Health Bill (First sitting)

Peter Prinsley Excerpts

Tuesday 16th June 2026 Public Bill Committees

[Liz Twist (Blaydon and Consett) (Lab)]

I am co-chair of the Unison group of MPs, which is linked to Managers in Partnership.

[Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)]

I am a retired ENT surgeon and a fellow of the Royal College of Surgeons.

[The Chair]

Thank you very much. It will be helpful if you reiterate those declarations at the start of any speech or question, if they are relevant.

Examination of Witness

Dr Penny Dash gave evidence.

--- Later in debate ---

[Helen Morgan]

Q Jacob, how prepared are ICBs and local authorities to take on the healthwatch functions? Is there a concern that splitting the local healthwatch function will lead to a lack of joined-up focus on health and on the social care element that resides with local authorities?

Jacob Lant: I will pick up the second part of the question first. The majority of the worst experiences of care—the worst incidents, where people feel most lost—tend to be in the gaps between services. Hospital discharge is a really good example of where the transfer between the NHS and social care services does not always work in the best interests of patients. That sort of insight will be lost entirely under the current structure, unless we build in a requirement for ICBs and local authorities to share the intelligence that they are hearing and to work collaboratively to understand patient and care user experience. That then raises the question, “Why are we splitting them?” If they have to work closely together to comment on the worst experiences of care, I do not understand the rationale for splitting them.

In terms of preparedness, I said earlier that ICBs will not have any additional resource for doing this. They have their own engagement teams at the moment, but even those that have been doing this very well have been leaning on their healthwatch for many years to help them engage with seldom-heard communities and build additional capacity. I worry about the capacity of ICBs to deliver once that is cut, particularly given the headcount and budget reductions in ICBs generally.

Local authorities are probably more experienced in doing direct community engagement and more confident about their ability to pick up the responsibilities. Indeed, I suspect that many of them will continue to commission some sort of external support to help them do this, but their budgets will be restricted. They will get only half the money for healthwatch, so that will be a concern.

[Peter Prinsley]

Q I am an ENT surgeon. Why has there been no effective single patient record in the past? If there were such a thing, who would you give ownership of the data to?

Sarah Woolnough: We have had developments over many years in the direction of a single patient record. We have shared care records; we have attempts in different parts of the country to move in that direction. On the one hand, we have been held back by legitimate concerns about trust, privacy and the right safeguards, but some practical barriers have also held us back. For example—and this is really important to make the single patient record a success—what does it take to ensure that we achieve interoperability, that the data is cleansed and that penalties are followed through if providers are not sharing data? We need to back up any legislative and policy intent with the resource and measures needed to make it happen. That is perhaps a bit of the history of why it has not happened. Sorry, what was the second part of your question?

[Peter Prinsley]

Q Who would the data belong to? Would it belong to the patient or to the healthcare provider?

Sarah Woolnough: My reading of the legislation is that perhaps this issue is not quite resolved; the legislation does not seek to shift necessarily from having the GP as the data controller. Of course, there will be concerns as the record is brought together nationally. Ultimately, the data should belong to people and patients, but they rightly want to feel that it is protected and safeguarded appropriately through the system.

There are a couple of other points to make as we design this. This is a work in progress, so it is not neat in the sense that you cannot say, “This is exactly what a single patient record is, and this is exactly what it will be for evermore.” I think the policy intent is to build and develop it over time. To give one example, patients and the public being able to understand who has access to their records, and for what purposes, might be really helpful in the process of building trust and belief that their data is being well looked after.

[Peter Prinsley]

Especially if it were the case that the patient were the data controller.

Sarah Woolnough: Yes.

Jacob Lant: Whoever ends up being the data controller, the most important thing is that patients have a right to express how their data is used. That is where it is really important to keep things like the national data opt-out up to date, and to ensure that it is clear and accessible for patients to express how their data is used for secondary purposes.

That becomes much harder in a direct care scenario. If you restrict the sharing of data for direct care, you could inadvertently create a second-class system for people who are not in that. It is a really clear distinction. For secondary uses, we need a very clear opt-out, where people can understand how their data is used and express a preference.

[Gregory Stafford]

Q Sarah, when we were at the Health and Social Care Committee, you and your fellow panellists seemed to suggest that the Government could achieve what they needed to in the 10-year plan without this reorganisation. Could you delve into that a bit more and tell us why you think that is the case?

Sarah Woolnough: The Government have an incredibly ambitious agenda, which is partly articulated in the 10-year plan. Our ongoing concern has been that some of the biggest-ticket items that the Government rightly want to achieve to fundamentally shift power to patients—delivering a shift towards prevention, moving care closer to home and allowing more digital enablement—do not require this kind of legislation or a reorganisation.

I go back to my first answer: what is honestly the opportunity cost of doing some of this at the expense of more focus and attention on, for example, delivering care closer to home? There is a lot of energy and activity in that area, but the Government want to make really good progress over the next few years. To take that example, if you are really serious, you need to understand what the barriers are to delivering more care in the community, closer to people and patients, and wrapping services around patients. It requires you to flow money differently and to have a different incentive scheme, but that is nowhere near this piece of legislation.

Our worry has been about what is not in the Bill, and what is the rightly and fantastically ambitious agenda to improve health for people and patients, versus the opportunity cost of a largely technical piece of legislation that reorganises some central functions.