King’s Speech

Baroness Shawcross-Wolfson Excerpts

Wednesday 20th May 2026 Lords Chamber

[Baroness Shawcross-Wolfson (Con)]

My Lords, I am delighted to follow the speech of the noble Lord, Lord Babudu, and I apologise in advance for reiterating some of his excellent points.

We spend over £2 billion a year on the NHS, 40% of our day-to-day spending, yet it never seems to be enough. As our population ages, as chronic illness increases, as ever more adults leave the workforce, or never even enter it, as a result of long-term sickness, spending pressure will rise further and our capacity for funding that pressure will fall, so the first point I wish to make to your Lordships is that improving the NHS, while necessary, is not sufficient. Even a superbly efficient health care service could be overwhelmed by an ever-sicker society, so I was delighted to hear the Minister emphasise the importance of prevention when she opened this debate and I urge the Government to be bold. I agree that we need improvements in air quality, inside and out, as the noble Baroness, Lady Linforth, reminded us, to tackle respiratory and cardiovascular disease; we need restrictions on social media to protect young people’s mental health; and we need a serious strategy to tackle alcohol harms, as the noble Baroness, Lady Watkins, set out. In short, we need a healthier population, not just a better NHS.

The second point I wish to make is that, unfortunately, redrawing the boundaries of NHS bodies will not automatically give us a better NHS. I understand why the Government want to abolish NHS England and I accept the valid arguments for doing so, but as the King’s Fund has observed, and those of us in government for the 2012 restructure can attest, reorganisations take far longer than we think, end up costing far more than we anticipate and leave us with a distracted and demoralised workforce. Change does not materialise because legislation transfers duties from one set of public servants in the NHS to another set of civil servants in the Department of Health and Social Care. Change does not materialise because we replace joint local health and well-being strategies with new neighbourhood health plans. Change materialises when Ministers and officials collaborate with clinicians and managers to deliver a coherent plan over a number of years.

I welcome the increase in patient satisfaction with GP access that we have seen under this Government and I commend Ministers and officials for all the work they have done to deliver this. I also point out that some of these improvements began with the primary care recovery plan published in 2023. I say that not to claim credit for the previous Administration but to point out that meaningful change really does require sustained focus over time. I hope that the Minister will ensure that she does not get lost in the legislation and instead is able to keep sight of the operational improvements that the public really care about, including the very urgent tasks of making maternity services safe and fixing social care.

There are two further elements we need to see if the Government are to meet their objective of NHS renewal. First, we need a longer-term capital strategy. The NHS has a capital budget of around £13 billion, yet we do not have a sufficient objective assessment of need, there is no reliable mechanism for efficient allocation, and there are too few incentives to ensure that assets are used productively. That needs to be fixed. Secondly, we need a credible long-term workforce plan. I was disappointed to see the 2023 workforce plan abandoned, but I look forward to seeing its successor. Like the Government, I hope that AI will improve productivity, but I do not recommend hope as the basis for a workforce strategy. I encourage the Government to listen to the Health Foundation’s advice and avoid both overstating the time technology will save and underestimating the staff and management capacity needed to implement it.

Turning to the details of the Health Bill, there will be plenty of opportunities to debate this at length, but I want to mention my concerns that despite the rhetoric of devolution, the Bill in fact represents a significant centralisation of power within the department and a reduced role for local authorities. I am also concerned about the impact of the abolition of HSSIB on patient safety and I look forward to discussing all these issues in more detail. However, there is a major opportunity here, as many other noble Lords have mentioned, and I share the Minister’s hope that the proposed single patient record, combined with wider technology reforms, will be truly transformative for this country. For years, we have aspired to achieve a digital NHS and now the Government have an opportunity to truly create one, but success will depend on public trust and clinical buy-in.

I hope that the Government will learn from the failures of the last 14 years, and in particular GDPR and care.data, as well as the recent cyber attacks that deliberately targeted very sensitive healthcare data. Privacy and security must be built into this project from the start.

There is much more to do to improve both public health and the NHS itself, but I hope that we can make meaningful progress this Session and I look forward to working across the House, with other noble Lords and the Minister, to do so.