Health Bill (Seventeenth sitting)

Debate between Caroline Johnson and Liz Twist

Committee stage
Thursday 16th July 2026 Public Bill Committees

[Dr Johnson]

The Minister said that the plan is being developed with the pace that is needed, but it is not. It was due to have been published already, but it has not been. It was due to have been published, then a later promise was made, and now she is making another promise with an uncertain date. I just do not think it is good enough. A theme of our consideration this afternoon has been all the different things the Government have promised but have failed to deliver.

[Liz Twist]

I too want to see a strategy—a strong strategy—and I will continue to talk about that, but will the hon. Lady acknowledge that the strategy has been talked about since before the general election? We needed to see action then, as we need to see action now.

[Dr Johnson]

Yes, I accept that it has taken too long, and that is the point. I assume that it must be ready to go, because the Minister has been working on having it published by the end of June, and we are in the middle of July. The Minister can inform us whether that is the case. We have reached a point where the Government keep saying “later”, “soon”, “imminent”, “in due course” and “working at pace”, but that is not helping to get this done. The new clause would force the Government to get on with it. That is what I think needs to be done, and that is why I will press it to a vote.

Health Bill (Second sitting)

Debate between Caroline Johnson and Liz Twist

Committee stage
Tuesday 16th June 2026 Public Bill Committees

[Dr Johnson]

Q The question was really about trust, and how people can be trusting of figures. For example, with Healthwatch, if you internalise patient experience into an organisation, do people then trust you when you say that it has got better? They will have only their own experience and the experience of their own family to work on; that will be the lens through which they look at things. We know that the waiting list numbers have come down, and there is not widespread trust in those numbers, for all sorts of reasons. If the numbers for patient experience are governed by the Department of Health, or the ICBs themselves marking their own homework, will the public trust them? Whether they should trust them is one question, but will they trust them?

Karin Smyth: I will come back to the waiting lists, but you are absolutely right about trust. In saying that I expect this to be the board’s job, I think it is its job to get this right, and we need to support it to do that. We heard a bit from Penny Dash about the national quality board and the patient experience directorate inside the Department of Health and Social Care reporting directly to the chief executive and the permanent secretary. That has to be part of the wider architecture, which is of course outside the Bill, so we need to be able to tell that story to the wider public.

We know from all the recommendations, reviews and the support that we give as Members of Parliament to our constituents that trust is really important. Getting that right and bringing people on that journey with us will be really important. Independence helps with that, and that it is why it is good to debate it as we consider the Bill—it is good to be able to air some of it—but I think people accept that things are not working and have not been working.

I think your question about waiting lists is about the data and the information that says where we are at. It is really complex. To follow NHS England’s data, of which there is a lot—I commend the amount of data that is available—you need to be quite clever at spreadsheets, and at finding and articulating data, in order to bring it back to your own constituency and local place. These things are complex. It is complex to record, track and recognise how people move through a waiting list, for example.

It is good that we are transparent about that. One thing that I am keen to push out is data on performance in trusts. Making so-called league tables is controversial, but the more information that we have out there, and the more we have honest debates about how complex and difficult it is—I am happy to take your questions around how that moves in order to for us to explain that—the more that helps to build trust.

[Liz Twist]

Q Minister, we have talked a lot today about ICBs, the local government Healthwatch and the single patient record, and we have heard some interesting comments. Can you summarise why you believe it is important that we look at this legislation now?

Karin Smyth: I will come to the single patient record because I think it is a gamechanger. We have heard today from some fantastic experts about the work they are doing to identify how it might work and how we might bring patients and the public with us. Again— I do not think we should just bank this—we have not heard anybody object to it.

We did have some evidence highlighting how things have gone wrong in the past. I worked at a primary care trust and clinical commissioning group at the time when care.data was brought forward. We can all point to where it has gone wrong, but nobody has said that this is not the right thing to do. That is good, but there is still a lot of detail to go through.

We need to keep highlighting the benefits. We heard from Peter Prinsley about whether patients have more control—we do think this is about empowering patients. That was what we said in the 10-year plan. The 10-year plan is about empowering patients in this very large system, for which they are now paying £200 billion of their taxes.

We heard from the excellent clinical panel. I defer to clinicians about what they need, both if they are dealing with chronic long-term conditions—we heard that it can sometimes take two and a half hours for an assessment—or if they are working in a busy emergency department. The fact that this is needed will be controversial. There will be a lot of questions about it and a lot of concern about privacy, data, cyber and so on. We need to hold on to those benefits, which are huge in clinical terms and for patients.

Another point we heard, which is also true, is that people think this already happens. People do not understand why, when they turn up at an A&E in Whitby, as we heard, or somewhere else, and then go back to central London, the systems cannot talk to each other. For me, that is about people’s trust and belief in what is a public service. It is a really important part of that.

On abolishing NHS England, I do not think anyone has come to one of my constituency surgeries and said, “Please do this,” or talked about it in great detail, but people do understand. My experience in opposition and so far in government is that MPs are perplexed when they try to intervene on behalf of patients, or to get an answer locally as to why on earth chief executives of ICBs or trusts sometimes do not respond even to a Member of Parliament’s requests for meetings. I find that shocking, but it does happen. How on earth is a patient or somebody struggling through the system expected to get a response? Getting it right is not black and white, and it is not easy to get the balance right between the Secretary of State’s democratic oversight and autonomy at a local level, but the Bill starts the process of doing that, and it is fundamentally important.

Regarding the other provisions, I accept that great work has been done by many people in Healthwatch and its predecessor organisations, and by people working in the patient safety landscape, but again it is not working. I think that those bodies have been allowed to abdicate responsibility for the core role of patient experience and patient voice. That is not their homework; it is their actual job. It is not something that should be outside, and that is why I think this Bill is really important.

Judicial Review and Courts Bill (Second sitting)

Debate between Caroline Johnson and Liz Twist

Committee stage
Tuesday 2nd November 2021 Public Bill Committees

[Liz Twist]

Q Talking of local stakeholders, do you think that the proposals might have an adverse impact on the independence of the magistracy?

Ellie Cumbo: I do not think we have considered that question in detail. Possibly the Magistrates Association would be best placed to comment, and we would usually defer to them. If you would like us to provide an answer at a later date, I am very happy to do that.

[Dr Johnson]

Q I want to clarify with Sara; you have talked about the importance of Government accountability, and the importance of judicial review to children with special educational needs and people who may be discriminated against because of a disability. I do not think there is anyone in the Committee who would disagree with you on the importance of those things. However, in practice, the decisions that are governed by the Cart reviews are not decisions of Government; they are decisions of an upper-tribunal court.

Sara Lomri: Absolutely. When I was talking about—