Health Bill (Thirteenth sitting)

Debate between Helen Morgan and Dave Robertson

Tuesday 7th July 2026 Public Bill Committees

[Dave Robertson (Lichfield) (Lab)]

It is, as ever, a pleasure to see you in the Chair, Ms Lewell.

Healthwatch was established, at least in part, as a response to the Mid Staffs scandal. Mid Staffs came up three times in our evidence sessions, and the hon. Member for Winchester mentioned it just now. That scandal matters to everyone, but it has a particular resonance for my role in Parliament. Many of my constituents were harmed by the failing at Mid Staffs. I was born in that hospital, and I speak as a Staffordshire MP. None of us should ever forget what happened or allow it to be swept aside without examining it. There were a great many failings at Mid Staffs over a long period. Oversight was just not in the room when decisions were being made.

Staffordshire county council’s health and care overview and scrutiny committee clearly did not do that job. The Francis report stated:

“The arrangements for public and patient involvement, and for local government scrutiny in Stafford, were a conspicuous failure.”

The report recommended some changes to ensure that Healthwatch, which was in the process of being set up at the time, was funded properly. In that light, the framing of this debate is important and timely. Healthwatch has been going for well over a decade. It is right that we now examine its impact, as it is a significant part of patient voice within the NHS.

Despite the very best efforts of a great many hard-working staff and an army of committed volunteers across the country, the quality of local healthwatch organisations is pretty changeable. Over the past few weeks, I have spoken with right hon. and hon. Members from across the House. The feedback that I have received has ranged from, “My local healthwatch team is brilliant— I work with them really closely and they have really helped out with a huge amount; they deliver great things in my constituency” all the way to, “I have some pretty significant concerns about their impact.” In a couple of cases I heard, “What is Healthwatch? I have never heard of it.”

[Helen Morgan (North Shropshire) (LD)]

We heard in evidence that the reason for that variability was a lack of funding. Would the hon. Gentleman support our new clause 78, which tries to deal with the lack of funding and ensure a consistent service from Healthwatch across the country?

[Dave Robertson]

Funding Healthwatch is really important, but to address the issue properly, we must make sure that Healthwatch is in the rooms it needs to be in. Funding needs to be part of the process that ICBs follow. I will touch on that later, so the hon. Member will hear further thoughts on the matter.

Local healthwatch organisations across all our constituencies have an important role. At the local level, they are geographically bound to counties. In constituencies like mine and that of the hon. Member for North Shropshire, those geographical areas are huge. The health disparities within my constituency, with two towns that are 4 miles apart, one with a significant mining—

--- Later in debate ---

[Helen Morgan]

Will the hon. Gentleman give way?

[Dave Robertson]

I will make some progress. There are concerns that if we roll some responsibilities into ICBs or councils, the Department needs to make sure that the issue does not get pushed to the side and that the funding does genuinely remain for patient voice. I am reassured that there will be a patient experience directorate within the Department. That will bring decision making and the patient voice into the Department while also keeping an eye on what is happening with those ICBs and ensuring that they have standards to hit.

The Department needs to ensure that it is sharing good practice and keeping oversight of local authority commissioning of social care. The CQC is starting to do that, and there are some positive indicators. There is obviously more work to do, and we need to stay on top of it because, as I said earlier, there are risks whenever there are changes to healthcare. I am reassured that bringing the patient voice into the room with decision makers is the right way to enact change.

Health Bill (Third sitting)

Debate between Helen Morgan and Dave Robertson

Committee stage
Thursday 18th June 2026 Public Bill Committees

[Helen Morgan (North Shropshire) (LD)]

The Liberal Democrats broadly support the abolition of NHS England. As constituency MPs and users of the NHS, we see a huge amount of duplication and unnecessary bureaucracy as our local health organisations try to navigate the processes of securing capital investment, for example. Reducing duplication between the Department and NHS England is clearly welcome if done well, but we have concerns about the way in which that is being undertaken.

We think that this centralising process, under which the Secretary of State takes on more powers, risks political capture. That may not seem like a huge risk considering who the current Secretary of State and shadow Secretary of State are, but given the febrile political atmosphere that we are working in, it seems a poor time to give a Secretary of State sweeping operational powers over the detailed functioning of the NHS, with few checks and balances. I will speak about the most concerning elements and make the argument in greater detail when we debate cause 11.

As the hon. Member for Sleaford and North Hykeham said, the former Health Secretary, the right hon. Member for Ilford North, said that top-down reorganisation of the NHS was the last thing he wanted to do, and yet that is where we find ourselves today. It feels as if the plan has been pulled together very quickly, and that it has been complex to turn into a piece of workable legislation. It has taken a long time even for the Treasury to agree on the funding of the redundancy bill. We have found out that redundancy costs of £800 million will be taken out of the future operating costs of the NHS. I hope that the Minister will describe how that will be delivered to ensure that the costs do not detract from patient care on the frontline.

There is still some uncertainty about the new structures within the DHSC and NHSE reorganisation. We have heard that the previously announced plan for three top-level roles—a permanent secretary, a chief medical officer and an NHS chief executive officer—might be changed, and that there is a proposal to merge the permanent secretary and NHS CEO roles. At this stage, as we start to consider the legislation, it would be helpful to have clarity on who will be in charge of the NHS and how the layers below will be organised. We have also heard that hours of staff time, leadership focus and money have been directed away from frontline services. In the oral evidence session, Sarah Woolnough of the King’s Fund and Jon Restell of the Managers in Partnership union suggested that that has been distracting and that, in any body, a significant reorganisation has an opportunity cost.

In my previous life, I was an accountant at Centrica plc—one of those back-office checkers everybody wants to get rid of, but who turns out to be quite important in providing the information that enables the business to run smoothly. We found reorganisation hugely distracting; it took away from our ability to do our day jobs well. Then, within a couple of years, a lot of the equivalent roles were re-hired and we were back to square one. It is critical that the Government avoid that scenario in this big reorganisation of the NHS. I hope that the Minister can provide reassurance that it has been well thought through and that we will not find ourselves, two or three years down the line, with similar numbers of people replicating the roles that exist currently, following a huge distraction that resulted in no improvement in patient outcome or experience.

My questions are fairly limited. Does the Minister know, at this point, what the impact the reorganisation has had on the system and how much it has cost in secondary impacts? We have had eight Health Secretaries in the past 10 years. After all that swapping and changing, how can the Minister ensure a degree of continuity when the new Secretary of State takes over? One benefit of quangos is continuity over a long time, divorced from the political turmoil of Westminster. We must be clear about how distractions will be avoided in the new structure.

Finally, we heard in evidence on Tuesday that the new structure feels like a centralisation of power in Whitehall, when what is needed is more power devolved down to local level so that local services can be shaped to reflect the demographics that they serve and to address the important point of health inequality. Will the Minister explain why she is confident that measures to ensure local accountability and local shaping of services will be able to go ahead? Tackling health inequalities is the priority of everybody in this Room, and we need to ensure that we have an efficient structure in place to ensure that it happens.

[Dave Robertson (Lichfield) (Lab)]

It is a pleasure to see you in the Chair, Sir Jeremy. One of the most powerful things we can do as Members of this place is bring our constituents’ stories here so that they can form part of our discussions. That is what I will do as we discuss the future of NHS England.

I openly admit that I have never knocked on a door and found that someone’s burning question was about the abolition of NHS England. I have never had that particular discussion, but I do have regular discussions about the NHS. We know how important it is to people. They value the greatest gift that the Labour party has ever given the United Kingdom. As we have those discussions, one thing that comes up time and again is that people will always want more; they will always want better healthcare, and they should be able to expect it.

Across my constituency, the biggest health need is access to primary care. Two towns each make up one third of my constituency, so a third of my constituents live in Burntwood, 4 miles up the road from Lichfield— I believe my constituency is misnamed, but that is a matter for the boundary commissioner, not for me. When I talk to people about healthcare and access to primary care in Burntwood, one thing comes up time and again: the new health centre for Burntwood that was promised but never delivered.

That centre was promised in 2009 when the old one was demolished, but its funding was cut in 2011 following the change of Government, and we are still waiting. A modular building had to be put up in the car park of the leisure centre—“modular building”, by the way, is a grand term for what are portacabins stacked on top of each other. A huge number of people have worked at that site for a long time, delivering the best care they can, but they are being failed by the facilities that they are forced to work in. When I have conversations about primary care with people in Burntwood, they are never unhappy about the care they receive, about their doctors or about others who work in the NHS; they are unhappy about the facility that they are forced to use. I am standing here in 2026 and we still do not even have planning permission for the replacement centre. It has been promised so many times that people are beginning to doubt that it will ever happen. That is so hard to hear.

Health Bill (First sitting)

Debate between Helen Morgan and Dave Robertson

Tuesday 16th June 2026 Public Bill Committees

[Helen Morgan]

Q As a former Secretary of State for Health, what are your reflections on the abolition of Healthwatch and the absorption of its functions into the Department of Health, ICBs and local authorities?

Sir Jeremy Hunt: It is not dissimilar to my earlier reflections. It is really important that patients have a voice, but it is even more important that their voice is heard not just through a bureaucratic process that listens to them, and gives them a sense of being listened to, but then nothing happens. The problem with the Healthwatch structure we have is that it is very good at the listening bit, but I do not think people have confidence that things actually change.

[Dave Robertson (Lichfield) (Lab)]

Q It is always a pleasure to see you in the Chair, Sir Roger. Sir Jeremy, I want to turn to NHS England’s accountability, or lack thereof. I know you made the point that you did not want clinically advised decisions to be overly politicised, but I had the reverse in my constituency when a decision was made after the lease on a doctors’ surgery ran out. It could not be extended because of some rule in NHS England, but due to that lack of accountability, there was nothing that we could do. The surgery closed, and one in six of its patients was just redistributed to another surgery, so that accountability clearly failed in that space.

If you are concerned that accountability ends up too close to the Department, where else should it land? I am quite comfortable with a Minister being accountable for that decision, because they are accountable to MPs, who are ultimately accountable to the people that it affects. Can you pare back your answer a little bit and talk about where that accountability should lie, and how we can ensure that it works?

Sir Jeremy Hunt: That is a story I think every single Member of Parliament could repeat, and it is a fundamental flaw in the system. Do you not think it is completely ridiculous that you have to go to the Health Secretary, who is responsible for a budget of £160 billion—the largest healthcare system in the world—to sort out something like a GP surgery lease in your constituency? That is a perfect example of a problem that we should be able to sort out locally, and that is why I think the bureaucracy has got completely out of hand.