Health Bill

Charlotte Cane Excerpts

Report stage
Monday 7th September 2026 Commons Chamber

[Dr Allison Gardner (Stoke-on-Trent South) (Lab)]

This Government aim to shift the focus from treatment to prevention, and it is in that spirit that I have tabled new clauses 90 and 91, which would strengthen the frameworks around health inequalities and address the wider determinants of health.

New data from Health Equals reveals a shocking reality: there is a gap of up to 18 years in life expectancy between different parts of the UK, and indeed between nearby neighbourhoods. Health Equal shows that in my constituency just a golf course separates two areas with an average life expectancy gap of eight years and 11 months. Reaching old age is somewhat of an aspiration in my more deprived areas. Indeed, in the most deprived communities people spend an average of just 52 years in good health. The stark inequalities are driven not only by healthcare, but by the wider determinants of health, including poverty, housing, education, employment and the environment.

Within Stoke-on-Trent, healthy life expectancy at birth has fallen by 6.6% for men in the last decade. For women, the picture is even worse, with a 9.6% fall in healthy life expectancy to just 53.5 years over the past 10 years. This Bill represents a real opportunity to enshrine in law a statutory duty for the Secretary of State to go beyond reducing inequalities in NHS access and outcomes, and to reflect wider cross-Government goals for health improvement.

Our health is shaped by the world around us—the food we eat, the money in our pockets, the air we breathe and the home we live in. In other words, every part of Government has an opportunity to influence people’s health. The purpose of new clause 90 is to ensure that the Government take greater responsibility for improving the nation’s health. That includes mitigating any increase in health inequalities, such as those seen in my constituency. The new clause would make improving health a duty, placing prevention on the same footing as treatment.

But a stronger duty alone is not enough. That is why new clause 91 would require the Government to publish a new health improvement and inequality strategy within six months. The strategy would include long-term targets for adults and children, public reporting on progress, a duty on Ministers across Government to have regard to the strategy, and independent accountability arrangements. The Minister, who has worked very hard on the Bill—I commend her for her engagement—has alluded to the fact that pre-existing guidance and processes are in place, and these are designed to tackle health inequalities, and she is right. However, I argue that they are clearly not working, because health inequality has increased. I ask again what the harm would be of embedding this duty in the Bill to tackle the most fundamental issue in health across England: health inequalities.

These amendments have cross-party support, and I note that they are also supported by the Health and Social Care Committee. I thank Health Equals for its work on these amendments. Again, I thank the Minister for her engagement and urge the Government to consider accepting these new clauses.

I will briefly mention new clause 109, which also stands in my name. It was written by myself and Haris Shuaib, with whom I worked on the standard BS 30440 and a validation framework for the use of AI within healthcare. I previously worked with the AI and digital regulations service for NHS England, working with NICE, the MHRA, the CQC and the Health Research Authority. In the interests of time, I will say that in that duty I identified a number of accountability and regulatory gaps that certainly need further addressing. I ask that the Minister responsible for health tech meets me so that we can discuss these further. They partner quite well with new clause 108, which I had not spotted, so I apologise for not signing the amendment of my hon. Friend the Member for Liverpool West Derby (Ian Byrne).

[Charlotte Cane (Ely and East Cambridgeshire) (LD)]

In my constituency, only 40% of adults have seen a dentist in the past two years, and only 54% of children have seen one in the last year. The impact of that is that 12.5% of children in East Cambridgeshire have tooth decay by the age of five. We are in a dental desert, and it is incredibly difficult to get an NHS dentist appointment. When I talk to the dentists, the most frustrating thing is that it is the contract that prevents them from treating people, not their intentions.

The contract is based on units of treatment. For example, dentists tell me that if they do one filling, they just about cover their cost for the unit they get paid for. That unit covers up to three fillings, however, and at three fillings they are making a loss. Even more frustrating is that they get allocated units at the beginning of the year. Once they have used them all, they can get no more; yet they are aware that other local dentists have not used all their units by the end of the year, and they hand them back. Why is there no mechanism whereby those units can be given to dentists who have the capacity to do more work, so that more people can be treated? It is really frustrating to know that my constituents are struggling without a dentist, and that there are dentists in my constituency who are willing to treat them but cannot get funding to do that from the NHS. It is utterly shocking. That is why I support new clause 18 and other amendments that seek to make dentistry more available to people.

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[Martin Wrigley]

Does my hon. Friend agree that that element of trust is even more important when we get the single patient record, and critical to enabling GPs and medical professionals everywhere to use it, and patients to trust it?

[Charlotte Cane]

I absolutely agree. The single patient record is so important to make the NHS work efficiently and effectively, and to help it treat patients better. To achieve that, patients have to trust that the data is being well protected, and I am afraid that a lot of the people I talk to, including GPs—who are obviously critical in convincing patients that Palantir is safe—do not trust it. We have to pull out of the contract with Palantir. Will the Minister please consider that, please consider the issues faced by rural areas, and please, please, please get us some NHS dentists in Ely and East Cambridgeshire?

[Apsana Begum (Poplar and Limehouse) (Lab)]

I rise to speak to new clause 108, tabled by my hon. Friend the Member for Liverpool West Derby (Ian Byrne), and new clause 34, tabled by the hon. Member for Newton Abbot (Martin Wrigley).

Countless numbers of constituents have contacted me about Palantir Technologies, telling me their concerns about the company’s involvement with Israel’s military and Trump’s ICE. Over 35 Members from across the House have signed my early-day motion calling on the Government to activate the break clause in the NHS federated data platform contract. The objection is not just about Palantir’s ethics, but about its operations under that contract. I share the concerns of many, including the National Data Guardian, about whether data identifiable to individual patients may be accessible by Palantir.

The potential success of the proposals on the single patient record and whether it manages to gain the confidence of the British public depends on the Government listening to these concerns, and making sure that issues around data access and limits, patient opt-outs and the data controller are resolved. I note that the hon. Member for Newton Abbot has tabled a number of other amendments related to data safety, which I support.

I also wish to speak in support of amendment 10, in the name of the hon. Member for North Shropshire (Helen Morgan), on ICB financing. I am deeply concerned by the introduction of a duty under clause 48 for each of the constituent bodies of the ICB to achieve financial balance. In east London, we are currently fighting against massive, eight-figure cuts to the East London NHS foundation trust, where workers have been on strike amid cuts to jobs in much-needed mental health services, all of which are being justified by reference to new requirements for financial balance across the trust. Under the provisions of clause 48, matters will be made much worse and the ability to shift and adapt capacity across the system will be rendered impossible. One of the reasons that this is so regrettable, particularly in an area like east London, where the need for mental health services is acute and rising, is that cuts to these services will simply lead to greater costs arising elsewhere. For that reason, I also support amendment 10, tabled by the hon. Member for North Shropshire, to place ICB spending on mental health services on a statutory footing.

I also support amendment 45, tabled by my hon. Friend the Member for York Central (Rachael Maskell), because I am concerned, as others are, about provisions in the Bill for the reorganisation of ICBs. The changes are among many aspects of this Bill that regrettably point towards a revival of marketisation policies from prior decades—policies that have now been largely discredited. To tackle the biggest health challenges that we face, we require partnership working, joined-up decision making between the NHS, local authorities and expert voices—a dialogue between providers and commissioners. Removing the potential for this type of dialogue appears to be a significant misstep, particularly for integrated care.

Turning ICBs into purchasers alone appears to be being done for the benefit of reinforcing a purchaser-provider split—a split that experts have said time and again does not work, and does not deliver improved performance and outcomes, or even value for money. While I am relieved that the Government are tabling their own amendment 60 to reverse the scrapping of local authority ICB membership, I remain in full support of amendment 45 in order to ensure that NHS trusts, and foundation trusts too, retain their voice in commissioning and public health decisions.

To conclude, the fundamental problem in the Bill lies in its adherence to a logic of marketisation. It is deeply regrettable that the Government are returning to the harmful public-private partnership model for capital investment and a rehashing of the private finance initiative disaster, the negative effects of which are still being felt across my east London constituency.