Health Bill

Debate between Helen Morgan and Steff Aquarone

2nd reading
Monday 1st June 2026 Commons Chamber

[Helen Morgan (North Shropshire) (LD)]

I start by declaring an interest as a member of the all-party group on patient safety and as a vice-president of the Local Government Association, and also by welcoming the new Secretary of State to his place. I very much look forward to working constructively with him during the passage of the Bill.

We all know that our NHS is in desperate need of transformation. Hospitals are in chaos, social care is overloaded and getting a GP appointment is a huge challenge for many. Labour has promised to put patients and communities at the heart of the NHS, but I fear that the Bill does not fulfil that promise. The Government promised to sort out social care, but two years later they are still only part-way through a three-year review. They promised to treat mental health with parity, but although mental health accounts for 20% of the disease burden, its share of NHS budgets is falling to just 8.4%. The Government promised to protect women’s health, but the women’s health strategy published this year was significantly weaker than the men’s health strategy, which received 60% more funding for new research. Healthy life expectancy in the UK is stagnating, and adult social care is under ever more pressure, putting immense stress on the budgets of councils and other local authorities.

The reality in rural North Shropshire is that people struggle to get GP appointments, 12-hour waits in A&E have become normal and finding an NHS dentist is becoming impossible. The social care crisis has left Shropshire council’s finances in a dire situation. A real NHS reform Bill would have changes to social care, general practice and prevention at its heart. Instead, this Bill passes responsibilities around Whitehall, centralising more power with the Secretary of State, while chaos reigns following 50% cuts to ICB budgets.

Early in his term, the right hon. Member for Ilford North (Wes Streeting) promised that another top-down reorganisation of the NHS was the last thing he wanted to do. Yet the abolition of NHS England is exactly that—focusing on reorganisation at the top, while failing to deliver real improvements for patients and staff. It is true that NHS England has allowed Ministers to shirk responsibility and accountability, but its abolition has been poorly planned, leaving both ICBs and specialised commissioning in chaos. Instead of the Government’s advertised aim of creating a more community-based NHS, the Bill centralises power in Whitehall, giving sweeping Henry VIII-style powers to the Secretary of State. Such powers carry a real risk that political considerations could influence what should be operational decisions about how the NHS provides for patients in future. That is particularly concerning in the current febrile political climate, and the Government must ensure that protections are in place for what may happen in the future.

The Government have made 50% cuts to ICBs, but the Bill gives them new legal responsibilities, different structures and centrally directed spending objectives. It is indicative of a lack of planning that could plunge ICBs into chaos. Meanwhile, the removal of the integrated care partnership and the extension of ICBs to cover multiple local authorities raises unanswered questions about the future of social care planning. In Shropshire, the council already spends around 80% of its budget on social care provision. That has a monumental impact on all services, as constant savings have to be found. Removing the pooling of the better care fund among local authorities and ICBs will discourage integrated working between these bodies on social care. Given existing complications over the sharing of costs and social care provision, the chaos of that reorganisation may only exacerbate confusion.

It is also astounding that the Bill plans to remove the duty of GP representation on ICBs, along with local authorities and NHS trusts. The replacement of council representation with mayors is extremely problematic for the many areas that do not have a mayor, and it removes the local accountability needed to ensure true community representation. Like so much Labour policy, such changes risk benefiting concentrated urban areas, while letting down rural communities such as those I represent.

[Steff Aquarone (North Norfolk) (LD)]

My hon. Friend will be aware of clause 4 on reducing health inequalities, which I welcome. As a rural MP, like me, she will also know that access and outcomes are poorer in our communities. Does she agree that the Government should go further and ensure that the Bill explicitly refers to equality of access and outcomes for rural and coastal communities such as North Norfolk?

[Helen Morgan]

My hon. Friend will not be surprised to hear that I agree with his point.

ICBs are already overstretched and underfunded. In North Shropshire, both Shawbury medical practice and Prescott surgery in Baschurch are in desperate need of expansion. Community infrastructure levy money is available and land is earmarked for a new site, but progress is being held up by the ICB’s inability to agree notional rent. That situation is replicated across the country, and there is no sign of such problems being solved by the Government’s changes.

The plan to abolish Healthwatch will ultimately strip patients of their voice. There has been a statutory independent patient voice in the health and care system for more than 50 years. More than half of patients who experienced poor care in 2024 did not take any action, with many citing fears that giving negative feedback directly to the NHS might affect their ongoing treatment. That is why it is crucial that we have an independent patient voice, rather than leaving the Department or the ICB to mark its own homework.

We need only look at the devastating consequences of the failings uncovered during the Mid Staffordshire scandal, and the long list of maternity failings since, to see how important it is to have Healthwatch exposing challenges in the health service and listening to patient feedback, and how the CQC can fail in that operation. In Shropshire more than 200 babies are thought to have died due to maternity failures; in the reviews that followed, the one thing that came up time and again was that grieving parents were not listened to.

Patients and their families must have a voice. The new system will give no incentive to investigate such issues, which are invisible in the main performance metrics of the NHS. To see the value of Healthwatch, we need only look at the Cabinet Office King’s Speech briefing for the Bill, which refers to a Healthwatch report from May 2025 on missing medical records in order to make the case for the single patient record. I urge the Government to protect both national Healthwatch and local healthwatch organisations, and the independent whistleblowing routes that empower and advocate for patients.

The Liberal Democrats welcome the move to create a single patient record; that part of the Bill could prove to be the most transformational for patient experience and, most importantly, for patient outcomes. People are tired of endless NHS admin and of having to reconfirm their medical histories over and over to different medical professionals. Patient harm has often occurred where clinicians have not had a patient’s full medical history, and different parts of the NHS having access to the same patient information is clearly necessary. However, that must come alongside essential new privacy protections and safeguards for patients, particularly given the understandable concerns surrounding Palantir’s involvement with the federated data platform. We would introduce a health charter to set out guiding principles for data sharing across the NHS, ensuring that patients are in charge of their own data.

The Bill’s references to carers are welcome, as is the Secretary of State’s duty to promote the involvement of carers alongside patients in decision-making around care and commissioning. However, the Bill goes nowhere near tackling the social care crisis and demonstrates a pitiful lack of ambition on one of the biggest challenges we face. As I mentioned, the chaos caused by the restructuring of ICBs will only worsen the challenges that local authorities face in providing care for an increasingly ageing population. We want to transform the NHS so that patients are empowered to live more healthily, for longer and in dignity. The nation’s health is stagnating, with an ever-widening gap in healthy life expectancy between the country’s most and least deprived areas and growing pressure on adult social care.

Fixing social care is fundamental to our vision for the NHS. It is the key to providing a better quality of life for the frail and vulnerable, freeing up hospitals and building independence for an ageing population. It also empowers our constituents to live as independently as possible in their homes and near to their families and communities. We cannot fix the NHS and move care to the community while ignoring social care—yet the Bill ignores it and, as I have outlined, the changes to ICB commissioning will undermine the structures that are supposed to integrate social care with the NHS.

Liberal Democrat plans will give people control, rooting services in communities, listening to patients and making it much easier to see a GP. We will give patients a right to see a GP within seven days, reverse surgery closures and ensure proper personalised management of chronic conditions and frailty, with guaranteed access to a named GP for those patients. We will also protect the mental health investment standard so that we can rebuild community mental health services—something that this Government have failed to do— empowering individuals with poor mental health by intervening early and allowing them to access care in their community. Our maternity rescue plan will ensure that Britain is the safest country in the world in which to have a baby, offering one-to-one midwifery care and empowering women at this most important moment.

This Health Bill could have been a moment for real change. Liberal Democrats are clear about what real modernisation of the NHS would look like. Our vision for a reformed, community-based NHS is one where proper care and restored investment in public health ultimately cut NHS waste and empower people to live healthier and more independent lives. This Bill focuses on shuffling responsibility around Whitehall and gives the Secretary of State the role of chief micromanager. The Government continue to procrastinate over bringing in real change to fix social care, empower patients and save our NHS. In Committee and on Report, Liberal Democrats will use every lever at our disposal to deliver the transformation the NHS so desperately needs.

Budget Resolutions

Debate between Helen Morgan and Steff Aquarone

Tuesday 2nd December 2025 Commons Chamber

[Helen Morgan]

We would all welcome that kind of innovative, community-led approach to improve local health services across the country.

The commitment to set up 250 neighbourhood health centres in communities by 2025 is clearly a welcome step, but there are 543 constituencies in England, so many communities will remain under-served. For example, my own constituency of North Shropshire is part of the pilot for neighbourhood health centres, for which we are grateful, but the numbers indicate that there may be only one neighbourhood health centre, although the constituency has five market towns, spread over a large distance and with different catchment areas. It is not one neighbourhood. Investment in our general practices is essential to ensure that people can continue to access primary care when they need it.

Neighbourhood health is not just about buildings—it is about how teams operate—but when so many local practices are constrained by the physical space in which they must work, buildings are an important part of the puzzle. There is a danger that rural and coastal communities continue to remain under-served and isolated, unable to access services that may be many miles away and only reachable by private car.

[Steff Aquarone (North Norfolk) (LD)]

My hon. Friend and I both represent rural constituencies that face similar challenges. Businesses in North Norfolk already face extra struggles to stay afloat, including training and retaining staff, finding affordable premises, and even things as simple as getting a strong and reliable phone and internet connection. Does she share my frustration that rather than tackling those problems, last week’s Budget has just lumbered rural businesses with more tax, more costs and more stress for the future?

[Helen Morgan]

I share my hon. Friend’s frustration.

Perhaps the most glaring and alarming omission of all in this Budget is that the words “adult social care” do not appear. The sector is already stretched to breaking point and is now suffering from the Government’s 2024 hike in employer national insurance contributions, which is unfunded for most businesses operating in that sector. The pressure is clearly reflected in the Association of Directors of Adult Social Services’ 2025 spring survey, which found that three quarters of directors have only

“partial or no confidence that their budgets are sufficient to meet their legal duties for prevention and wellbeing.”

That is not only terrible for disabled and vulnerable people; it is a disaster for the NHS. One in seven hospital beds are taken by someone who should be discharged but for whom there is no appropriate social care package. The situation could not be more pressing.

We need the cross-party talks to move far more quickly. As we have heard, there has been only one meeting, back in September, and there are no current plans for further engagement. I ask Ministers to ask the Prime Minister to lead those talks and to treat them with the seriousness and urgency that they deserve. We also need a solution to provide the social care beds needed to stop a devastating winter crisis; 2028 is too late for that.

In addition to spiralling NIC costs, there is increasing demand and huge staff shortages in the sector. With an immigration policy that is clearly designed to disincentivise overseas workers in this area, there is no clear plan to ensure how those vacancies will be filled. In formulating their 10-year workforce plan, the Liberal Democrats urge the Government to introduce a funded and higher minimum wage for carers, and a new royal college of care workers to improve training and career progression and to give carers the recognition that they deserve.

When social care is not available, family carers must step in to fill the need. A fairer deal for family carers, such as guaranteeing more respite care and introducing paid carer’s leave, would enable many to continue caring for longer at home. We want to see more support for young carers in school by introducing a young carers pupil premium. These are simple but potentially transformational steps in supporting the millions of carers without whom our health service would collapse.

Winter is quickly closing in, and there are signs that the annual winter crisis could be even worse this year, having already become a year-round permacrisis. The Budget should have funded an emergency package to prevent A&Es collapsing this winter. Liberal Democrats have called for 1,000 extra hospital beds, emergency social care places to free up places in hospitals, a recruitment and retention drive to increase the number of out-of-hours GPs, and a qualified clinician in every A&E waiting room to protect patients who are at risk but stuck on trollies. Without those measures, there is a significant risk of another winter of harrowing scenes of corridor care and ambulances queuing outside hospitals, which should have no place in our society.

Let us take a step back and ask what this Budget really means for the NHS. The topic of today’s debate is investment and renewal, but this Budget means cost pressures are left unaddressed and reforms that are confused and disorientating. Inflation is forecast to run higher than the budget set by the Department of Health and Social Care back in March 2025 for the spending review. As a result, average real-terms growth in departmental budgets has shrunk by 0.1% since then.

The OBR notes that spending on branded medicines alone is expected to rise by 25%—an extra £3.3 billion—between 2025-26 and 2028-29. For context, that is equivalent to the budget for maternity care in England. Yesterday’s recent agreement confirms that it will be at least that sum, and possibly as much as another £6 billion a year, which is an eye-watering amount. Industrial action could add a further £1.2 billion by 2028-29. It is hard to see what would be left to repair our GP services, expand social care or take any of the other measures needed to lift the NHS off the floor.

On top of that, we have no clarity on the impact of the reorganisation of NHS England and ICBs. The Chair of the Public Accounts Committee has warned that the Department has removed

“a key piece of machinery without articulating a clear plan for what comes next”

and compared the reforms with those of HS2.

The 10-year plan sets out a vision that Liberal Democrats share, but it is missing any clear explanation of how it will be funded within the spending review settlement. Nowhere, across 170 pages, is there a credible costing or delivery plan. Five months on, we still have no idea whether the Government can deliver the essential reforms that they have promised. Unless the Government adopt a genuine “spend to save” approach, investing now to prevent greater costs and worse outcomes later, we are at risk of seeing only managed decline, mounting pressure and the continued loss of faith in the health service.

Rather than Labour’s unfair tax rises, we have set out a number of fair ways to fund our public services properly. Most importantly, this Government are refusing properly to fix our broken relationship with Europe. We are calling for a new EU-UK customs union, which could raise more than £25 billion a year. The Government would have plenty of time to put the deal in place by 2030, raising billions in extra tax revenue in a fair way after 2030. We have also called for a targeted windfall tax on the big banks, which would raise £30 billion in total by 2030.

Let me take this opportunity to say to the Government that if we are to rescue the NHS, they must tackle the crisis at its front door and at its back door. That means investing in public health and early access to community services, including GPs, pharmacists and dentists, so that fewer people need to go to hospital in the first place. It also means fixing the crisis in social care to stop so many people being stuck in hospital beds. Only these measures can bring down waiting lists, improve the quality of care and help people live longer, healthier lives. The NHS needs transformational change; the Government must wake up from their complacency, or it will be patients who pay the price.