It is a salutary reminder that one of the reasons why we wish to have central interventions is that the local NHS seems incapable of sorting out things such as this. I am not sure about the noble Lord’s amendments, but I think his aims are very important.
Baroness Pidgeon Portrait Baroness Pidgeon (LD)
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My Lords, these amendments tabled by my noble friend Lord Rennard raise some important points and are intended to safeguard national diabetes services following the planned abolition of NHS England, and to ensure that patients do not lose access to proven programmes during that transition.

This is a point that has come to me time and again from different charities representing different disease groups. They are concerned that the specialism and some of the services that are commissioned will be lost. I am sure we will discuss this again on other Committee days.

As we have heard, diabetes is one of the greatest health challenges facing us all. According to Diabetes UK, over 12 million people in the UK are living with diabetes or prediabetes, and it costs the NHS around £10.7 billion every year. That expenditure is linked to complications that can often be prevented through early intervention, effective treatment and consistent monitoring, as well as routine diabetes care.

The amendments would therefore require the Secretary of State to maintain, at a minimum, the current provision of key national programmes. As we have heard, these include the NHS type 2 diabetes prevention programme, the diabetes path to remission programme, continuous glucose monitoring, the rollout of hybrid closed-loop technology and the national diabetes audit programme. I flag that the type 2 diabetes prevention programme is recognised as a world-leading prevention intervention. We do not want to see that lost with this reorganisation.

The amendments would also strengthen transparency and accountability. Before any transfer of functions, the Secretary of State would be required to set out how continuity of these services would be guaranteed. Annual reports to Parliament would then provide clear information on patient access, waiting times and outcomes, while separate assessments over the first four years following the abolition would monitor the impact on funding, workforce capacity or clinical audits, and access to technologies.

At a time when diabetes continues to rise and the impact felt both by individuals and financially throughout the NHS is so significant, it is essential we have confidence that these vital national programmes will not only survive the organisational change but continue to improve outcomes for people living with diabetes. I look forward to hearing the Minister’s response.

Earl Howe Portrait Earl Howe (Con)
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My Lords, I too am grateful to the noble Lord, Lord Rennard, for bringing forward these amendments and for drawing the Committee’s attention to the important issue of diabetes prevention, treatment and care. I particularly welcome the focus in these amendments on innovation, because this is an area in which we see some genuinely promising developments. One example, mentioned by the noble Lord, Lord Rennard, and the noble Baroness, Lady Pidgeon, is the emergence of hybrid closed-loop systems. For people living with type 1 diabetes, this technology has the potential to make an enormous difference.

In April 2024, NHS England began a five-year programme to roll out this technology to eligible children, young people and adults living with type 1 diabetes. That was a very welcome development, and I hope we will continue to see the programme expanded so that more patients who would benefit from the technology are able to access it. It would be helpful to hear from the Minister about that, and about how the rollout of the programme is progressing and how many patients have received the technology so far. As with any issue like this, improvements in accessing the technology are always forefront of commissioners’ minds, so it would be helpful if the Minister can say anything about that. I would also be interested to hear what assessment the Government have made of the availability of specialist staff to support this rollout. Developing an effective new technology is one thing; ensuring that patients can access it, and that clinical teams have the resources and expertise to provide it, is another.

More widely, these amendments raise an important question about the future scale and impact of diabetes in this country. The noble Lord, Lord Rennard, highlighted the statistics and predictions from the International Diabetes Federation. Those predictions present a considerable challenge for not only patients and their families but for the health service. They also reinforce the importance of prevention, particularly in relation to type 2 diabetes, where earlier intervention can make a considerable difference. Can the Minister tell us what steps the Government are taking to strengthen prevention and early diagnosis and to support the wider adoption of new technologies?

Finally, I want briefly to touch on Amendments 225 and 226, which raise a wider point about the abolition of NHS England and the continuity of existing national diabetes programmes. During our consideration of the Bill, we have discussed at some length the importance of ensuring that the abolition of NHS England does not disrupt the delivery of essential services or lead to the loss of programmes and expertise that are already delivering benefits to patients. The noble Lord is absolutely right to raise that concern in the context of diabetes. I am not necessarily persuaded that we need to place each of these requirements in statute, but he raises some entirely legitimate questions. I would welcome assurances from the Minister that these programmes will continue to receive the attention and support they require throughout the transition. I look forward to what the Minister has to say.