Health Bill

Debate between Baroness Hayman and Baroness Boycott

Wednesday 11th November 2026 Lords Chamber

[Baroness Hayman (CB)]

My Lords, I am grateful for the support for my Amendment 52 from the noble Baronesses, Lady Sheehan and Lady Ritchie of Downpatrick, and the noble Lord, Lord Crisp. I shall listen with interest to the debate on, and particularly the Minister’s response to, Amendment 248, tabled by the noble Baroness, Lady Boycott, which is a very practical way forward.

I did not take part in Second Reading on the Bill. Actually, I had a self-denying ordinance. I decided, having had my first involvement with the NHS in 1980, having seen so many reorganisations and, I am afraid, having become a little jaundiced about the effectiveness of those reorganisations in transforming patient care rather than changing administrative structures, that I would not say anything. My mother always said that if you cannot say something nice, do not say anything at all. However, here I am, and I am here because of the recent history of legislation on the NHS, in particular, the NHS Health and Care Act 2022.

I was involved in the debate on issues relating to climate in that Bill. After cross-party pressure on the issue, the Conservative Government of the time tabled amendments which became part of the Act, and which are mirrored in Amendment 52 in my name today. They were described thus by the then Minister, the noble Baroness, Lady Penn:

“They place a duty on NHS trusts, foundation trusts, ICBs and NHS England to have regard to the Government’s key ambitions on climate change and the natural environment in everything they do. This could mean preparing thousands of NHS buildings to adapt to climate impacts, protecting and enhancing biodiversity across 25 million square metres of trust estate, or decarbonising the millions of kilowatts of energy used by trusts every year”.—[Official Report, 1/3/22; col. 729.]


That, of course, saves money for the trusts involved. The amendments were warmly welcomed by the then Opposition, with the noble Baroness, Lady Wheeler, saying:

“I thank the Minister and welcome these government amendments in response to the key concerns raised in Committee about the crucial importance of including the NHS’s duties on climate change and working towards net-zero emissions in the Bill”.—[Official Report, 1/3/22; col. 733.]


My amendments, which mirror those amendments, are trying to maintain the status quo. They are essentially Conservative in the sense that it was a Conservative Government who introduced them.

Therefore, I ask the Minister to help me understand why, when NHS England’s functions transfer to the Secretary of State along with responsibilities to consider the impacts of climate change on our health services and public health and the significant role the NHS has to play in helping the UK to meet its national climate and environmental targets and to provide leadership—we saw that at COP 28 in Glasgow, with other countries’ health services actually responding—the Bill before us omits the NHSE’s statutory duty to publish guidance on what it regards as the best way for ICBs and the organisation itself to meet those duties and how it is fulfilling them, along with an established framework for reporting details of progress on reducing emissions in its annual report and accounts. There is no in-kind replacement for these requirements on the Health Secretary, meaning that without legislative change and amendments of this sort, there will be no obligation on DHSC to continue driving progress, specifically on the health service’s carbon emissions reduction work.

Ministers may say that they will have powers to issue fresh guidance if they choose to, but whether it is issued and how robust its contents are will be contingent on the priorities of the Government of the day, and we have an example before us of how those can change. That outcome does not bring the same level of certainty or direction that the NHS needs to maintain regular accountability and long-term national momentum towards its targets. I hope that the Government will not try to argue that, because the Climate Change Act 2008 applies to all government departments, this amendment is unnecessary. It is clear that the powers that were put in the 2022 Act are much more specific to the NHS and the health system and essentially provide accountability and transparency. The NHS itself says that the duties supported the health service’s own ambition to become the world’s first health system to embed net zero in legislation. The 2022 Act requires commissioners and providers of NHS services specifically to address the UK net-zero emissions target and environmental targets and to adapt to any current or predicted impacts of climate change identified within the Climate Change Act 2008. We saw quite a few of those this summer and quite a few of the effects on the health service.

The Bill before us does not require the Health Secretary, when making decisions about the NHS, to consider how the organisation is contributing to carbon targets, to regularly report on its performance or to prepare it for the climate risks it faces. That is what we risk losing if we do not amend the Bill. I know the Government are trying to clear provisions and responsibilities out of the way and do not want to put extra bureaucratic requirements on the NHS, but my amendment recognises this. Because it is already in the 2022 Act, it does not widen the requirements in any way. It is simply trying to restore the status of the existing duties. The need to co-ordinate and steer responses to climate change and nature loss at the national level ought not to be treated as unnecessary paperwork. These duties have been quietly working as intended in the face of rising climate challenges. NHSE appears to have been getting on with them and setting emissions reductions targets that now have a statutory basis. It reports that direct emissions were reduced by 14% in the years 2020-25 and that the NHS is on track to meet its 2032 and 2040 goals.

Within the last four years, the evidence points to climate change increasingly becoming a major challenge for health and health services. The Parliamentarians’ Guide to Health and Climate Change, developed by Peers for the Planet—in which I declare a past interest—and the Wellcome Trust is insightful reading and shows why climate change is already a UK public health issue. A number of organisations, such as the Wellcome Trust and the UK Health Alliance on Climate Change, have expressed concerns that failing to replace these obligations once NHSE functions are transferred to the Secretary of State will mean that there is no obligation for Ministers to report annually on progress towards NHS net-zero commitments, to publish sustainability guidance or to account to Parliament for this work. This will leave future transparency and oversight reliant to an unacceptably large degree on ministerial discretion, and it will undermine co-ordination of national objectives. I hope the Minister will be able to tell us how, if these duties for the DHSC are not replaced, we can ensure that our national health services have appropriate regard to the challenges of climate change. I beg to move.

[Baroness Boycott (CB)]

I will speak to Amendment 248, but first I want to say that that was a terrific introduction by the noble Baroness, Lady Hayman, who is such a long-term, amazing campaigner for climate change. I would be horrifically surprised if the Minister does not reply completely in the affirmative towards this amendment, because, especially following the summer we have had, I do not see how anyone could continue to have their head in the sand about this risk. Climate change is not a hypothetical threat. There were 2,877 health-related deaths in May and June alone in the heatwaves—and this is not going to get better. This is not a one-off thing. In the climate emergency film there is a memorable line which says, “This is the best weather you are going to get in your lifetime”. That is truly scary. It may not happen next year, but it sure as hell will happen within the next two or three years.

The effects of this heat are not spread evenly over the population. It affects vulnerable people, children, the elderly, people living with chronic conditions, those in poor-quality housing and pregnant women. The noble Baroness, Lady Hayman, mentioned our work with the Wellcome Trust. I am vice-chair of Peers for the Planet. We have examined the effects of heat on pregnancy and maternal health, and it is not about being somewhere super-hot, which is what I have always thought. It is about being somewhere where your normal temperature condition changes. You are just as vulnerable if you are in Bristol as if you are in a field in southern India. It is about temperature change rather than extremes of temperature. It is important that we understand that, because that is going to hurt us. The climate and environmental impacts are also adding strain, as we have heard, to a service under pressure. The NHS said that this summer’s heatwaves piled pressure on its services and the NHS showed that A&E bore the brunt. We have just heard the amendments from the noble Baroness, Lady Coffey, and the other amendments about the emergency services. This is just going to make it worse.

Heat-related A&E attendances already account for 6% of average daily total attendances across the UK on extreme heat days, and the impact is estimated to cost £538 million a year. This cost could rise by 144% by the 2030s. That is almost tomorrow, really, when you come to thinking about putting a new building together. It is welcome that the NHS trusts will retain their current “have regards” to climate change, but we really need to do more. We are not ramping up enough. The climate itself is not standing still. The Climate Change Committee warned that our health service remains chronically underprepared to deal with the risks, and there remains a lack of resilience for the physical NHS estate to cope with extreme weather.

High Seas Treaty

Debate between Baroness Hayman and Baroness Boycott

Monday 10th March 2025 Lords Chamber

[Baroness Boycott (CB)]

I thank the noble Baroness very much for that Answer. It is very good news to hear that we are limiting bottom trawling in MPAs, but the point of my Question was to ask whether we have a Bill going through the noble Baroness’s department—or, indeed, the FCDO—which will ratify the global ocean treaty. The UN conference will happen in June. If we have not ratified our treaties, as I understand it, we will not have a seat at the first ocean COP.

[Baroness Hayman of Ullock (Lab)]

The UK will continue to be proactive in preparing for implementation and entry. We are committed to partnering with others, in particular the global South and the Commonwealth Secretariat, to ratify and implement the agreement. We are actively engaging in that. The first meeting will take place at the UN in New York this April. We very much support this, and we are working with others to move forward.