Health Bill

Lord Faulkner of Worcester Excerpts

Committee stage
Wednesday 28th October 2026 Lords Chamber

Amendment 15 would require national health data systems to collect, analyse and publish data sufficient to identify and monitor these inequalities. Amendment 16 would ensure that the particular barriers facing inclusion health groups are considered when the Secretary of State exercises the health inequalities duty. Amendment 17 would require annual reporting on progress, including action taken in relation to Gypsy, Roma, and Traveller communities—this is essential for transparency and accountability. These amendments are all complementary. They would help ensure that inclusion health groups are visible in the evidence used to make decisions. They build on existing commitments to reduce health inequalities, and they aim to ensure that the system we have is better able to recognise and respond to the needs of these communities. I beg to move.

[The Deputy Chairman of Committees (Lord Faulkner of Worcester) (Lab)]

I should advise the Committee that if this amendment were agreed to, I would not be able to call Amendments 7 to 15 for reasons of pre-emption.

[Lord Patel (CB)]

My Lords, we are entering the phase of debate on the Bill which I personally consider to be the most crucial part. Why do I consider it to be the most crucial part? It is because tackling health inequality is central to the revival, if not the survival, of the NHS and the broader economy.

I will speak mainly to my Amendments 7, 13 and 19, but before I do so, I want to say something because I feel strongly about it. I regret that consultants have decided to go on strike. No doctor should ever, under any circumstances, withdraw their services from the sick and the vulnerable. I think any doctor, and I hope every doctor in this House, would support that idea. They might have grievances, but they could settle those without going on strike, and they should not withdraw services. I hope the professional bodies, including the royal colleges, will align with that comment.

Having said that, my amendments about reducing inequalities are there because what we have in the Bill is a direct transfer of the issue of reducing inequalities from what was part of NHS England’s duties and was already in the duties of ICBs. There is nothing new in the Bill about reducing inequalities. It is a great pity that an opportunity is being missed by this Government to put a mark on how to reduce inequality. Why do I say “this Government”? It is because in the last 30 years, it was only once that we succeeded in reducing health inequalities, and that was from 2000 to 2010. An academic review, which was a proper assessment, demonstrated that, in mortality, infant mortality and ill health, the strategy devised by the then Labour Government managed to reduce health inequalities. But we have now come to a point where they are all rising for all kinds of reasons.

Who were the people who were responsible at the time? Their names were Alan Milburn; John Reid, now the noble Lord, Lord Reid; Yvette Cooper, now Secretary of State for Health; the noble Lord, Lord Darzi of Denham, who produced a report on the NHS; and Andy Burnham, the last Secretary of State for Health in that Government, and now the Prime Minister. Surely the present Government can find people of same calibre who can tackle health inequalities—or maybe not.

The strategy was a cross-governmental public service agreement—PSA—which was a legally binding framework used by the Treasury in the spending review process. It was as simple as that. It could be argued that my amendment is too strong. It would make the Secretary of State responsible, and I might be told that cannot be, because it removes the Secretary of State’s autonomy and flexibility, and therefore putting that in the Bill is not appropriate. If it is not, it does not make the policy of inequality strategy development inappropriate. As demonstrated between 2000 and 2010, the then Government found a way—cross-governmental ministerial responsibility—where, although the strategy was based on ill health, all the other Ministers were responsible for making sure that their ministries contributed to that improvement in reducing health inequality.

Therefore, if the Minister does not like my Amendment 19, there might be other ways for the Government to decide how the same could be achieved through another strategy; for instance, the same kind of agreement that Government did in 2000-10 or through Cabinet Secretary responsibility, as the Cabinet Secretary is responsible for making sure that all the Ministers and different government departments contribute and are mindful of a strategy that reduces health inequality.

In my view, if we do not do this, and there is no strategy coming forward, nothing will change. We will be talking about the same things that we have been talking about for the last 15 years, quoting the same statistics that have already been given about life expectancy being reduced in disadvantaged populations, how the time people spend being unhealthy will increase, how infant mortality will go up, how maternal mortality will go up, as it is doing now, and all the other things.

I thank the noble Baroness, Lady Cass, who might speak after me on children’s issues, and the noble Baroness, Lady Manzoor, who added her name to my amendment. I hope the Minister might agree to four things that I will ask her. I am not asking questions but asking her to agree that health equality and health outcomes are key to the overall welfare of the NHS and the broader economy; that now, after two decades, there has not been any improvement; that the improvement that previously occurred was as a result of a cross-government strategy; and that the increase in health inequality is being driven by rising ill health in England, but the Bill does not have a plan for the Secretary of State, a Minister of the Crown or Ministers in other Governments to demonstrate how they will reduce inequalities.