Health and Care Bill

Baroness Winterton of Doncaster Excerpts

2nd reading
Wednesday 14th July 2021 Commons Chamber

Second Reading

[Madam Deputy Speaker (Dame Rosie Winterton)]

The reasoned amendment in the name of the Leader of the Opposition has been selected.

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[Jim Shannon]

It is just, Secretary of State, because you mentioned the issue I wanted to bring up about people getting older. I spoke to your colleague, the Minister for Health, yesterday and I am appreciative of that—

[Madam Deputy Speaker]

Order. The hon. Member really must not refer directly to the Secretary of State; it is through the Chair.

[Jim Shannon]

Recent statistics show that over 40,000 people under 65 in the UK have dementia, and many more have not been diagnosed as of yet. It would seem that these figures are not addressed in the Health and Care Bill, so can I ask the Secretary of State what more will be done to offer support to those suffering with dementia and Alzheimer’s in the UK through this social services care Bill?

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[Sajid Javid]

If it is on this issue, yes I will.

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. Just a reminder that interventions need to be short and to the point, because there is a lot of pressure on time in this debate.

[Tim Farron]

My point is about boundaries. Lancashire and south Cumbria have a perfectly reasonable boundary, but does the Secretary of State agree that there is concern that, because most rural communities are attached to bigger, more populated urban ones, that can lead to an imbalance in decisions? One of the proposals that our community faces is that the Preston and Lancaster hospitals could be replaced by a single super-hospital somewhere in the middle. HIP2—the health infrastructure plan 2—is a good thing, but that would be very bad thing, because it would mean that people in south Cumbria could have a two-hour round trip just to get to A&E. Will he intervene and ensure that any proposals under HIP2 that undermine access to healthcare in rural communities are taken off the table?

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[Sajid Javid]

The Labour party said it not just 10 years ago but in 2015, 2017 and 2019—in all those manifestos—so I am sure that its members agree with this direction. [Interruption.]

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. If Members want to intervene, let me say to them that the Secretary of State has been very generous in giving way, but just shouting at him is not working.

[Sajid Javid]

They are excited, Mr Deputy Speaker, and I understand that. Let me excite them much more.

The third theme of the Bill is greater accountability. We have never seen so clearly as we have in the past 16 months how critical the health of our constituents is for the House. The Government of the day always work hand in hand with the NHS to deliver that priority. That is what people would expect from a responsible Government. People also rightly expect there to be clear lines of accountability for how this priority is delivered. Accountability is the foundation of our democracy, and on that I hope we all agree.

On the nation’s greatest priority, our health, this Bill sets out clear lines of accountability to the people we all serve. The Bill simplifies what has been a complex structure, bringing the three different bodies that oversee the NHS into just one, as NHS England. NHS England will continue to have clinical day-to-day operational independence, but it is right that the NHS must be accountable to Ministers, and Ministers must be accountable to Parliament, where we are all accountable to the people we serve.

Naturally, that accountability will extend to these integrated care systems. The right hon. Member for Leicester South (Jonathan Ashworth) is on the record, in an interview with the Health Service Journal in December 2019, as saying that he agrees with the principle of the legislative changes that had been put forward by the NHS for “democratically accountable” ICSs. He cannot have any objection to this point. We will see what he has to say from the Dispatch Box.

I hope we can all agree that this is a sensible and pragmatic step. Let me quote once more:

“We will reinstate the powers of the Secretary of State for Health to have overall responsibility for the NHS.”

Those are not my words but the words of the 2017 Labour manifesto. I look forward to working with the shadow Health Secretary on this and other aspects of the Bill, and I urge him to set aside petty party politics and point scoring and do what the NHS wants him to do, which is to back this Bill.

Before I finish my opening remarks, I turn to the reasoned amendment in the name of the Leader of the Opposition and other Opposition Members. What is claimed by the reasoned amendment is entirely wrong. This is exactly the right time for these reforms. The response to covid-19 has quickened the pace of collaboration across health and social care, showing what we can do when we all work together, when we adopt new technology and when we set aside bureaucratic rules. The pandemic has also brought home the importance of preventing ill health in the first place. The Bill lays the framework to achieve all that.

More than that, this Bill is what the NHS has been asking for. It builds on the NHS’s long-term plan and the work the NHS has already started to do voluntarily. We have invested record sums in the NHS, both before and, of course, during this pandemic, and we will continue to do so.

The systems are telling us that they are ready, that they want us to go ahead with this Bill. They do not want to see any delay, which is why this is important work for all of us. Hopefully Parliament can deliver what the NHS is asking for.

The unprecedented challenges of the pandemic have only deepened our affection for the NHS, and it has reinforced the noble idea that the NHS is there for all of us when we need it. I started learning about the NHS from a very early age when I used to go to check-ups with my mum and translate for her. It was there for her, it has been there for me, it has been there for my family, it has been there for my children and it has been there for all of us and our constituents.

Even in this fast-changing world, with the new and evolving threats to our health, the founding principles of the NHS are as true today as they ever were. It is our responsibility to build on this incredible inheritance. Our NHS is the envy of the world, so it is right that this Government should work across health and care to shape a system that is truly fit for the future. Our colleagues in health and social care have achieved extraordinary things in the most extraordinary times, and we in this place must give them the firm foundations they need to build back better in the years that lie ahead.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Rosie Winterton)]

Before I bring in the shadow Secretary of State, I remind hon. Members that there will be an immediate three-minute limit on Back-Bench contributions. There is a countdown clock for those in the Chamber, and for those participating virtually, there will be a clock on the screens.