Health and Care Bill

Diana Johnson Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Mel Stride]

I think the heart of the matter is that we have to be clear and wide-eyed about what this change will do. Yes, it is true that it will leave us in a better position than the status quo, but it is not the case that it will leave those who are less well-off in a better position than if new clause 49 were not passed by the House. For those with assets of about £106,000, by my read of this graph, about 59% of their assets would be lost on average under the original proposals. Under the amended proposals, that figure would rise to 70%. When it comes to those who would be better off as a consequence of new clause 49, many are the better off, because they benefit from the changes being made to daily living costs, to which my hon. Friend the Minister referred.

I am out of time, but I believe that these measures should have been better ventilated in this House—certainly in Committee, if not earlier. We would then have had better information and more time in which to make these important judgments.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

I want to speak briefly to amendment 15, which focuses on the membership of integrated care partnerships—the bodies that will be responsible for developing plans to address the health and care needs of local populations. The amendment would enable the Secretary of State to make specific provisions ensuring the representation of particular areas of healthcare on ICPs via secondary legislation.

In particular, I am concerned about having a strong voice for women’s health in ICPs. I also mention in passing the need for other groups to be represented, such as carers, in an ICP area. As co-chair of the all-party parliamentary group on sexual and reproductive health, I have seen how the experience of women in relation to their healthcare is often an afterthought in a fragmented health system, as in the case of the vaginal mesh scandal; the recent debate about pain during the insertion of intrauterine devices, a form of contraception; maternity provision; and cuts to contraceptive services.

The amendment would ensure that the issue of representation was considered by the Government. It has strong support from the medical bodies in this area, including the Faculty of Sexual and Reproductive Healthcare and the Royal College of Obstetricians and Gynaecologists, as well as in other areas of healthcare, such as childhood cancer, and, as previously mentioned, carers groups.

It is important to protect the independence of ICPs and ensure that they can set a strategy that effectively meets local needs, but there is also a need to ensure that women’s voices are not left behind in the decision making. Without this amendment, it cannot be assumed that those voices will be heard on all ICPs. I hope that the Government will consider the purpose of the amendment, which is to strengthen the Bill.

[Theresa Villiers (Chipping Barnet) (Con)]

There is much to be positive about in relation to the recent history of the national health service. NHS England research indicates that the outcomes for most major conditions are significantly better than they were 10 years ago, and the NHS is seeing more patients and delivering more tests, treatments and operations than at any time in its 73-year history—millions more than 10 years ago when the Conservatives returned to power.

To reassure those concerned by some of the campaigns around the Bill, I emphasise that this Conservative Government are committed to NHS values. We are delivering the biggest ever cash increase in NHS funding. It is just plain wrong to accuse the Government of trying to privatise the NHS. In fact, it was the last Labour Government who pushed competition and private sector involvement, including many private finance initiative contracts that proved to be unwise and massively expensive. If anything, the Bill takes the NHS in the other direction by reducing the role for competition and increasing the scope for co-operation.

At the Bill’s core are the integrated care systems considered by this group of amendments. Its provisions on ICSs enjoy considerable support from within the NHS and build on the NHS’s own proposals for reform to make it less bureaucratic and more accountable and to enable it to be more integrated with other local service providers, such as councils.

I will not be backing the amendments in this group except those tabled by the Government. I welcome Government amendment 25 for the clarity that it provides to ensure that appointments to ICBs will not in any way jeopardise their independence. By dismantling elements of the complex system for compulsory tendering of services, we will free up time and resources in the NHS and remove barriers to local co-operation so that we can improve patient care.

We all recognise that ever-increasing healthcare needs place great pressure on the NHS, which will rise in years to come as more of us become frail and need extra care. I ask the Minister, in his response, to emphasise how we will train, recruit and retain the professionals we need to deliver NHS services. Record numbers of doctors and nurses are working in our NHS, and I pay tribute to each and every one, but it is crucial to step up the numbers, especially of GPs. GPs in my constituency are overstretched and we need more of them. That needs to be a priority for the Government.