Health Bill

Janet Daby Excerpts

Report stage
Monday 7th September 2026 Commons Chamber

[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.

[Janet Daby (Lewisham East) (Lab)]

I thank the Minister for the Bill. I put it on record that I am chair of the all-party parliamentary group on sickle cell and thalassaemia. I rise to speak to new clause 162. It is well known that the NHS commissions specialised services unevenly across England. I am confident that this Government’s ambition is to end the postcode lottery of specialised services, and I would like to hear more about that. New clause 162 is designed to do something simple: to ensure that Parliament can identify where inequalities exist, measure where they are improving and hold the Secretary of State to account when they are not.

I will make the case for the provision through the experience of people who live with sickle cell. Sickle cell disorder is the fastest growing serious genetic condition in England. It causes episodes of serious chronic pain, spasms and a crisis that will continue if left untreated. It can damage organs and frequently requires hospital care. When the crisis strikes, patients have to attend A&E and wait for hours, often only to be seen by medical staff who may have little or no familiarity with their condition. Due to past experiences, many sufferers do not trust the NHS to meet their needs, and stories of sufferers who have died in hospital due to complications, such as Evan Nathan Smith, are well known.

In 2021, the “No One’s Listening” report demonstrated that people with sickle cell need to be listened to. That report prompted NHS England to act. It initiated the sick cell and thalassaemia quality improvement programme, from which came seven pilot emergency department bypass units. These dedicated facilities allow sickle cell patients to avoid A&E and receive immediate care to bring a crisis under control. The service works, but there is a problem, which brings me to the new clause. When the APPG met last week, we heard from stakeholders that this progress is fragile. There are only seven bypass units across the country, and with the transfer of commissioning responsibilities under the Bill, there is a real and legitimate fear that what has just begun to be built will not be protected to continue.

[Ben Coleman]

I am also a member of the APPG, and I was also at that meeting. On the Health Committee, we raised the point about these short-term pilots, and we managed to get an extra year’s funding. I have to say—I will say this as the person I am—that I feel that if this was a problem that predominantly affected white people instead of black people, it would be taken a lot more seriously. I think that the Government need to reflect on that when they are deciding whether to accept this amendment and whether they wish to give sickle cell sufferers the full support that they need, which they are not getting.

[Janet Daby]

I thank my hon. Friend. He could not have said that more clearly. This is absolutely about inequalities in the health service. He has explained and expressed that extremely well. I know that he, like me, will continue to advocate for people from ethnic minority and diverse backgrounds.

New clause 162 would require the Secretary of State to do two things: first, to lay an annual report before Parliament on the performance of specialised services against national standards; secondly, to ensure the regular publication of data on quality and outcomes of the kind currently captured in the specialised services quality dashboards, which NHS England has maintained on a non-statutory basis. Without legislation, those dashboards could quietly disappear when NHS England does, and that must not happen. The new clause would make their continuation, or the continuation of something equivalent, a legal requirement.

I want to be clear about the modesty of this ask. We are not asking the Government to build new services, ringfence budgets or second-guess local commissioning decisions. We are asking them to measure, publish and report, in order to ensure basic accountability for patients with rare conditions, and for geographically dispersed people, predominantly from black and minority ethnic backgrounds, so that they have services that work.

The patients who rely on specialised services are often marginalised twice over: once by their condition, and again by a system that does not always see them clearly. New clause 162 would require the Secretary of State to identify them, and to report back to this House on what they find. I urge the Government to take this new clause seriously and to respond appropriately.

[Steff Aquarone (North Norfolk) (LD)]

Amendment 19 closes a dangerous gap in the Bill and commands the support of Members from across the House. It is right that clause 4 calls for the Health Secretary to reduce inequality of access to health services, but the Bill must explicitly cover rural and coastal health inequalities, or else less densely populated communities will always lose.

At face value, it makes sense to measure success by the greatest number helped; however, in the long run, that is a false economy, as delayed diagnosis and treatment ultimately cost the NHS more. It is a little bit like access to high-speed broadband—we rolled out the first phase to the places where the most people could be connected, which rewarded the Government and providers with some impressive-sounding numbers while disguising failure in the margins. Rural and coastal communities are literally and politically at the end of the line, and are therefore reached last.