Health Bill

Graham Stuart Excerpts

Report stage
Monday 7th September 2026 Commons Chamber

[Sir Jeremy Hunt (Godalming and Ash) (Con)]

I want to start by thanking the Minister for the emphasis that the Bill places on a single patient record. Despite many problems in NHS care, that is an area where the NHS is a world leader, but putting a single patient record on the right legal footing, making it possible to share data with proper governance, gives the NHS an opportunity to become a world leader in artificial intelligence, and it creates the opportunity to transform care for patients, so that has my full support.

I speak in support of new clause 25. The biggest structural reform in this Bill is the abolition of NHS England, but my worry is that there are other structural reforms that are not in the Bill that would have a much bigger impact on patient care. New clause 25 is about continuity of care, particularly in general practice and maternity. It is now very clear to many people that the abolition of the old GP list system in the 2004 contract changes was a huge mistake. In fact, restoring the system so that GPs have their own patients was part of the Labour manifesto, so that is an issue that the Government understand, but it is not in the Bill.

A study in Norway, published in the British Journal of General Practice in 2022, of over 4 million patients showed that patients who have their own doctor for more than 15 years are 30% less likely to need out-of-hours care, 28% less likely to need hospital care and 25% less likely to die. Why is that? Because GPs who know their patients are less likely to make mistakes, more likely to give an accurate diagnosis and will better calibrate risk, as they will have situational awareness of a patient and their family. The experience of a patient is infinitely better when they are dealing with a GP whom they know.

Instead of that, we have moved to a system in which many GP surgeries effectively operate like call centres. People will contact a GP and they may never see that GP again. It is exactly the same when someone calls 111, if you get put through to a clinician. Contacting a GP in the NHS should never be like calling an Uber driver who will never be seen again.

[Graham Stuart (Beverley and Holderness) (Con)]

Labour Members who had that commitment in their manifesto may want to reflect on how much more commitment we have to constituents because they are our constituents than we would if we shared constituents from day to day. We often go out of our way—I hope—to look after our constituents because of that sense of ownership and obligation. It is only because we are allocated those people and they are our responsibility that we go that extra mile. Why would doctors not be the same, and can colleagues not see the sense of what my right hon. Friend is saying?

[Sir Jeremy Hunt]

My right hon. Friend is speaking wisely. Of course, this is not just about massively improving care for patients—it is also about improving motivation for doctors and GPs, who are among the most demoralised groups in the NHS.

There is a GP surgery in Horfield, in the Bristol area, that kept the old GP list system, as 10% of surgeries have done. When I chaired the Health and Social Care Committee, I interviewed Dr Lee from that surgery and he said that because around 60% of the patients they see every day are their own patients, they do not have any problem with GP retention. The GPs who go to work there are happy, because they are seeing people they know. That would be transformative for morale inside general practice.

People might very reasonably say, “Well, you were in that job for rather a long time. Why didn’t you restore that system?”. I want to share a little secret with the House: I did actually try to do that. I changed the GP contract in 2015 so that every NHS patient in England has a named, accountable clinician. Unfortunately, I was outfoxed by the system. As a result of that change, on every electronic patient record, every one of us here will have a named accountable GP on the record. However, absolutely nothing else changed, and the NHS continued as it had done.

The Bill offers a real opportunity to transform care, as well as transforming life for GPs and patients. The same principle applies to maternity care. We know from inquiry after inquiry that despite reams of recommendations, things have not been getting better. If every mum was told at the moment she knew that she was pregnant, “This is the team who will be responsible for the safe delivery of your baby, in antenatal, birthing and post-natal,” we would restore the personal connection to maternity care. That is one of the biggest issues coming from so many mothers; they say that they feel anonymous in the system, and not listened to.

At its best, the NHS delivers absolutely incredible care—I have three wonderful children who exist because of amazing NHS care—but at its worst, it turns patients into numbers and human suffering into box-ticking. Lots of things are necessary to turn that around, but one of the biggest things is restoring continuity of care, so that every patient always knows who is the doctor responsible for their care. That is why I urge the Government to consider how to restore continuity of care in both general practice and maternity, if that is not going to be done through this Bill.

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[Jen Craft]

I completely agree with my hon. Friend. Owing to the lack of early intervention for my constituent Elizabeth and her son William, he has missed countless hours and days and weeks of schooling at a critical point in his development.

At a drop-in that I hosted last week, I met a woman called Annika. Her daughter Winnie has cerebral palsy, and her EHCP clearly states that she requires a physiotherapist, but the family have been forced to arrange that for themselves. Countless other families are in the same position. I think that every single Member in this House will have encountered similar constituency cases, and it is just not good enough.

[Graham Stuart]

The hon. Lady is making a most powerful speech. We will all have experienced the frustration of parents with a child whose EHCP lacks the health element. Does the hon. Lady share my concern that, furthermore, the abolition of Healthwatch might remove one of the few elements that externally and independently marks the homework of the NHS, and that we are moving to a situation in which the NHS itself, and Ministers, will collect the data and mark their own homework, and we will lose yet another of the few tools that a frustrated parent has to hold the system to account?

[Jen Craft]

I agree that there needs to be better accountability in the health service. It currently does not work, and the mechanisms by which we can hold healthcare bodies to account are few and far between. I believe that it is most acutely felt in paediatric care and in the special educational needs and disabilities system, where a mechanism for holding public bodies to account already exists: EHCPs. The idea that the responsibility should fall entirely on local authorities is misguided, because roughly 50% of what a child with an EHCP needs in order to access education is healthcare, which should be provided by a healthcare service. There must be better accountability and transparency for parents, and for their children, when that does not happen. I know that parents often have to go out of their way and spend, on average, £8,500 a year on their child’s healthcare so that they can access education.

--- Later in debate ---

[Steve Barclay (North East Cambridgeshire) (Con)]

I rise to speak to clause 1 on the abolition of NHS England and clause 6 on promoting innovation.

What characterises the first of those is an announcement without any clear plan. That is what has driven the cost and confusion that a number of Members across the House have spoken about. Those in any doubt about that can just look at NHS England’s own 2025-26 annual accounts, which show that the costs are already more than £100 million higher than forecast and now sit at above half a billion pounds. I do not recall seeing that on election leaflets. Indeed, just six directors at NHS England are being paid over £800,000, and that points to the cost.

Sometimes such big figures are hard for constituents to get their heads around. Just to localise it to my own constituency, the Cambridgeshire and Peterborough ICB alone paid out £14 million in redundancies last year. It merged with a number of other ICBs to form the Central East ICB, yet we know hear from the Government that it should align with metro mayors, which means going back to exactly what it was before: the Cambridgeshire and Peterborough ICB.

That is just one of many confusions around the announcement. The hon. Member for North Shropshire (Helen Morgan) spoke about confusion over the timetable and what was described to the media as now an impossible timetable. We also saw reports in the media this weekend about the destination of staff in NHS England. Can they actually go into the Department, or will another body be set up because of the pay disparity between the two? All this is around 18 months on from the actual announcement.

The confusion seems to extend to the Government themselves, because they seem unable to answer pretty straightforward written parliamentary questions. Given the time limit, I will give just a few examples. I asked how many people have been hired to NHS England since the announcement of its abolition, not least given the huge cost—over half a billion pounds—of voluntary redundancies. Despite the deadline passing, the Minister has not answered the question. We know from another written parliamentary question that more than 1,000 jobs have been advertised. It is relevant to know, in an organisation that is paying people to leave, how many people it is hiring. I also asked how many people had accepted voluntary redundancy, another written parliamentary question that has passed the deadline without answer. The process is characterised by a lack of transparency.

[Graham Stuart]

My right hon. Friend is giving a typically punchy speech. Does he agree that every signal suggests that this measure has not been thought through? While the Government have conceded by saying, “Oh we’re going to have local government coming back onboard,” how could they have conceived of health and social care without local government being engaged? On every front, it looks as if they have not thought it through, abolishing everything from the safety inspectorate to Healthwatch England. We have a Government that are out of control, spending tens if not hundreds of millions on redundancies with no clear end destination in view, wasting a huge opportunity.

[Steve Barclay]

My right hon. Friend is absolutely right: the Government are spending millions of pounds and there is no plan. The measure was announced without working that out, it came as a surprise to many within the system, and it has had a chilling effect on many decisions.

That is not isolated. Just today, we had the complete shambles of local government reorganisation. On the last day before the summer recess, the then Secretary of State rushed to the House to push through an announcement, which the new Secretary of State for Housing, Communities and Local Government is now reversing, while the Chief Secretary to the Treasury is contradicting her by saying that the Government want to have a higher legal appetite for risk and fewer consultations. There is confusion across Departments, and the issues with clause 1, which a number of Members have spoken to, illustrate that.

Given the time limit, I will turn to clause 6. I do not doubt for a minute that the Health Minister and the Secretary of State—anyone in the Department—want to promote innovation. My right hon. Friend the Member for Godalming and Ash (Sir Jeremy Hunt) spoke a lot about capital to revenue switches in his book, and the pressure that takes away from innovation. As Health Secretary, I used to have a wry smile at the battles I had with him, when I was pushed by the Treasury to do exactly the same thing. The issue is not the lack of will; the issue is the alignment between procurement, regulation and clinical leadership, particularly in the colleges, as well as the ability to scale innovation—it is not about having more ministerial pilots.

Finally, because I am almost out of time, I will pick up on the Chair of the Health and Social Care Committee’s good points around data. When I was in the Department, my frustration was that I often had to go on open-source dashboards to get information that should have been available to me as a Minister, and I suspect that that is still the case. We should make data dashboards a common theme—the CSV files that the Department publishes are extremely difficult to access. Make data more transparent; it will help the debate in Parliament and, I dare say, it will help Ministers get more support.

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[Steff Aquarone]

I absolutely agree. In order to achieve genuine equality of access, the Government must go outside-in; in other words, they must design provision around the hardest places to serve—my hon. Friend gives a great example—and then work inwards from there.

“If Australia can effectively serve communities living in the remote outback, we can meet the needs of people living in rural and coastal England.”

Those are the words of the right hon. Member for Ilford North (Wes Streeting) when he was Health Secretary. Not only do I agree with him, but I challenge the current Health Secretary to turn her Government’s own words into law. We got it wrong with broadband; we cannot afford to get it wrong with people’s health.

In North Norfolk, I see the struggle for health access and outcomes at first hand. People living on the coast start with half the access that those in inland areas have. Conventional service models assume that people can access healthcare from any direction, but for our coastal communities, half of the area is the sea. The sea may be beautiful, but it does not run a bus service, staff a clinic, or provide a patient catchment. Coastal communities, which may have sparse populations and poor transport, need more local points of care, not fewer. On top of that, the services we do have are burdened by exceptionally long waits. We are not unique in this; some of the poorest healthcare access and outcomes can be found in communities like mine.

We know the challenges for health and wellbeing in these areas from the excellent work of Professor Sir Chris Whitty. He spelled out that we suffer from shorter life expectancy and higher rates of major chronic illness, higher rates of alcohol and drug-related harm, and more cardiovascular and chronic lung conditions. These are very serious problems, and they cannot remain an afterthought in national health policy. National systems must not mistake population density for severity of need.

Besides, when problems are caught earlier and treated faster, it leads to better outcomes. That is one of the reasons why I was so frustrated to be told by the Government before recess that they have “no plans” to provide an urgent treatment centre at Cromer hospital in my constituency, although it would transform access to urgent care across North Norfolk. I am putting the Department on notice today: my constituents and I will continue pressing the case until Ministers reconsider.

Let me tell the House what these inequalities mean in human terms. They mean that constituents like Kelly, who has been waiting more than 70 weeks for a hip replacement, are living every day in pain. Another constituent, Samantha, told me that she waited 30 weeks to see a gynaecologist. The NHS standard is 18 weeks. Appallingly, our wait times made a young woman so unwell that she was forced to sacrifice her education; during the wait, her symptoms worsened to the point that she had to step back from the degree that she was studying for.

I heard from Ian, who has metastatic prostate cancer and requires treatment at the Norfolk and Norwich hospital. It is a half-day trip for him by car to get the essential treatment that he needs. He told me that he considered using a local bus service, but that it would be an hour just to get there. He lives with a damaged bladder, due to his condition, and he told me that it makes life “very unpleasant”. I would go further and say that it is undignified and dehumanising.

[Graham Stuart]

The hon. Gentleman is giving a powerful speech on behalf of rural and coastal areas. One word that he has not used yet is “age”. Age is the clearest proxy for health need that there is. It is not deprivation or anything else—it is age. The distribution of health funding in this country has, under successive Administrations, failed to recognise that and allocate funding accordingly. That is why cancer patients in his constituency and mine find themselves with chronically less spent on them than cancer patients in areas where there are many fewer of them.

[Steff Aquarone]

I could not agree more. That is one of many respects in which rural and coastal communities around the country have much more in common with each other than with their inland neighbours just a few miles away. Theoretically available treatment becomes practically inaccessible if it requires a journey to be made without reliable toilet access, as in Ian’s case, and in cases where access to private transport is more limited, as in the cases that the right hon. Gentleman raises.

Kelly, Samantha, Ian and so many more are entitled to the same access to good treatment and the same chance of good health as people living in urban and inland communities. It is absolutely right for the Government to pursue this Bill, and I support their aim wholeheartedly, but I challenge them to assess the Bill based on who is left behind, not just who can be helped. Accept this amendment, or explain why rural and coastal communities do not merit explicit protection.