Future of Health and Care

Baroness Neville-Rolfe Excerpts

Tuesday 23rd February 2021 Lords Chamber

[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.

[Baroness Neville-Rolfe (Con) [V]]

While the costs of reorganisation are certain, the expected benefits may or may not be realised. The fate of the Lansley reforms is a lesson for us all. The country will judge the performance of the NHS over the coming decade in the light of this truth. Will the Minister specify objectives against which the new reforms can be assessed?

[Lord Bethell (Con)]

My Lords, the objectives outlined in the White Paper are reasonably clear. The four headline objectives are to make it easier for different people in the system to join up to find ways to address complex issues, to remove unnecessary bureaucracy, to empower local leaders to make the best decisions for the populations they serve and to facilitate a range of other improvements held back by existing legislation.

This is a large Bill with a very large number of measures. It is not, and does not pretend to be, unified by a single thought or held together by an ideology or motivation of any particular philosophy. It is the application of a very large number of recommendations that have come out of a huge engagement with the NHS family, patients and other stakeholders. As such, it is a pragmatic, thoughtful and restrained approach to an important piece of legislative housekeeping of this much-loved healthcare institution.