King’s Speech

Lord Kakkar Excerpts

Wednesday 20th May 2026 Lords Chamber

[Lord Kakkar (CB)]

My Lords, it is a great pleasure to follow the noble Baroness, Lady Nargund, and in so doing echo her remarks about the remarkable and customarily imaginative and enthusiastic way in which the noble Baroness, Lady Merron, introduced this debate. In so doing, I declare my interests as chairman of King’s Health Partners and the King’s Fund. It will be, of course, on the NHS modernisation Bill that I will contribute the majority of my remarks.

Before so doing, I would like to touch on one other Bill that has appeared in the gracious Speech, the peerage removal Bill. Here I declare my interest as chairman of your Lordships’ Conduct Committee and as a former chairman of the House of Lords Appointments Commission. This is an important Bill because it touches upon many important constitutional principles. It is designed to address an issue, as stated in the gracious Speech, with regard to the standing and reputation of your Lordships’ House. In its so doing, there will need to be careful consideration of how any statutory provisions touch upon the procedures and processes agreed by your Lordships’ House with regard to conduct and whether any such provisions will extend your Lordships’ provisions for assessment of conduct beyond conduct related to parliamentary activity to conduct outside your Lordships’ House.

Indeed, your Lordships will need to understand in some detail the mechanisms by which it is proposed that, if enacted, the Bill will function. Will it function as a function of your Lordships’ House—that is, a question of resolution by the House—or will it function through the creation of an additional body outside what would be normally considered the processes of a self-regulating Chamber?

In addition, it is going to be very important to understand what other opportunities might be reflected in the passage of such a measure, in particular, whether the provisions of the advisory House of Lords Appointments Commission are ultimately put on a statutory basis so that all nominations, be they political or to the independent Cross Benches, are subjected to the same evaluation in terms of individual propriety and suitability. These are important questions that, no doubt, your Lordships will be able to consider when the Bill comes for consideration in your Lordships’ House.

I now turn to the NHS modernisation Bill. As the noble Baroness stated, His Majesty’s Government began their term in office by undertaking a detailed and forensic examination of the condition of the NHS, which identified it to be in a state of some crisis. It is therefore important that any measure of such substance as those in this proposed Bill should be judged against the standard of addressing that crisis urgently, as I think all noble Lords would agree that time is now running out. We need to take serious, long-term decisions to achieve what was first described with eloquence and clarity in a report led by my noble friend Lord Patel. This was the 2017 report of a special Select Committee on the long-term sustainability of the health and care system in our country.

That report made a number of recommendations. I shall not rehearse all of them with your Lordships this evening, but two important ones regrettably do not appear to have been addressed in the measures proposed in the NHS modernisation Bill. The first was the need to bring together health and social care into a properly co-ordinated system to ensure the ultimate sustainability of our healthcare system. As we have heard earlier in this debate on the humble Address, it has not so far been easy to identify how the measures in this Bill will achieve that objective. The second recommendation was to secure an appropriate investment, not only in innovation and technology but in the development of the workforce, to ensure that innovation and technology could be adopted at scale and pace across the NHS and to achieve the objectives that we all recognise are vital to secure its sustainability.

I make one last point. The measures in the Bill once again centralise an awful lot of power, on the basis of a need for accountability, in the hands of the Secretary of State for Health and the Department of Health and Social Care. It is proposed thereafter to transfer some of those powers back to ICBs, which will become strategic commissioners of healthcare at a local level. Those important mechanisms, and indeed the willingness and determination of the Department of Health and Social Care to use those powers not to control but rather to facilitate, will need to be understood fully as we consider the Bill during its passage.