Queen’s Speech

Lord Patel of Bradford Excerpts

Wednesday 12th May 2021 Lords Chamber

[Lord Patel of Bradford (Non-Afl) [V]]

My Lords, I congratulate the noble Baroness, Lady Blake, and the noble Lord, Lord Lebedev, on their maiden speeches and I greatly look forward to working with them both. I am grateful to be speaking on the gracious Speech, and I will focus my time on the health and care Bill. In doing so, I declare my interest as chair of the Independent Healthcare Providers Network.

I shall make three short points. First, there is an urgent need to tackle the elective backlog that has built up during the pandemic. Secondly, the proposed new integrated care systems need to be open and inclusive, with good governance in place to avoid potential conflicts of interest. Finally, we must avoid any further delays in addressing the critical issues for social care.

Tackling the growing backlog of elective care is the public’s number one priority for the NHS according to recent polling. If not effectively addressed, this issue will dominate political and health debates in the years to come. Over recent years, NHS waiting lists have steadily been rising, and we now have a situation where more than one-third of patients, around 1.7 million people, are waiting longer than 18 weeks, with almost 400,000 people waiting more than one year. Behind these numbers are heart-breaking stories of people who have had to give up their jobs and livelihoods while they wait in extreme pain and of those who have completely lost their independence and quality of life. Given the level of current suffering and the build-up of long-term chronic health problems, I am sure that noble Lords will agree that the success of this Bill must at least in part be judged on whether it can reduce this backlog. I would welcome the Minister’s thoughts on how the proposed changes in NHS structures will support local areas better to prioritise patient access to the care they need now.

The response to the pandemic has undoubtedly shown how health is best served through a system of interconnected agencies from across different sectors, including local government, pharmacies, the voluntary sector, social enterprises and independent providers, and that effective healthcare is not something that can simply be addressed by the NHS alone. The move towards integrated care systems is therefore an opportunity to entrench the benefits of greater partnership working and collaboration. However, talking to colleagues across the independent, voluntary and social enterprise sector and particularly to the mental health and pharmacy sectors, there is much to do to ensure that ICSs are not too NHS-centric with too little consideration for the wider system with which the NHS seeks to integrate. This is key if we are to tackle health inequalities, with local voluntary, social enterprise and independent providers very often being much closer and more responsive to the local communities they serve than the statutory bodies. We must therefore see integrated care systems established on an inclusive and transparent basis, with good governance, clear accountability and safeguards against conflicts of interest.

While new ICSs should support the NHS and its partners to deliver joined-up care to local populations, there are real risks that the current proposals could lead to conflicts of interest around those who are commissioning and those who are providing healthcare services. For example, ICS partnership boards are likely to be led by NHS provider organisations, but blurring the lines between who is procuring and who is being paid to deliver public services poses a danger of a lack of due process and transparency. I would welcome thoughts from the Minister on how such conflicts of interest will be identified and managed in ICSs to ensure that their decisions are based entirely on the needs of local populations, not on specific providers.

Finally, while I welcome the mention of the much-heralded plan for settling social care once and for all, as noble Lords have already said, we have still to see further details of what this will entail. Given the importance of this issue to so many people, all that we have learned about the problems faced by the social care sector during the pandemic and the incredible efforts that have been made by providers to keep people safe, can the Minister assure me that there will be no further delays in bringing forward some concrete plans and that we will not have to wait until the next Queen’s Speech to hear about them?