the Department of Health and Social Care, NHS England and ICBs, we will see a 50% reduction in headcount. That means that the money that would otherwise be spent on those members of staff will now go towards healthcare on the frontline, which is what patients want to see.
As hon. Members will know, NHS England was established by the Health and Social Care Act 2012. That Act established more than 300 new NHS organisations, and has led to too much time, money and effort being wasted on overlapping processes, as good people try to navigate a labyrinthine system that holds them back from delivering for patients. In short, we have a system that gets in the way of what staff, patients and taxpayers want to see.
Wendy Morton (Aldridge-Brownhills) (Con)
I welcome the right hon. Gentleman to his new role as Secretary of State. The point about ICBs and the devolution of responsibility for NHS eye tests is one that we often forget to talk about in this place, as is the case with eyecare—I know that there are some ophthalmic experts in the Chamber. On that point, can the Secretary of State assure me that the changes will not result in a postcode lottery in the provision of eyecare tests? At the end of the day, NHS sight tests are a universal entitlement, so can he ensure that that will continue?
James Murray
The right hon. Lady raises an important point, but local services are already commissioned locally in many cases. The changes that we are making by abolishing NHS England will mean that more power and resources go to ICBs and local areas to allow them to make the right choices for their local area. That is a way of bringing the services that we deliver closer to the people who need them.
Let me be absolutely clear that abolishing NHS England is in no way a reflection on the committed public servants who work at NHS England and in my Department. The truth is that unnecessary structures are getting in the way of them doing their crucial work and it is time for us to change that. The Bill will mean that more time, money and effort will be spent on improving the care that patients receive, rather than navigating the system around them.
Tom Gordon
Obviously, the Secretary of State has just outlined a huge raft of changes that are coming with the abolition of NHS England and everything else that goes with that. Last year, families and MPs got the inquiry into the Tees, Esk and Wear Valleys health trust—the mental health trust in the north of England that had been failing. My worry is that a chair of that inquiry was meant already to be in place. Will that inquiry now be lost amid all the changes to the healthcare system? Will the Secretary of State commit to meeting the families of those affected by the TEWV scandal, and will he get a chair in place as soon as possible?
James Murray
I am happy to look into the case to which the hon. Gentleman refers. The abolition of NHS England and the transfer of its responsibilities either to the Department of Health and Social Care or to local ICBs is being managed carefully, to ensure that we can continue making progress while the structural change happens. To return to my earlier point, the money saved as a result of these changes can go directly to frontline patient care. We expect about £1 billion to be saved, which is the equivalent of 15,000 nurses. I do not see how anyone can disagree with our decision to ensure that resources are spent on the frontline.
As I have explained, abolishing NHS England as a separate organisation will strip out bureaucracy and ensure that we focus on delivery. The decision also has an important democratic role. The core goal of the 2012 Act, brought in by the Conservatives and Lib Dems, was to take politics out of the day-to-day running of the NHS. However, that is a fundamental misunderstanding of the NHS and its place in the democratic life of the nation. The public pay for the NHS; they own it, use it, care deeply about its future, and so they should always have a say in how it is run.
People voted Labour because they trust us to build on our party’s legacy by transforming the NHS for the future, and they will rightly hold us responsible for the decisions we take as we do so. It is not about politics getting in the way; it is about accountability driving change. That accountability has been lost in the confusion of having two separate centres for the NHS, and the Bill will end that.
Dr Ben Spencer (Runnymede and Weybridge) (Con)
I welcome the Secretary of State to his post. Could he explain what the pathway of local accountability is for ICBs?
James Murray
ICBs, as the hon. Gentleman will know, have a board structure that oversees how they operate. The removal of local healthwatch organisations will mean that the voice of patients and their experiences go directly into the bodies that are commissioning and overseeing services. One of the changes the Bill makes is to ensure that strategic mayoral authorities will have a place on the board of ICBs, which helps them ensure that wider objectives in an area of health are aligned.
Several hon. Members rose—
James Murray
I am going to make more progress.
Alongside the removal of confusion and duplication at a national level, the Bill also gives those with local expertise the power, resources and flexibility they need to design and deliver health and care services for their area. The Bill will empower them to innovate, drive progress and do what is in the best interests of the patients they serve.
Under the Bill, ICBs will have more direct responsibility for their services than ever before. They will be at the heart of integrating health and social care, and they will include those people responsible for housing, transport and jobs, so that we can tackle the root causes of ill health, which is better both for patients and for the NHS.
The NHS gave me a second chance at life, and so as Health Secretary I will fight for the NHS every day with the strength it has given me back. The Tories ran down the NHS through 14 years of neglect, and the Lib Dems enabled them. Reform wants to abolish the NHS altogether and replace it with an insurance-based system. The Greens seem intent on ignoring clinical advice and have no practical solutions for the health service. Only Labour has a plan to get the NHS back on its feet. Only Labour is determined to both invest in and fundamentally transform the NHS for the future. Only Labour is showing that change is possible.
We promised to cut waiting lists—we delivered the biggest annual fall in 16 years. We promised an extra 1,000 GPs in our first year—we delivered twice that number. We promised 8,500 more mental health staff by 2029—we have delivered them three years early. We promised 700,000 more NHS dentistry appointments—we have delivered an extra 1.8 million already.
We promised to transform the NHS for the future, and that is what this Bill will do. We are already boosting investment in the NHS where it needs more. We have begun stripping out bureaucracy from the NHS where it needs less. And now we will build a truly modern NHS that will be there for generations to come. The Bill is the next crucial step in our mission, and I commend it to the House.
Madam Deputy Speaker (Judith Cummins)
I call the shadow Secretary of State.
The Minister for Secondary Care (Karin Smyth)
I was going to say that sometimes it is the hope that kills you, but instead I will say that it is a pleasure to close the debate on behalf of this Government.
Let me begin by commending the many fantastic speeches that we have heard this evening. My hon. Friend the Member for Middlesbrough and Thornaby East (Andy McDonald) made some excellent points about spinal cord injury and specialised commissioning. His comments apply to many people, and I take them on board. My hon. Friend the Member for Beckenham and Penge (Liam Conlon) talked about the experience of Alex Savage and his work with the Tessa Jowell Foundation; we thank Mr Savage for that, and mourn his passing. The Chair of the Health and Social Care Committee, the hon. Member for Oxford West and Abingdon (Layla Moran), made a number of valuable points, and I will continue to engage with her and her Committee. I also note the points made by my hon. Friend the Member for Calder Valley (Josh Fenton-Glynn). My hon. Friends the Members for Thurrock (Jen Craft) and for Bexleyheath and Crayford (Daniel Francis) talked about the experience that they bring to this place in relation to SEND, supporting disabled people—particularly children—and joining up services. My hon. Friend the Member for Dudley (Sonia Kumar) drew on her experience of designing services for the future around people and patients.
As ever, I thank my hon. Friend the Member for Sunderland Central (Lewis Atkinson)—another excellent manager from the service—for the expertise that he brought to the debate. My hon. Friend the Member for Cannock Chase (Josh Newbury) made some excellent points about professionals in NHS England, and about communications professionals as well. We know that it is difficult, and we want to use their expertise as we go forward. My hon. Friends the Members for Gloucester (Alex McIntyre), for Rossendale and Darwen (Andy MacNae) and for Stockport (Navendu Mishra) talked about mental health, obesity prevention and their local services. I thank the former Secretary of State, my right hon. Friend the Member for Ilford North (Wes Streeting), for his support for my work in presenting the Bill, and I am relieved that he is still here in support this evening. That is good to know. A week is a long time in politics.
As I often tell people—you have heard it before, Madam Deputy Speaker—I have Lord Lansley to thank —or blame—for my being at this Dispatch Box. I left the NHS and stood for the Bristol South constituency because I could see the coming catastrophe of those coalition reforms. In 2010, patient satisfaction was an all-time high; in 2024, it is at an all-time low. In 2010, the last Government inherited the shortest waiting lists in history; in 2024, they left the waiting lists at record highs. In 2010, the NHS was efficient and delivered value for money; by 2024, we had dropped down international rankings despite a massive increase in headcount at the centre. That is the scorecard that the last Government left for the 2012 reorganisation.
In preparing for this debate, I have looked through my past comments since becoming an MP. In 2016, I said that despite being a non-executive director and manager in the NHS, I could not easily navigate the plethora of bodies in the health and care field. From 2016, it got worse. Each crisis or scandal brought more so-called independent bodies, but no more efficiency, effectiveness or, crucially, safety. We on the Public Accounts Committee were desperately trying to get clarity on accountability for spending, but we did not get it. In 2019—this is on the record—I did an interview with the Health Service Journal in which I highlighted how the role of Parliament in nodding through the estimates bore no relation to financial accountability or spending in my local NHS, and how it was impossible to follow through on funding allocations for facilities for my constituents, or even to understand the decision making of local commissioners, trust boards, regions, NHS England, the Department or the Treasury. When I sat on the Opposition Benches, I watched Tory MP after Tory MP chastise their own Government about what was happening in their constituencies, which was met with a shrug of the shoulders to say, “It’s all down to NHS England.”
The Opposition spokesperson, the hon. Member for Sleaford and North Hykeham (Dr Johnson), talked about ICB accountability, but there is none. Many MPs come to me and say that they cannot get a response from their ICBs. At the moment, some people cannot even get a response to their emails. It is shocking, as my hon. Friend the Member for Lichfield (Dave Robertson) outlined so clearly. The Conservatives’ approach was to hand £200 billion of taxpayers’ money to one body, and more taxpayers’ money to a host of others that were charged with delivering, monitoring and checking a health system in which there is a lot of monitoring, a lot of checking and no end of tick boxes but, crucially, too little delivery of the high-quality services that the British public deserve and the staff want to give.
That cavalier approach changed with this Labour Government, why is why we are bringing forward this Bill. We are abolishing NHS England, devolving commissioning budgets to ICBs, putting patient voice at the heart of the new directorate, and making local commissioners in councils and ICBs embed patient voice and experience in their commissioning, rather than outsourcing their responsibility and then ignoring it. The system does not work, and Members know it. Patients deserve better.
This is the biggest transfer of power to local systems that we have seen. Most significantly, this Government are delivering on giving power to patients, who are frankly astonished to find in 2026 that their records are not joined up in the NHS. My hon. Friend the Member for Portsmouth North (Amanda Martin) made an excellent point about the impact that that has on veterans. Although we have a patchwork of local workarounds that benefit a few people—in Manchester, Bristol or the north-east, for example—patients across England have the right to their own record, and for their clinicians to have access in order to deliver the care they need. That point was well made by my hon. Friends the Members for Glasgow South West (Dr Ahmed), for Ashford (Sojan Joseph), and for Bury St Edmunds and Stowmarket (Peter Prinsley), all of whom gave us real examples of patient experience. As my hon. Friend the Member for Stroud (Dr Opher) says, it is about time that we had single patient records. We heard about the impact on patients from my hon. Friend the Member for Basingstoke (Luke Murphy), who spoke about the sad passing of his father.
A lot of questions have rightly been asked about the single patient record and data, including by the hon. Member for South Northamptonshire (Sarah Bool), my hon. Friend the Member for Morecambe and Lunesdale (Lizzi Collinge), the hon. Member for Newton Abbot (Martin Wrigley), and my hon. Friends the Members for City of Durham (Mary Kelly Foy), for Worthing West (Dr Cooper), for Bournemouth West (Jessica Toale) and for Wolverhampton North East (Sureena Brackenridge). We want to make sure that we get this right. They should know that although the Bill establishes the legal framework for the SPR, much of the detail will be in secondary legislation. I can assure the House that all Members will have a chance to scrutinise the regulations in due course. However, we firmly believe that pursuing a single patient record is the right thing to do. We have found that patients and staff support it, as long as it is built with the strongest safeguards for security and privacy. We hear their concerns, and we will make sure that those safeguards are built in.
The single patient record will protect personal data by default. It will be considered critical national infrastructure, with the highest standards of cyber-security and information governance, so that only the right people can access the right information at the right time and for the right reasons. There will be audit trails of who has accessed a patient’s data, and UK GDPR and the Data Protection Act 2018 will apply. The Bill does not create new legal gateways for purposes other than direct care. It does allow data to be used for research, population analysis and service improvement, but only where there is a separate legal basis for doing so.
Let me pick up on the issue of accountability, which is very important to me personally. I agree that it is important to get this right, and we need to work both nationally and locally. I am old enough to remember the world before 2012. For 60 years, the Secretary of State had overall responsibility and accountability for this service. I think the comments about local accountability were well made by the hon. Member for Runnymede and Weybridge (Dr Spencer) and my hon. Friends the Members for Birmingham Erdington (Paulette Hamilton) and for York Central (Rachael Maskell). Let me be clear: the Bill puts more power, not less, in the hands of local organisations. ICBs will be responsible for commissioning a wider range of services, including primary care, and they will hold a large proportion of the NHS budget—over £179 billion, as before—but at the same time the public expect Ministers to be accountable for the NHS they pay for.
Therefore, Ministers should have the tools to hold ICBs to account and direct the system where necessary. That is why the Bill provides the Secretary of State with a power of direction, but with important safeguards on appointing specific individuals and directions to intervene in decisions about services provided to a particular person. If a NICE recommendation on a drug or treatment exists, this takes precedence over a direction. The powers in the Bill will ensure the Secretary of State is able to create the conditions for ICBs to succeed with effective and proportionate forms of intervention, where necessary.
Another major point made this evening was about Healthwatch. I think there is an important philosophical point about independence, the perception of independence and effective decision making, which we will discuss in Committee and it will be important to do so. However, as the Liberal Democrat spokesperson, the hon. Member for North Shropshire (Helen Morgan), outlined very well, we have had these bodies for 50 years. Patients are saying that the system does not work and are not reporting to it, so the system does not work. I listened carefully to the hon. Member for St Neots and Mid Cambridgeshire (Ian Sollom) and my hon. Friends the Members for Blaydon and Consett (Liz Twist) and for Dartford (Jim Dickson) about getting the balance right, and we will discuss those really valuable points.
Currently, the patient voice sits isolated in separate organisations, which criticise the status quo but are not able to change it. That is why we want a new director of patient experience in the Department to ensure that voices are heard as part of every decision. Locally, it is the job of the commissioner—and I have been a commissioner—and of a good commission organisation to include the patient voice and experience in all its decision making. That is where the difference is made, and such organisations should not be outsourcing those decisions. That is the difference, but a debate is to be had, and we have to assure people on the perception issue. We want to ensure local ICBs incorporate the patient voice and experience appropriately—including digitally excluded people, as the hon. Member for Meriden and Solihull East (Saqib Bhatti) said— into their decision making. How that happens is not set in stone. It is our job to set the destination, not exactly how we get there. If an organisation can provide a good service locally for the patient voice and experience, the ICB could continue to contract with it.
Briefly on HSSIB, I hear the points from the hon. Member for Harwich and North Essex (Sir Bernard Jenkin), whom I have met, and my hon. Friend the Member for Shipley (Anna Dixon) and other Members have raised these issues. The Dash review is very clear—I recommend Members to read it—and it is why the new CQC will combine its regulatory functions with the depth of HSSIB’s investigatory capability to the benefit of both. As was rightly raised by the hon. Member for St Ives (Andrew George), the safe space is important to enable people to share concerns in confidence, and that is safeguarded in the Bill. I understand that there is a perception issue, but we must ensure that that is real. The CQC has also raised some operational issues with implementing the integration of HSSIB, and we are working with it to ensure that, when passed, the measures concerned will be implemented effectively.
To conclude, the Bill is only one part of our modernisation agenda, but it is a crucial one, because for decades Governments have failed to grapple with this fragmentation. Like capital and the workforce, the problem was put in the “too difficult” box and left to this Government to solve, but solve it we will. The single patient record will finally mean patients get the joined-up, proactive care they deserve. By voting for this Bill, we can have a fresh start in NHS history. I commend it to the House.
Question put and agreed to.
Bill accordingly read a Second time.
Health Bill: Programme
Motion made, and Question put forthwith (Standing Order No. 83A(7)),
That the following provisions shall apply to the Health Bill:
Committal
(1) That the Bill shall be committed to a Public Bill Committee.
Proceedings in Public Bill Committee
(2) Proceedings in the Public Bill Committee shall (so far as not previously concluded) be brought to a conclusion on Thursday 16 July 2026.
(3) The Public Bill Committee shall have leave to sit twice on the first day on which it meets.
Consideration and Third Reading
(4) Proceedings on Consideration shall (so far as not previously concluded) be brought to a conclusion one hour before the moment of interruption on the day on which those proceedings are commenced.
(5) Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion at the moment of interruption on that day.
(6) Standing Order No. 83B (Programming committees) shall not apply to proceedings on Consideration and Third Reading.
Other proceedings
(7) Any other proceedings on the Bill may be programmed.—(Jade Botterill.)
Question agreed to.