Health Bill

Steff Aquarone Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[Helen Morgan (North Shropshire) (LD)]

I start by declaring an interest as a member of the all-party group on patient safety and as a vice-president of the Local Government Association, and also by welcoming the new Secretary of State to his place. I very much look forward to working constructively with him during the passage of the Bill.

We all know that our NHS is in desperate need of transformation. Hospitals are in chaos, social care is overloaded and getting a GP appointment is a huge challenge for many. Labour has promised to put patients and communities at the heart of the NHS, but I fear that the Bill does not fulfil that promise. The Government promised to sort out social care, but two years later they are still only part-way through a three-year review. They promised to treat mental health with parity, but although mental health accounts for 20% of the disease burden, its share of NHS budgets is falling to just 8.4%. The Government promised to protect women’s health, but the women’s health strategy published this year was significantly weaker than the men’s health strategy, which received 60% more funding for new research. Healthy life expectancy in the UK is stagnating, and adult social care is under ever more pressure, putting immense stress on the budgets of councils and other local authorities.

The reality in rural North Shropshire is that people struggle to get GP appointments, 12-hour waits in A&E have become normal and finding an NHS dentist is becoming impossible. The social care crisis has left Shropshire council’s finances in a dire situation. A real NHS reform Bill would have changes to social care, general practice and prevention at its heart. Instead, this Bill passes responsibilities around Whitehall, centralising more power with the Secretary of State, while chaos reigns following 50% cuts to ICB budgets.

Early in his term, the right hon. Member for Ilford North (Wes Streeting) promised that another top-down reorganisation of the NHS was the last thing he wanted to do. Yet the abolition of NHS England is exactly that—focusing on reorganisation at the top, while failing to deliver real improvements for patients and staff. It is true that NHS England has allowed Ministers to shirk responsibility and accountability, but its abolition has been poorly planned, leaving both ICBs and specialised commissioning in chaos. Instead of the Government’s advertised aim of creating a more community-based NHS, the Bill centralises power in Whitehall, giving sweeping Henry VIII-style powers to the Secretary of State. Such powers carry a real risk that political considerations could influence what should be operational decisions about how the NHS provides for patients in future. That is particularly concerning in the current febrile political climate, and the Government must ensure that protections are in place for what may happen in the future.

The Government have made 50% cuts to ICBs, but the Bill gives them new legal responsibilities, different structures and centrally directed spending objectives. It is indicative of a lack of planning that could plunge ICBs into chaos. Meanwhile, the removal of the integrated care partnership and the extension of ICBs to cover multiple local authorities raises unanswered questions about the future of social care planning. In Shropshire, the council already spends around 80% of its budget on social care provision. That has a monumental impact on all services, as constant savings have to be found. Removing the pooling of the better care fund among local authorities and ICBs will discourage integrated working between these bodies on social care. Given existing complications over the sharing of costs and social care provision, the chaos of that reorganisation may only exacerbate confusion.

It is also astounding that the Bill plans to remove the duty of GP representation on ICBs, along with local authorities and NHS trusts. The replacement of council representation with mayors is extremely problematic for the many areas that do not have a mayor, and it removes the local accountability needed to ensure true community representation. Like so much Labour policy, such changes risk benefiting concentrated urban areas, while letting down rural communities such as those I represent.

[Steff Aquarone (North Norfolk) (LD)]

My hon. Friend will be aware of clause 4 on reducing health inequalities, which I welcome. As a rural MP, like me, she will also know that access and outcomes are poorer in our communities. Does she agree that the Government should go further and ensure that the Bill explicitly refers to equality of access and outcomes for rural and coastal communities such as North Norfolk?

[Helen Morgan]

My hon. Friend will not be surprised to hear that I agree with his point.

ICBs are already overstretched and underfunded. In North Shropshire, both Shawbury medical practice and Prescott surgery in Baschurch are in desperate need of expansion. Community infrastructure levy money is available and land is earmarked for a new site, but progress is being held up by the ICB’s inability to agree notional rent. That situation is replicated across the country, and there is no sign of such problems being solved by the Government’s changes.

The plan to abolish Healthwatch will ultimately strip patients of their voice. There has been a statutory independent patient voice in the health and care system for more than 50 years. More than half of patients who experienced poor care in 2024 did not take any action, with many citing fears that giving negative feedback directly to the NHS might affect their ongoing treatment. That is why it is crucial that we have an independent patient voice, rather than leaving the Department or the ICB to mark its own homework.

We need only look at the devastating consequences of the failings uncovered during the Mid Staffordshire scandal, and the long list of maternity failings since, to see how important it is to have Healthwatch exposing challenges in the health service and listening to patient feedback, and how the CQC can fail in that operation. In Shropshire more than 200 babies are thought to have died due to maternity failures; in the reviews that followed, the one thing that came up time and again was that grieving parents were not listened to.

Patients and their families must have a voice. The new system will give no incentive to investigate such issues, which are invisible in the main performance metrics of the NHS. To see the value of Healthwatch, we need only look at the Cabinet Office King’s Speech briefing for the Bill, which refers to a Healthwatch report from May 2025 on missing medical records in order to make the case for the single patient record. I urge the Government to protect both national Healthwatch and local healthwatch organisations, and the independent whistleblowing routes that empower and advocate for patients.

The Liberal Democrats welcome the move to create a single patient record; that part of the Bill could prove to be the most transformational for patient experience and, most importantly, for patient outcomes. People are tired of endless NHS admin and of having to reconfirm their medical histories over and over to different medical professionals. Patient harm has often occurred where clinicians have not had a patient’s full medical history, and different parts of the NHS having access to the same patient information is clearly necessary. However, that must come alongside essential new privacy protections and safeguards for patients, particularly given the understandable concerns surrounding Palantir’s involvement with the federated data platform. We would introduce a health charter to set out guiding principles for data sharing across the NHS, ensuring that patients are in charge of their own data.

The Bill’s references to carers are welcome, as is the Secretary of State’s duty to promote the involvement of carers alongside patients in decision-making around care and commissioning. However, the Bill goes nowhere near tackling the social care crisis and demonstrates a pitiful lack of ambition on one of the biggest challenges we face. As I mentioned, the chaos caused by the restructuring of ICBs will only worsen the challenges that local authorities face in providing care for an increasingly ageing population. We want to transform the NHS so that patients are empowered to live more healthily, for longer and in dignity. The nation’s health is stagnating, with an ever-widening gap in healthy life expectancy between the country’s most and least deprived areas and growing pressure on adult social care.

Fixing social care is fundamental to our vision for the NHS. It is the key to providing a better quality of life for the frail and vulnerable, freeing up hospitals and building independence for an ageing population. It also empowers our constituents to live as independently as possible in their homes and near to their families and communities. We cannot fix the NHS and move care to the community while ignoring social care—yet the Bill ignores it and, as I have outlined, the changes to ICB commissioning will undermine the structures that are supposed to integrate social care with the NHS.

Liberal Democrat plans will give people control, rooting services in communities, listening to patients and making it much easier to see a GP. We will give patients a right to see a GP within seven days, reverse surgery closures and ensure proper personalised management of chronic conditions and frailty, with guaranteed access to a named GP for those patients. We will also protect the mental health investment standard so that we can rebuild community mental health services—something that this Government have failed to do— empowering individuals with poor mental health by intervening early and allowing them to access care in their community. Our maternity rescue plan will ensure that Britain is the safest country in the world in which to have a baby, offering one-to-one midwifery care and empowering women at this most important moment.

This Health Bill could have been a moment for real change. Liberal Democrats are clear about what real modernisation of the NHS would look like. Our vision for a reformed, community-based NHS is one where proper care and restored investment in public health ultimately cut NHS waste and empower people to live healthier and more independent lives. This Bill focuses on shuffling responsibility around Whitehall and gives the Secretary of State the role of chief micromanager. The Government continue to procrastinate over bringing in real change to fix social care, empower patients and save our NHS. In Committee and on Report, Liberal Democrats will use every lever at our disposal to deliver the transformation the NHS so desperately needs.