Health and Care Bill

Baroness Cumberlege Excerpts

Lords Hansard - Part 2 & Report stage
Thursday 3rd March 2022 Lords Chamber

[Lord Kamall (Con)]

I thank noble Lords for those interventions. If they will allow me, I will come to answer them in my remarks.

We understand the concerns about how these powers will be used. It is in the interests of nobody, least of all the Secretary of State, to be making every decision in the system, and stakeholders will be encouraged to continue to resolve matters locally where possible. Duties for those responsible for reconfigurations to involve patients and consult the local authority will continue. Nevertheless, the Secretary of State is ultimately accountable for all changes to the health service. Therefore, it is entirely consistent with democratic principles that he or she should have the ability to intervene where it is deemed to be in the interests of the public.

We recognise that, in exercising these powers in this clause and schedule, it will be vital that the Secretary of State receives expert and clinical advice. That is why the Independent Reconfiguration Panel will continue to provide independent advice to the Secretary of State, allowing them to benefit from its many years of experience. This will mean that the Secretary of State will have independent advice that will include the views of both overview and scrutiny committees and patients, and the clinical case for change—

[Baroness Cumberlege (Con)]

I thank my noble friend. On this clinical advice, he is aware of the enormous changes that were made to stroke services in London. In the reconfiguration that took place, many lives were saved. But when it came to east Kent, the reconfiguration request, which was to do with stroke services, sat on the Secretary of State’s desk for two years. I just wonder how many people died for that delay.

When I put forward an amendment in Committee, I said that a decision must be made within three months by the Secretary of State if it is before his view, on his desk. Delay costs lives. It is absolutely critical that decisions are made fast in these reconfigurations, because we will lose lives.

[Lord Kamall (Con)]

Indeed, sometimes it is absolutely critical that decisions are made quickly. Where there are concerns about the speed of those decisions, the Secretary of State may ultimately decide to intervene, subject to advice from the Independent Reconfiguration Panel, overview and scrutiny committees, and patients, and based on the clinical case, should he or she decide to exercise powers under this clause.

I understand the concerns raised in this House and have heard the arguments presented today and in Committee. However, I think it would help if I reminded noble Lords that the Secretary of State’s powers included in the Bill are to ensure accountability. The public rightly want to hold the Government to account for the health service, and these powers allow that to happen effectively. The other place acknowledged that approach and supported it—