Queen’s Speech

Lord Patel Excerpts

Wednesday 12th May 2021 Lords Chamber

[Lord Patel (CB) [V]]

My Lords, I congratulate the noble Baroness, Lady Blake, and the noble Lord, Lord Lebedev, on their brilliant maiden speeches and look forward to hearing more. To the right reverend Prelate the Bishop of Portsmouth I say thank you; like others, I will miss him and wish him well.

I will speak in relation to three areas mentioned in Her Majesty’s gracious Speech but will focus mostly on the health White Paper, with a brief reference to proposed legislation on education and research. The Health and Social Care Act 2012 passed into legislation despite a lack of consensus for it in the wider health service. This time there is a broader consensus, particularly in relation to a more collaborative approach to healthcare that the Bill proposes which includes local authorities, to help drive changes to benefit patients in the form of integrated care services driven locally. However, several areas will require very careful scrutiny.

These are unprecedented times for the NHS as it continues to respond to the pandemic and the worsening effect it has had on health inequalities, rising demand for services, an exhausted workforce and a huge backlog of care across acute, community and mental health services. The pandemic has shown how capable the NHS is when left to get on with the task of making rapid changes, creating partnerships and delivering world-class care. It is to be hoped that the Government produce a strategy to deal with the huge backlog in waiting lists for treatment and diagnostics before implementing any of the changes proposed in the Bill.

The proposed health Bill needs to be clear with regard to regulation, the nature of accountability, and avoiding duplication and increased bureaucracy. The proposals in the White Paper paint a picture of a very crowded field: health and care partnerships, the proposed integrated care system boards, NHS England, provider collaboratives, the commissioning groups, primary care networks, place-based working, and health and well-being boards, to mention but a few. The nature of the regulation, governance and accountability of these different bodies will need a great deal of scrutiny.

The Bill proposes sweeping powers for Ministers to direct and change at will the delivery of healthcare in 10 or more key areas. Such sweeping ministerial powers need transparent accountability to Parliament and the wider public. The House of Lords report The Long-term Sustainability of the NHS and Adult Social Care identified two key challenges facing the NHS: a clear plan to address the workforce problem and a long-term settlement to deal with adult social care, neither of which is being addressed in the White Paper. The Bill is an opportunity that should not be missed to put in legislation a long-term, costed, transparent plan for the health workforce to deliver safe, effective and high-quality care, including future projections. When it comes to the funding and delivering of adult social care, the gracious Speech said that the Government will bring forward proposals. As the health Bill is not likely to reach our House until the autumn, I hope that we will at least see a consultation document on social care by then.

I turn briefly to two other areas of legislation proposed in the gracious Speech: lifelong learning and research, including the creation of ARIA—the advanced research and invention agency. I support the Government’s plans to support further education colleges, which have long been deprived of funding. The plans in the further education White Paper, Skills for Jobs, need to guard against competition between higher education universities and further education colleges. Funding changes institutional behaviour but can also promote collaboration. For FE colleges to succeed and develop collaborations, they will need appropriate funding streams. I look forward to the debates.

Lastly, and briefly, I turn to proposals for research in life sciences and the creation of ARIA. While the Government have found the means to fund the UK’s subscription to Horizon Europe in the short term, I hope the Minister will confirm that future funding to Horizon Europe will not come from the current R&D funding. On ARIA, apart from its modest funding there are also issues of governance, independence and whether grants will be covered by the Haldane principle. There is also the issue to be explored in relation to government funding to take innovations to commercialisation. I hope the Minister will comment. I look forward to the debates.