Queen’s Speech

Lord Kakkar Excerpts

Thursday 9th January 2020 Lords Chamber

[Lord Kakkar (CB)]

My Lords, I thank the Minister for the very thoughtful way in which she introduced this broadly based debate. She was able to reaffirm Her Majesty’s Government’s commitment to public services—none more than our National Health Service. She also demonstrated the very important government commitment to the area of science and innovation. In so doing, I remind noble Lords of my own registered interests, and in particular a new registration as chairman of the King’s Fund.

The issue of the provision of healthcare is critical to every citizen in our country. Not only is the provision of healthcare vital in terms of protecting our fellow citizens; it is critically important in ensuring that we have a healthy population who are able to contribute to the economy, and of course in ensuring that the vital investment that is made in the National Health Service and in the broader ecosystem that surrounds our National Health Service can be used to drive an important element of our economy: life sciences.

In the gracious Speech, Her Majesty’s Government outlined a number of important commitments to strengthen the provision of healthcare in our country in this coming Parliament, including: the area of the workforce, in terms of enhanced training, and the capacity to attract trained professionals from overseas to work and support our NHS through the provision of a new visa scheme; ensuring and enhancing patient safety through the introduction of a new investigatory mechanism, which needs to be thoughtfully introduced so as not to cut across the important regulators and the multiple mechanisms for investigation that already exist when there has been a mishap in the delivery of healthcare and where lessons need to be learned; and the commitment to enshrine in law the additional funding that is critically required to deliver the sustainability of our NHS.

I turn to two other important issues highlighted in the gracious Speech. The first is the capacity for integrated care, which will be critical if the additional funding provided is to be used in an appropriate way that will have a meaningful impact. Integrated care is of course the integration of primary with specialist care, the integration of care for physical and mental health, and the integration across the health and social care boundaries.

Her Majesty’s Government have received from NHS bodies some suggestions on legislative change that may be required to ensure that they can mobilise themselves effectively to deliver this important integrated care agenda. When do the Government propose to respond to suggestions that NHS England and NHS Improvement be merged, and that providers and commissioners of healthcare at a local level may form joint decision committees able to ensure a better integration of care, rather than having to have major legislative change to create new statutory bodies? It is critically important that, ahead of determining how this additional investment in the health service is to be spent, the structures in which the money will be applied are properly defined and the Government are absolutely content that they are fit for purpose to deliver the important objectives necessary for the long-term sustainability of the NHS.

It is also critically important to be clear that the voluntary joint decision-making committees, between commissioners and providers at local level, will be of sufficient authority to drive the changes in the delivery of care and working practices, and the construction of care environments, that will be necessary to ensure the successful application of this additional funding.

I turn finally to the question of innovation. Once again, Her Majesty’s Government, through the high-risk science fund—of which life sciences might represent an important component—seeks to demonstrate a broader commitment to the life sciences sector in our economy. The publication of the industrial strategy recognises the important contribution life sciences make to our economy—£74 billion per annum—and the 250,000 of our fellow citizens who are employed in the life sciences industry, to such great effect.

An important question remains about how that industry will interact in undertaking clinical research. The Government are committed to ensuring that our life sciences and healthcare economy become the most advanced and innovative in clinical research and the evaluation of innovation. How do the Government propose to do that in the context of still being able to participate effectively in the new clinical trials regulations that will exist for the rest of the health economy in Europe?