Health Bill

Shockat Adam Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[Shockat Adam (Leicester South) (Ind)]

We all cherish the NHS, and all of us in this Chamber have a duty to ensure that anybody who does not believe in the basic principle that care should follow need, not wealth, must be nowhere near the jewel in our crown that is the NHS. I begin with primary care—or, indeed, the glaring inequality in primary care. Practices in the most deprived areas carry, on average, 300 more patients per fully qualified GP than those in the least deprived. That gap has grown by 50% since 2018. In Leicester—my constituency and my home—there are 1,985 patients per GP, which is significantly above the national average. The Bill introduces a statutory duty to reduce health inequalities and, under clause 24, to produce neighbourhood health plans, but a plan without the workforce to deliver it is a plan in name only.

I must also declare my interest as a practising optometrist. Clause 14 gives integrated care boards new responsibilities over primary care services, and the Bill transfers commissioning of NHS sight tests from a national framework to individual ICBs. I completely understand the logic of localisation, but I have already seen what happens in practice. In Coventry and Warwickshire, a community urgent eye care service that was diverting more than 13,000 A&E attendances per year was withdrawn at the end of 2025. In Hampshire, community glaucoma schemes have been moved back into hospitals. This is the postcode lottery in action.

Glaucoma affects approximately 700,000 people in the UK, with about half of them walking around undiagnosed. It causes irreversible sight loss, it increases the risk of falls, and it carries serious long-term costs for both the NHS and social care, and we now have the technology to address it more efficiently than ever. The iStent inject device can be inserted during routine cataract surgery in a single procedure, treating both conditions simultaneously. This is exactly the kind of innovation that the 10-year health plan calls for, yet uptake is inconsistent because there is no national commissioning guidance. I urge the Government to ensure that the single patient record supports consistent clinical decision making across the glaucoma pathway, and that integrated care boards are required, not merely permitted, to commission those procedures.

The Bill also abolishes NHS England, and we have heard much about that. History gives us cause for concern, especially when it comes to private finance initiative arrangements, which have cost the NHS tens of billions of pounds over decades.

Let me end by saying something about the Palantir question. The creation of a single patient record is welcome, but the vessel matters as much as the vision. The £330 million NHS federated data platform contract, awarded by the last Government and inherited by this one, raises serious and unresolved questions, and it must be addressed.

Health Bill

Shockat Adam Excerpts

Report stage
Monday 7th September 2026 Commons Chamber

[Apsana Begum (Poplar and Limehouse) (Lab)]

I rise to speak to new clause 108, tabled by my hon. Friend the Member for Liverpool West Derby (Ian Byrne), and new clause 34, tabled by the hon. Member for Newton Abbot (Martin Wrigley).

Countless numbers of constituents have contacted me about Palantir Technologies, telling me their concerns about the company’s involvement with Israel’s military and Trump’s ICE. Over 35 Members from across the House have signed my early-day motion calling on the Government to activate the break clause in the NHS federated data platform contract. The objection is not just about Palantir’s ethics, but about its operations under that contract. I share the concerns of many, including the National Data Guardian, about whether data identifiable to individual patients may be accessible by Palantir.

The potential success of the proposals on the single patient record and whether it manages to gain the confidence of the British public depends on the Government listening to these concerns, and making sure that issues around data access and limits, patient opt-outs and the data controller are resolved. I note that the hon. Member for Newton Abbot has tabled a number of other amendments related to data safety, which I support.

I also wish to speak in support of amendment 10, in the name of the hon. Member for North Shropshire (Helen Morgan), on ICB financing. I am deeply concerned by the introduction of a duty under clause 48 for each of the constituent bodies of the ICB to achieve financial balance. In east London, we are currently fighting against massive, eight-figure cuts to the East London NHS foundation trust, where workers have been on strike amid cuts to jobs in much-needed mental health services, all of which are being justified by reference to new requirements for financial balance across the trust. Under the provisions of clause 48, matters will be made much worse and the ability to shift and adapt capacity across the system will be rendered impossible. One of the reasons that this is so regrettable, particularly in an area like east London, where the need for mental health services is acute and rising, is that cuts to these services will simply lead to greater costs arising elsewhere. For that reason, I also support amendment 10, tabled by the hon. Member for North Shropshire, to place ICB spending on mental health services on a statutory footing.

I also support amendment 45, tabled by my hon. Friend the Member for York Central (Rachael Maskell), because I am concerned, as others are, about provisions in the Bill for the reorganisation of ICBs. The changes are among many aspects of this Bill that regrettably point towards a revival of marketisation policies from prior decades—policies that have now been largely discredited. To tackle the biggest health challenges that we face, we require partnership working, joined-up decision making between the NHS, local authorities and expert voices—a dialogue between providers and commissioners. Removing the potential for this type of dialogue appears to be a significant misstep, particularly for integrated care.

Turning ICBs into purchasers alone appears to be being done for the benefit of reinforcing a purchaser-provider split—a split that experts have said time and again does not work, and does not deliver improved performance and outcomes, or even value for money. While I am relieved that the Government are tabling their own amendment 60 to reverse the scrapping of local authority ICB membership, I remain in full support of amendment 45 in order to ensure that NHS trusts, and foundation trusts too, retain their voice in commissioning and public health decisions.

To conclude, the fundamental problem in the Bill lies in its adherence to a logic of marketisation. It is deeply regrettable that the Government are returning to the harmful public-private partnership model for capital investment and a rehashing of the private finance initiative disaster, the negative effects of which are still being felt across my east London constituency.

[Shockat Adam (Leicester South) (Ind)]

I refer the House to my entry in the Register of Members’ Financial Interests. I am a practicing optometrist and an officer for the APPG for eye health and visual impairment.

Sight is precious and none of us would like to lose it—but, sadly, 2 million people in this country are living with some form of sight loss today. On the Department’s own projection, that figure will rise to 2.7 million by 2030. Every day, 250 people in the UK start to lose their sight—one person every six minutes. Left unaddressed, that number is set to more than double to over 4 million by 2050. We are witnessing a growing problem, which, sadly, the Bill does not treat with the urgency it deserves.

Tonight, I urge the Government to strengthen this legislation in some specific ways. On governance, clause 21 rightly ensures that ICBs reflect local political accountability, but it says absolutely nothing about clinical accountability. Optometrists have no guaranteed voice in the rooms where commissioning decisions affecting their patients are made. It would be unthinkable to build localised healthcare without GPs at the table. It would be equally unthinkable to do so without pharmacists. I say to the Government plainly: optometrists have the expertise, the infrastructure and the systems already in place to relieve pressure on our hospitals, yet this Bill says nothing about it.

I want to see eyecare—glaucoma monitoring in particular, along with the management of minor eye conditions—commissioned consistently by every ICB in England and not left to a postcode lottery. Optometry already has what I call the TAC effect: it is trusted, accessible and capable. Commissioning it properly would reduce unnecessary demand on emergency departments, freeing them to focus on genuinely specialist cases while improving patients’ access to specialist eyecare where they need it.

A recent report by the Association of Optometrists has found that right now, 780,000 people—the equivalent of the entire population of Greater Nottingham—attend A&E with eye problems annually, at an average cost of £145 to the NHS per A&E presentation. That is £113 million a year. At least seven out of 10 of those people with eye problems could be successfully managed in a community optometry setting with the right service commissioning. Those stats reflect a lived reality for many across our country. If the new Government want to make smarter decisions with public money, they must consider that.

Finally, I turn to the single patient record. Proposed new subsection (7) to clause 51 should be amended so that it explicitly includes optometry in the single patient record framework, ensuring that optometrists have appropriate access to relevant patient information.

This Bill takes real and welcome steps in many areas, but more than 2 million people have already lost their sight—a number that none of us wants to see double to more than 4 million by 2050. Fundamentally, seeing should be a right, not a privilege, so I ask the Government to look again.

[Andy McDonald (Middlesbrough and Thornaby East) (Lab)]

I rise as the chair of the all-party parliamentary group on spinal cord injury to speak to amendments 103 and 104, new clause 160 and amendment 105 in my name. I thank the Minister for meeting me during the passage of the Bill and for her subsequent letter. I also thank the Spinal Injuries Association for its support for the APPG and, crucially, for people living with spinal cord injury. These amendments are not about preventing reform; they are about ensuring that when responsibility for highly specialised services changes, patients continue to receive safe, equitable and nationally consistent care.

Spinal cord injury is a relatively low volume but complex lifelong condition requiring specialist expertise, rehabilitation and long-term follow-up. National commissioning exists to prevent fragmented services and postcode variation. If commissioning moves to integrated care boards, we need confidence that specialist workforce capacity, national standards and the sustainability of specialist centres will be protected. I therefore ask the Minister to clarify how those safeguards will work in practice, particularly around workforce, rehabilitation and geographical variation. I also seek clarity on whether spinal cord injury services will transfer to ICBs and what criteria will determine that decision.

Amendment 104 and new clause 160 would provide national assurance and parliamentary accountability for outcomes, access, workforce and geographical variation. Amendment 105 addresses the single patient record. Specialist charities provide vital practical and peer support after life-changing injury, even where they are not part of the clinical care. That is why this appeal is so resonant. If we can engage with those providers at that early stage, the outcomes will undoubtedly be improved. The amendment would allow referral, with patient consent, to approved condition-specific organisations sharing only necessary information.

I will not press these amendments to a vote today. I hope that the Minister will consider further safeguards and clarification during the Lords stages of the Bill. The care and access to support for patients dependent on specialist services should not depend on where those patients live.