King’s Speech

Baroness Neuberger Excerpts

Wednesday 20th May 2026 Lords Chamber

[Baroness Neuberger (CB)]

My Lords, I rise to welcome the health Bill part of the King’s Speech and declare an interest as chair of University College London Foundation NHS Trust and of Whittington Health. I express my gratitude to the King’s Fund, the Health Foundation and colleagues at both my trusts, to whom I pay great tribute for all the work they do, and many others for their briefings and conversations.

I want to welcome the Bill, but there are a lot of buts. I completely agree with the noble Baroness, Lady Pitkeathley, about the absence of a mention of social care. Where is social care? We were expecting to see it in this King’s Speech, and there is nothing. Alas, that is the first point where there is a big but.

Secondly, abolishing NHS England and transferring its powers to the Secretary of State in the Department of Health is fine, and in many ways very sensible, but the detail is slim and, let us be clear, we tend to go through phases of restructuring in the NHS. Moving the deckchairs is something that Health Secretaries like to do, despite this Government having said that they were not going to do it. Bringing powers back to the Secretary of State without a clear way of keeping a public eye on what is going on is clearly a cause for concern. We await the detail. I would be very grateful if the Minister could spell out for us where accountability, independence and the public interest will lie in this new system, all the more so when so many powers are transferring from NHS England to the Secretary of State, including the ability to direct local NHS organisations.

These powers risk Ministers being given too much power over the day to day, with too little power lying in the hands of patients and the public. That is all the more important given the decision—or the intention, anyway—to abolish Healthwatch. A stronger replacement than what is currently on offer will be needed. The NHS is a public service, deeply rooted in our communities. Many of us are even more worried about what this means for the patient and public voice, given the lack of clarity at best about governors, with whom we at University College Hospital have worked extremely well, and I pay tribute to them. We are seriously concerned that their role will not be compulsory in this new future, with no adequate patient and public voice replacement.

Thirdly—and this is the compliment—there is the single patient record. I think we are all thrilled about that, but even there the devil is in the detail. We know there is a long history of NHS IT failures that have been quite expensive. Who is going to be in charge? What will be the safeguards? Will the Government recognise deep concern among staff and the public about Palantir, as my noble friend Lord Patel has already said? The Department of Health has brought in Palantir, but disquiet is widespread and is expressed at our public meetings. How will privacy and security be guaranteed with a company that is not UK-based? We need far more detail. Trust from patients, staff and the public will be essential for the plans to succeed.

Then there are the changes to the local management of the NHS with the revision of integrated care boards’ membership. It might well help simplify the system, but the changes also risk undermining partnership working, which is needed to improve health and care. Removing, for instance, mandatory local authority representatives from ICBs could make things worse, and bringing in mayors is really not enough.

Lastly, there are the things that we were expecting to see. I had expected to see something on the role of the new advanced foundation trusts. We need to understand something about the proposals to cap some trusts’ spending, including that of foundation trusts and maybe even advanced foundation trusts, in order to use the cash to support other cash-deprived trusts. Will the Minister clarify? Will she also tell us what really lies within this new Bill about neighbourhoods and integration?

To sum up, I and many others were delighted to see much of what is in this Bill, but we are puzzled by some of the changes, by more power going to the Secretary of State and by the lack of a patient voice. I hope the Minister can provide some clarity and, indeed, some comfort.