King’s Speech

Lord Patel Excerpts

Wednesday 20th May 2026 Lords Chamber

[Lord Patel (CB)]

My Lords, I thank the noble Lord for that notice before I got up. In the brief few minutes I have, I am going to speak mostly about the Health Bill. The Bill is light in legislation, with 72 clauses and 48 pages, but it has 143 pages of schedules. One wonders whether most of the powers might therefore be through SIs and guidance, and that is what we have to explore.

I will concentrate my remarks on the notes produced by the Government following the gracious Speech. It is customary, as has been noticed over the last three days, that most noble Lords offer their alternative legislation to that which the Government are going to bring forward. This is evidenced by the 300-plus noble Lords who will have spoken by the close of business tomorrow. I will refrain from doing that; I will stick to what is in the legislation and follow the notes that have been circulated.

Early this morning, I listened to a podcast about health and social care. It was recorded just a few weeks ago, and the person who was interviewed was Andy Burnham. Some of the things that he reflected on in the podcast are in the legislation, but he focused mostly on social care and prevention in the wider sense. I do not want to predict the future, but I wonder whether we will have another Bill in times to come following that podcast. However, I put that aside.

Sticking to the Bill, I am grateful to the Minister, the noble Baroness, Lady Merron, for introducing its health aspects, and I will pick up some of the points she made. The first is the abolition of NHS England. I accept that there was a disconnect between NHS England and the Department of Health and Social Care that needed to be addressed, and this Bill tries to do that. However, in doing so, it gives wider and deeper powers to the Secretary of State and to Ministers, to the point of the ability to intervene both locally and nationally. That might be a good thing, if the leadership recognises that any intervention has to be for the benefit of the patient, but that will have to be tested in times to come. That is my anxiety about that— I hope that is not my phone I can hear ringing; it is not.

The Bill strengthens local democratic accountability in the health system by means of mayoral nominees on the integrated care boards. In some areas, such as Manchester, these are referred to as health commissioners. If the responsibility of the mayoral representative is to focus on local and regional healthcare and to drive the ICB’s commissioning powers that way, that will be most welcome.

There are other issues, such as the CQC now being responsible for patient safety. The CQC has not improved the quality of healthcare in all its time. There are issues around the recognition of the patient voice, which will be taken away from Healthwatch and put into the Department of Health via a patient experience directorate. I do not know whether that can be regarded as the patient voice.

In my last minute or so, I comment the single patient record—it is universally accepted that we should have a patient record that goes from GPs to hospitals to social care—but there are issues with the curation and use of this data and with who has ownership, which now appears to be in the hands of the department and the Minister, not the patient. We have to explore how this data will be released and to whom, and its relationship with the NHS data platform, which is contracted out just now to organisations such as Palantir. This is an important issue to explore in depth, which I hope we will do in Committee.

There are issues around ICBs and their role now as a commissioner of services, and the representation on their boards. That requires further exploration, because it appears that the local authority representation might now be removed.

I will engage with this Bill constructively, with a view to be helpful and not in any way to criticise. The 10-year health plan and the 10-year cancer plan are good documents to drive improvement in healthcare.