Future of Health and Care

Baroness Watkins of Tavistock Excerpts

Tuesday 23rd February 2021 Lords Chamber

[Baroness Watkins of Tavistock (CB) [V]]

My Lords, I declare my interests as outlined in the register and broadly welcome this paper. I particularly applaud the removal of the need for competitive tendering and the introduction of the discharge to assess model, which I and many other professionals have long advocated. However, could the Minister explain why such extensive powers are planned for the Secretary of State prior to the reforms of social care coming before Parliament? Why can they not come concurrently? He has partly just explained that, but it would be much better if we waited and did the two things together. Section 5.153 of the White Paper is designed to widen the scope of Section 60 of the Health Act 1999 to provide further powers enabling the Secretary of State to

“make a large number of changes to the professional regulatory landscape through secondary legislation.”

I seek assurance that there will be ample opportunity to debate this latter issue during the passage of the Bill.

[Lord Bethell (Con)]

I am extremely grateful to the noble Baroness, Lady Watkins, for her generous remarks on competitive tendering and discharge to assess. These are examples of where we have listened to stakeholders and those in the NHS who have called for changes. In terms of the powers given to the Secretary of State and the link with social care, it is worth remembering that this Bill is a stepping stone towards other changes. Changes to social care funding can take place largely without any legislative change; they can be introduced by secondary legislation. Changes to the funding model in social care are a matter for a very large engagement process that will include other parties, as the Prime Minister has outlined, and will include very considerable engagement with stakeholders.

In the meantime, we are seeking to correct an overreach in the seclusion and mandation of the NHS to give the Secretary of State the kinds of powers that are reasonable in a parliamentary democracy in the governance of such a large and important national institution. Those powers are to be used with restraint and a degree of circumscription, but they rebalance the political geography of the NHS to give it full accountability. As such, they give the kind of authority the Secretary of State needs to institute the kinds of social care reforms I know the noble Baroness, Lady Watkins, is interested in.