Health Bill (Third sitting)

Debate between Jo White and Helen Morgan

Committee stage
Thursday 18th June 2026 Public Bill Committees

[Jo White (Bassetlaw) (Lab)]

We all know how important our NHS is to the people we represent. I know how frustrated patients and staff have become after years of rising waiting lists, cancelled appointments and growing bureaucracy. Since coming into office, this Labour Government have already started to turn things around by delivering more than 3 million extra appointments ahead of schedule, cutting waiting lists and agreeing a new GP contract that begins the work of restoring the family doctor.

However, the challenge remains enormous. We inherited an NHS facing the worst crisis in its history, and public finances under severe pressure. That means that every pound must work as hard as possible for patients. That is why I welcome the decision to abolish NHS England and bring its functions back into the Department of Health and Social Care. The complex structure created by the 2012 reorganisation has left us with duplication, inefficiency and too many layers of management, separating decision makers from the frontline. Far too many NHS leaders and clinicians tell us that they spend their time filling in reports and navigating bureaucracy, when they should be focused on delivering care. We owe it to taxpayers and patients to change that.

These reforms are not about criticism of the dedicated public servants working in NHS England; they are about creating a simpler, more accountable system that supports staff rather than holding them back. By reducing duplication and cutting unnecessary bureaucracy, we can redirect hundreds of millions of pounds to frontline services. That will cut waiting times, improve access to care and give local NHS leaders more freedom to innovate. This is about one simple principle: fewer checkers and more doers; less bureaucracy and more patient care. It will create a stronger NHS that delivers for communities such as Bassetlaw and for people across the country.

The NHS is facing huge challenges. With the right reforms and leadership, we can build an NHS fit for the future and there for every patient when they need it most.

[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.

Health Bill (Second sitting)

Debate between Jo White and Helen Morgan

Committee stage
Tuesday 16th June 2026 Public Bill Committees

[Helen Morgan]

indicated assent.

[Jo White]

Q You are speaking with tremendous passion and I can tell that you see this as an opportunity to make the NHS function far better. You mentioned at the very beginning that it took eight months to make the announcement that you were going to abolish NHS England. How quickly did you realise that NHS England was malfunctioning, far too bureaucratic and not delivering on the priorities for people in this country?

Karin Smyth: That is a good question. When I was in opposition, I spoke frequently about accountability and democracy, as the hon. Member for Sleaford and North Hykeham was trying to highlight—I am sure that we will hear some more quotes. I cannot speak for the former Secretary of State, as he is not here, but it did surprise us going into the financial year when, despite very clear direction and expectation about the financial situation that the Government inherited and what needed to happen, we were still faced with a very large projected deficit. The duplication meant that there were a lot of people in the room and clearly things were being handed off and that was not working. Ultimately, this is a question that always lurked. I know that the right hon. Member for Melton and Syston is here, and during the passage of the Bill that became the Health and Care Act 2022, we said to the Department that that might have been the opportunity to act. I think that previous Secretaries of State, as was alluded to earlier, thought that they might do that. Ultimately, the benefits of doing it now outweigh the risks and that is the only way to make the system change. We heard from the King’s Fund about opportunity costs and that the benefits do not outweigh the risks—we do not think that is true.