Health Bill

Debate between Baroness Pidgeon and Baroness Watkins of Tavistock

Committee stage
Monday 9th November 2026 Lords Chamber

[Baroness Pidgeon (LD)]

My Lords, I am moving Amendment 42 and speaking also to Amendment 44, in the name of my noble friend Lady Tyler, who is not in her place today. These amendments are both designed to make explicit in the legislation that the Secretary of State’s duty, in line with the ministerial title, embraces social care as well as health—the two being inextricably linked, as we have said so many times during the passage of this Bill.

Amendment 44 would extend the Secretary of State’s core duty in Section 1 of the National Health Service Act 2006 to cover social care, so that the duty matches the ministerial title. It also reflects Section 2 of the Health and Social Care (Reform) (Northern Ireland) Act 2009. Amendment 42 would extend the Secretary of State’s ministerial responsibility to Parliament under Section 1(3) of the National Health Service Act 2006 to the promotion of social care alongside the provision of the health service.

Let me just explain why we think that this is necessary and would send a really important signal. The amendments recognise the importance of ministerial responsibility at a time when power is being transferred back to the Secretary of State, with the abolition of NHS England.

These relatively small changes would signal acknowledgement of and respect for the growing number of people in England who need and will continue to need a well-supported social care system alongside a properly functioning NHS. The amendments would give legislative effect to the so-called

“new way of doing politics where we come together, face the challenge head on and build an integrated system that gives people security and dignity”,

announced by the Prime Minister when outlining his commitment to social care in July 2026. He also said explicitly that

“broken social care will in the end break the NHS”.

Correcting the mismatch and seeming imbalance between the ministerial title and duty would also help to ensure that the current momentum is sustained into future Parliaments and would not fall down the agenda again.

The background here, as I am sure many noble Lords will remember, is that the ministerial title was changed back in January 2018 as part of Theresa May’s Cabinet reshuffle. Jeremy Hunt went into Downing Street, amid all sorts of expectations that he might be moved on, and emerged an hour later with the enhanced title of Secretary of State for Health and Social Care—such is politics. However, let us make sure that the title and responsibilities fully match up and social care is given the important standing it needs alongside health. I beg to move the amendment.

[Baroness Watkins of Tavistock (CB)]

I have added my name to Amendments 42 and 44. I agree with the need for them, as outlined by the noble Baroness, Lady Pidgeon, on behalf of the noble Baroness, Lady Tyler, and will add only a few points. The health service is designed to prevent ill health, as well as providing services. Provision of high-quality social care reduces hospital care and provides respite to carers, as previously described on the first day in Committee on this Bill.

The Secretary of State for Health and Social Care has proposed a new special health authority to replace NHS England which, it is argued, will be a temporary measure. Earlier in Committee, I asked the Minister whether the Bill should be delayed to make adequate provision for the proposed revision of social care, which is to be initially detailed in the report of the noble Baroness, Lady Casey. If these amendments are supported in principle, this would prepare a path for further integration, where appropriate, of health and social care provision, and enable consideration of the metamorphosis of the special health authority to a new body—or possibly two bodies, depending on how we move forward on social care—to oversee areas in both health and social care services, particularly where they need to overlap.

Throughout our debate today, I have listened to various discussions about patients, but essentially the health service and social care are for the public. If we are to take health promotion and social care seriously, it should be feasible for service users to have real choice, not only in acute care but in mental health and physical health promotion, screening, prevention, deterioration prevention and, of course, where necessary, evidence-based health treatment, which is a vital end-process but should not in most cases be the beginning of the support that people have.