Health Bill

Lord Patel of Bradford Excerpts

Committee stage
Tuesday 3rd November 2026 Lords Chamber

[Baroness Coffey (Con)]

My Lords, I agree with the amendments. The original duty included by the Government feels a bit lightweight and almost declaratory, rather than anything of substance. That it is why it is proving a useful debate, through the variety of amendments, to look at putting more substance to this.

In the real world of the NHS, in my experience as a patient and previously as an advocate, what is convenient for the NHS is more important. We will come to this in a broader sense later in the Bill, but it is vital that we try to help patients, as with the earlier duty in the clause that is not being changed, to have more involvement in their healthcare. As my noble friend Lady Manzoor just said, patients are often not aware of the availability of other services. It would be useful to get an understanding of how the Secretary of State intends, through this clause, to make patients more aware.

At the same time, as my noble friend Lady Neville-Rolfe points out, in effect, probably due to budget constraints, rationing has started by not allowing patients to take advantage of provision in the interests of trying to manage budgets. I am not saying that the NHS is a bottomless pit—it is not—but we have to come back to what the NHS is there for. The constitution is quite clear that patient choice is a key element. That is reasonable in order to try to make sure that we have a healthier society. As my noble friend pointed to, quite a lot of illnesses are stopping people working, or working to their full potential. That is no good. A lot of illnesses mean children are not allowed to reach their full potential and are spending time out of school.

We need to consider such factors when carefully considering the amendments tabled by my Front Bench and that of the Liberal Democrats to beef up what it means to ensure that other provision can be readily accessed to have a healthier society. I hope that my noble friends will bring this back on Report if we do not have any satisfaction today.

[Lord Patel of Bradford (Non-Afl)]

My Lords, I support the aims of Amendments 22 and 24 and welcome the intentions of Amendments 67 and 68 in this group.

I want to concentrate on what these proposals would mean in practice for patients and families. The question is whether choice is meaningful, accessible and protected throughout their care. For patients, the questions are straightforward: where can I receive appropriate care, how long will I wait and how will I get there? Amendment 22 rightly draws attention to the information that is needed to make those decisions, including waiting times, location, quality and travel costs. Simply presenting someone with a list of providers does not necessarily give them a meaningful choice. A service offering an earlier appointment may be difficult to reach, while a nearby service may involve a much longer wait. Patients need help to understand those options and decide what works for them.

Does the Minister accept the case for strengthening patient choice in services outside of hospital? Whether she accepts Amendment 22 or not, how will the Government ensure that patients receive the information and practical support that is needed to exercise choice, particularly those patients who cannot readily use digital services, have communication needs or require help with transport?

Amendments 23 and 24 raise an equally important question about onward referrals. A patient’s ability to choose should not depend on which door they entered through, or which organisation happens to make the next referral. As services become more integrated and virtual services play a greater role, we must ensure that patients are told about the choices that are available to them. Integration should make their journey easier, while preserving access to suitable providers beyond the organisation arranging their care. Can the Minister explain how patients will be protected from being directed automatically to a closed list of preferred providers without being offered the choice to which they are entitled?

Amendments 67 and 68 raise a related issue about choice in community services, including eye care and audiology, very eloquently expressed by the noble Baroness and the noble Earl, Lord Howe. Moving care closer to home should bring benefits to patients. We should ensure that a change in the setting or organisation of care does not unnecessarily narrow their options. For a family seeking an ADHD or autism assessment, choice can also have very practical consequences. Where choice rights apply and an eligible provider can offer appropriate care sooner, families need to know that this option exists and understand what the service includes. They should also have the confidence that their choice will be respected as referral pathways change.

As the noble Earl said, choice must operate within appropriate clinical criteria, with providers meeting the required standards and regarding the sustainability of local services. It must also be available fairly, rather than depending on a patient’s confidence or ability to navigate the system. Can the Minister explain how existing choice rights will be protected as services are reorganised, how compliance will be monitored and what remedy a patient will have if available choice is denied? The practical test is whether patients can reach appropriate care sooner, with clear information and continuity of treatment. I hope that the Minister will respond to the concerns behind these amendments and explain what the Government will do to make meaningful patient choice a reality.

[Lord Mawson (CB)]

My Lords, I too support Amendment 22 and am encouraged by this debate, which definitely needs to happen. Indeed, the GPs I work with in the East End of London would definitely want to open up these very choices to patients from many different backgrounds, because sometimes one can get a sense on the ground, certainly in challenging communities, that the NHS can be quite condescending to people in assuming they do not want these kinds of choices. Yet if you go into East End housing estates you will find lots of different people living there from lots of different backgrounds who do want choice. This is a really important message and needs to be grappled with and taken seriously.

Health Bill

Lord Patel of Bradford Excerpts

Committee stage
Tuesday 3rd November 2026 Lords Chamber

[Baroness Manzoor (Con)]

My Lords, I understand and support the aims and sentiment behind this group of amendments—particularly Amendment 29 and 258. Any form of discrimination or racism is abhorrent. How one identifies oneself should not be a problem. Antisemitism is not acceptable.

It may be helpful to remind ourselves of some figures as, sadly, racism and discrimination remain embedded challenges within the NHS, affecting both staff and patients, as acknowledged by the noble Baroness, Lady Gerada. It is worth noting that 28.6% of NHS staff in 2024 were from ethnic-minority backgrounds. That was around 450,000 people, yet only 12.7% of senior managers came from those backgrounds. The 2025 NHS staff survey found that ethnic-minority staff were more likely to experience discrimination from managers and colleagues: that is 13.9% of ethnic-minority staff compared with 6.51% of white staff. Some 29.16% of ethnic-minority staff experienced harassment, bullying or abuse by patients and by the public, compared with 23.54% of white staff. It is important to further strengthen legislation as there are gaps.

The Equality Act 2010 prohibits racial discrimination, harassment and victimisation. However, significant weaknesses remain. The public sector equality duty requires organisations to “have due regard to” equality but does not guarantee measurable improvements. The NHS equality standards lack sufficient enforcement and meaningful consequences for persistent institutional discrimination. Will the Minister consider how the Government can strengthen this further, particularly as reporting, investigating and addressing racism remains inconsistent, with inadequate protections and support for whistleblowers? How will the Government address this? There is no sufficiently robust uniform accountability framework ensuring that perpetrators and senior leaders face consequences, as the noble Baroness, Lady Gerada, stated. Will the Government consider developing such a framework on all forms of discrimination? This would also support the 2026 review by the noble Lord, Lord Mann, which reinforces the need for stronger investigations, transparency and organisational accountability.

[Lord Patel of Bradford (Non-Afl)]

My Lords, I strongly support the intentions behind these amendments. Two practical issues are leadership and accountability, and the protection of those who speak out.

Tackling antisemitism and racism must be a clear responsibility of NHS leadership. These issues should be included in the performance objectives of every chief executive in the NHS—I have done this in the past. The boards would be required to monitor them and hold the executives and themselves to account. I am sure the CQC could incorporate this into its well-led reviews and make sure it happens. It is not enough to have policies and training programmes; we need to know whether they are making a difference and who is responsible when they are not.

Secondly, we must protect those who report racism or antisemitism. Too often, staff are reluctant to speak out because they fear the consequences for their careers or their relationships with colleagues. We need clear reporting arrangements, protection against victimisation and retaliation, and independent routes to raise concerns if senior managers themselves are involved. I hope the Minister agrees that we should hold boards and NHS chief executives to account and properly protect those who call this out.

Children’s and Young People’s Mental Health Services

Lord Patel of Bradford Excerpts

Thursday 2nd July 2026 Lords Chamber

[Baroness Merron (Lab)]

The mental health of children and young people is completely fundamental to the new strategy, which will cover all ages and be published later this year. But what really needs to be done, as I know the noble Baroness is aware, is to transform mental health care in this country, because the system currently responds too late, is not reducing waiting times and is allowing distress to escalate before intervention. The strategy will work to turn all that around, because we need that system-wide change.

[Lord Patel of Bradford (Non-Afl)]

My Lords, the Children’s Commissioner’s report is a timely reminder that we continue often to respond to crisis rather than preventing it. Twenty years ago, during the passage of the Mental Health Act, Parliament strengthened the safeguards around the admission of children into adult psychiatric wards. That should happen only in exceptional circumstances and only with specialist assessments. At that time, more than 350 children had been admitted, some as young as 11, into adult psychiatric wards. Ten years later, the figure was exactly the same. Can the Minister tell the House what the position is today? Also, what further action is being taken by education and community services to prevent that crisis in the first place?

[Baroness Merron (Lab)]

I do not have the figures the noble Lord very fairly asks for, but I will certainly ensure that they are provided. He will be aware that Parliament recently passed the Mental Health Act, which updated the Mental Health Act to which he referred. The real issue here is about a move to prevention rather than waiting for crisis. That is our whole direction of change.

Prostate Cancer Screening: AI

Lord Patel of Bradford Excerpts

Thursday 18th June 2026 Lords Chamber

[Baroness Merron (Lab)]

I wish the noble Lord well as he deals with the diagnosis. I am sure that many would associate with his kind comments about the NHS care he has received.

I very much agree that early diagnosis is key. That is why we have introduced the first targeted prostate cancer screening programme. It will roll out next year and will focus on those at the highest risk. To the noble Lord’s question on AI, there is a whole range of ways in which we will gather the information necessary—for example, developing a new National Institute for Health and Care Excellence clinical knowledge summary. That will support discussions for those men who are not eligible for this programme. Also, through the cancer programme innovation open call, we will pilot the use of AI to assist radiologists using MRI to detect clinically significant prostate cancer. There is much scope in this area, and indeed our 10-year plan confirms that.

[Lord Patel of Bradford (Non-Afl)]

My Lords, while artificial intelligence may improve the interpretation of diagnostic tests and support earlier identification of prostate cancer, does the Minister agree that technology alone will not reduce late diagnosis unless it is embedded within a wider prevention and early detection strategy? What steps have been taken to ensure that AI tools are integrated into primary care pathways, with targeted outreach to high-risk groups, particularly Black men, and equitable access to different communities?

[Baroness Merron (Lab)]

Yes, I agree with the noble Lord. While we are ambitious about the benefits of AI and wish to embrace them, we are equally clear that safety, fairness and public trust have to come first. That means that the National Commission into the Regulation of AI in Healthcare, which was established by the MHRA, will review the current regulations and provide the recommendations for a new regulatory framework. I assure your Lordships’ House that AI always will support professionals, not replace accountability.

Integrated Care Boards: Budgets

Lord Patel of Bradford Excerpts

Wednesday 17th June 2026 Lords Chamber

[Baroness Pidgeon (LD)]

My Lords—

[Lord Patel of Bradford (Non-Afl)]

My Lords—

[Captain of the Honourable Corps of Gentlemen-at-Arms and Chief Whip (Lord Kennedy of Southwark) (Lab Co-op)]

We will hear from the Lib Dem Benches.

[Baroness Merron (Lab)]

In February 2025 we published an overview of core community health services, Standardising Community Health Services, in order that ICBs should not just bear it in mind but act on it when planning for their local populations. I know that noble Lords are aware of this, but I often remind myself that ICBs are the best place to ensure that local health services meet the needs of local people. To assist the noble Baroness, we have also set very clear ambitions in our medium-term planning framework that mean that, by 2028-29, at least 80% of community health service activity should take place within 18 weeks, which would bring it in line with targets for elective care.

[Lord Patel of Bradford (Non-Afl)]

My Lords, Sir Chris Whitty produced a report on coastal health that exposed deep and persistent health inequalities in many of our coastal communities. Coastal communities, about 55 towns, make up nearly 20% of the UK population. Five years later, can the Minister tell the House what has changed as a result of that report? How will integrated care boards be encouraged to invest in prevention and community-based services in those areas? They are big enough to have problems but not big enough to have the infrastructure surrounding them.

[Baroness Merron (Lab)]

I take the noble Lord’s point, but allocations take account of factors such as rurality and the different costs of providing care. For example, the formula says that reflecting longer travel times in sparsely populated areas for emergency ambulances, which would make the costs higher, is permitted; travel time for community services also reflects that additional time. The financial allocations are far more sensitive to the needs of local areas than they have been.

Drug-related Deaths in England and Wales

Lord Patel of Bradford Excerpts

Tuesday 26th November 2024 Lords Chamber

[Baroness Merron (Lab)]

As always, I pay close attention to the contributions of my noble friend, who makes helpful observations. We do indeed need to continue our work in this area. It is quite important to look back at the history that Dame Carol Black reported on. She talked about one of the difficulties being that funding for community drug and alcohol services was subsumed into the public health grant in 2013, which meant that by 2019-20 funding for those services had been reduced by over a third. That is a £212 million disinvestment. The result of all this is that drug use has increased, with all the major indicators of its harm. This is something we need to turn around.

[Lord Patel of Bradford (Non-Afl)]

My Lords, I echo what the Minister has just said. The last Labour Administration set up the National Treatment Agency for Substance Misuse and ring-fenced £800 million to provide treatment when drug users needed it. It reduced drug-related crime, drug use plateaued, and drug-related deaths were at an all-time low. Sadly, this funding was pulled suddenly, which resulted in the highest level of drug-related deaths ever, with drug use on the increase and drug-related crime going up. Can we go back to some of the sensible ideas we had about providing treatment for drug users?

[Baroness Merron (Lab)]

My ministerial colleague Andrew Gwynne will be looking at how we improve drug and alcohol addiction services. In the light of recent Office for National Statistics data, the Office for Health Improvement and Disparities has an action plan to reduce drug and alcohol-related deaths. Because of this recent data showing major increases, it will review the plan to make sure it is properly grounded and effective.