Health Bill

Steve Barclay Excerpts

Report stage
Monday 7th September 2026 Commons Chamber

[Anna Dixon]

I worked as a civil servant for the coalition Government, and I saw at first hand some of the duplication and confusion caused when NHS England was set up, so I welcome this Bill and the decision to abolish NHS England. However, reversing the fragmentation caused by the Tories’ failed reforms of the NHS will not on its own create a more integrated and joined-up service for patients and carers. That is why I have tabled new clause 106, which would require the Secretary of State to report to Parliament within six months of the Act passing on how well NHS bodies and local authorities are working together to integrate health and social care in England.

Having worked in the health and care sector, I know how vital it is to have integrated services, and I know as an MP, as I am sure do others, and from personal experience how devastating unco-ordinated care can be for patients, their families and our NHS. One of my constituents, Ellerie Carroll, was diagnosed with diffuse intrinsic pontine glioma, an inoperable brain tumour, in September 2024. Very sadly, she died in May this year, aged just nine. Ellerie and her parents, Freya and Christian, suffered in ways that are unimaginable, but it was a lack of co-operation between services that added to their suffering. To give just one example, after going for a MRI scan at Great Ormond Street hospital, Ellerie had to endure a repeated scan at Leeds General Infirmary in Leeds due to an inability to share results between hospitals. I hope that the single patient record, which the Bill also creates, will help to join up systems and reduce such problems.

We see disjointed care within the NHS between hospital and community services, but also between health and social care. Another constituent, Roger, in his 90s, had a fall and serious head injury last year. After the acute hospital treatment in Leeds, there was a failure in the NHS to join up his care with Bradford social services, resulting in delays to his discharge. He developed infections and delirium. After nine months of being moved from one hospital to another, and despite his wife fighting to get him home with support, he died in hospital. These are the consequences when our health and care systems are not integrated. It is also expensive. Around one in 10 hospital beds in England are occupied by someone who does not need to be there, often because community care or social care are not available.

Any reform of the NHS will ultimately fail unless we simultaneously reform adult social care. That is why I welcome the priority given to this issue by the Prime Minister and the commitment he made to bring forward the conclusion of the Casey commission. But even if we build a national care service, which we must, there is a risk if it does not work in sync with our national health service. It is essential that we place very clear obligations on all parts of the NHS to co-operate and integrate with social care.

I ask the Minister to set out in her closing remarks how she and the Secretary of State will monitor the Bill’s impact on integration, and how they will ensure co-operation remains a critical priority for the NHS—not just on paper, not just in law, but in the way that we all experience health and care in a joined-up way.

[Steve Barclay (North East Cambridgeshire) (Con)]

I rise to speak to clause 1 on the abolition of NHS England and clause 6 on promoting innovation.

What characterises the first of those is an announcement without any clear plan. That is what has driven the cost and confusion that a number of Members across the House have spoken about. Those in any doubt about that can just look at NHS England’s own 2025-26 annual accounts, which show that the costs are already more than £100 million higher than forecast and now sit at above half a billion pounds. I do not recall seeing that on election leaflets. Indeed, just six directors at NHS England are being paid over £800,000, and that points to the cost.

Sometimes such big figures are hard for constituents to get their heads around. Just to localise it to my own constituency, the Cambridgeshire and Peterborough ICB alone paid out £14 million in redundancies last year. It merged with a number of other ICBs to form the Central East ICB, yet we know hear from the Government that it should align with metro mayors, which means going back to exactly what it was before: the Cambridgeshire and Peterborough ICB.

That is just one of many confusions around the announcement. The hon. Member for North Shropshire (Helen Morgan) spoke about confusion over the timetable and what was described to the media as now an impossible timetable. We also saw reports in the media this weekend about the destination of staff in NHS England. Can they actually go into the Department, or will another body be set up because of the pay disparity between the two? All this is around 18 months on from the actual announcement.

The confusion seems to extend to the Government themselves, because they seem unable to answer pretty straightforward written parliamentary questions. Given the time limit, I will give just a few examples. I asked how many people have been hired to NHS England since the announcement of its abolition, not least given the huge cost—over half a billion pounds—of voluntary redundancies. Despite the deadline passing, the Minister has not answered the question. We know from another written parliamentary question that more than 1,000 jobs have been advertised. It is relevant to know, in an organisation that is paying people to leave, how many people it is hiring. I also asked how many people had accepted voluntary redundancy, another written parliamentary question that has passed the deadline without answer. The process is characterised by a lack of transparency.

[Graham Stuart]

My right hon. Friend is giving a typically punchy speech. Does he agree that every signal suggests that this measure has not been thought through? While the Government have conceded by saying, “Oh we’re going to have local government coming back onboard,” how could they have conceived of health and social care without local government being engaged? On every front, it looks as if they have not thought it through, abolishing everything from the safety inspectorate to Healthwatch England. We have a Government that are out of control, spending tens if not hundreds of millions on redundancies with no clear end destination in view, wasting a huge opportunity.

[Steve Barclay]

My right hon. Friend is absolutely right: the Government are spending millions of pounds and there is no plan. The measure was announced without working that out, it came as a surprise to many within the system, and it has had a chilling effect on many decisions.

That is not isolated. Just today, we had the complete shambles of local government reorganisation. On the last day before the summer recess, the then Secretary of State rushed to the House to push through an announcement, which the new Secretary of State for Housing, Communities and Local Government is now reversing, while the Chief Secretary to the Treasury is contradicting her by saying that the Government want to have a higher legal appetite for risk and fewer consultations. There is confusion across Departments, and the issues with clause 1, which a number of Members have spoken to, illustrate that.

Given the time limit, I will turn to clause 6. I do not doubt for a minute that the Health Minister and the Secretary of State—anyone in the Department—want to promote innovation. My right hon. Friend the Member for Godalming and Ash (Sir Jeremy Hunt) spoke a lot about capital to revenue switches in his book, and the pressure that takes away from innovation. As Health Secretary, I used to have a wry smile at the battles I had with him, when I was pushed by the Treasury to do exactly the same thing. The issue is not the lack of will; the issue is the alignment between procurement, regulation and clinical leadership, particularly in the colleges, as well as the ability to scale innovation—it is not about having more ministerial pilots.

Finally, because I am almost out of time, I will pick up on the Chair of the Health and Social Care Committee’s good points around data. When I was in the Department, my frustration was that I often had to go on open-source dashboards to get information that should have been available to me as a Minister, and I suspect that that is still the case. We should make data dashboards a common theme—the CSV files that the Department publishes are extremely difficult to access. Make data more transparent; it will help the debate in Parliament and, I dare say, it will help Ministers get more support.

[Janet Daby (Lewisham East) (Lab)]

I thank the Minister for the Bill. I put it on record that I am chair of the all-party parliamentary group on sickle cell and thalassaemia. I rise to speak to new clause 162. It is well known that the NHS commissions specialised services unevenly across England. I am confident that this Government’s ambition is to end the postcode lottery of specialised services, and I would like to hear more about that. New clause 162 is designed to do something simple: to ensure that Parliament can identify where inequalities exist, measure where they are improving and hold the Secretary of State to account when they are not.

I will make the case for the provision through the experience of people who live with sickle cell. Sickle cell disorder is the fastest growing serious genetic condition in England. It causes episodes of serious chronic pain, spasms and a crisis that will continue if left untreated. It can damage organs and frequently requires hospital care. When the crisis strikes, patients have to attend A&E and wait for hours, often only to be seen by medical staff who may have little or no familiarity with their condition. Due to past experiences, many sufferers do not trust the NHS to meet their needs, and stories of sufferers who have died in hospital due to complications, such as Evan Nathan Smith, are well known.

In 2021, the “No One’s Listening” report demonstrated that people with sickle cell need to be listened to. That report prompted NHS England to act. It initiated the sick cell and thalassaemia quality improvement programme, from which came seven pilot emergency department bypass units. These dedicated facilities allow sickle cell patients to avoid A&E and receive immediate care to bring a crisis under control. The service works, but there is a problem, which brings me to the new clause. When the APPG met last week, we heard from stakeholders that this progress is fragile. There are only seven bypass units across the country, and with the transfer of commissioning responsibilities under the Bill, there is a real and legitimate fear that what has just begun to be built will not be protected to continue.

--- Later in debate ---

[Karin Smyth]

I will not. We have heard a lot from the hon. Gentleman, and I want to make some clear points to the House this evening.

We have heard a great deal of discussion about commercial processes, and Members—including the hon. Member for Newton Abbot (Martin Wrigley)—have raised important points about data security, governance and ethical standards of contracts, and support for domestic suppliers and for voluntary, community and social enterprise organisations. Contracts involving NHS data and digital services must be subject to proper scrutiny. The Government’s approach is to assess risks on the basis of the nature of the data, service and supplier access. Crucially, we already have the tools that we need to carry out appropriate due diligence through legal powers and robust contractual provisions.

I agree with the spirit of new clause 108, tabled by my hon. Friend the Member for Liverpool West Derby (Ian Byrne). I fully recognise the importance of ensuring that the NHS does not inadvertently support exploitation or rights abuses. UK legislation already incorporates some international laws: for example, the Human Rights Act 1998 incorporates the European convention on human rights into UK law. Similarly, we can use existing legislation and guidance to exclude suppliers from NHS procurements. Both the Procurement Act 2023 and the provider selection regime allow us to exclude providers when there has been serious misconduct or illegality. For instance, we could exclude a supplier under the Procurement Act for breaches of modern slavery and/or human trafficking laws. We have very high standards and expect all suppliers —including whichever companies go on to provide the single patient record—to meet them.

On a related note, the Chancellor has already written to the Secretary of State to ask that the NHS procurement better support British industry. In the light of that, the Secretary of State has commissioned, within the health family, a review of strategic procurement pipelines to find opportunities for the new social value model to support more British jobs, skills and innovation. The First Secretary of State, my right hon. Friend the Member for Sheffield Heeley (Louise Haigh), who is leading work on procurement across Government, would be happy to meet my hon. Friend the Member for Liverpool West Derby as part of this important work as it progresses, and I can assure him that the actions that we take will be fully in line with the principle of international law.

[Steve Barclay]

Will the Minister give way?

[Karin Smyth]

I thank my hon. Friend the Member for Stroud (Dr Opher)—with his example of the sore throat—for his help in driving down demand for healthcare. Indeed, I thank Members in all parts of the House for their contributions to what has been an interesting and helpful discussion. Their expertise and their scrutiny will continue to strengthen the Bill.

[Steve Barclay]

Will the Minister give way?

[Rachael Maskell (York Central) (Lab/Co-op)]

Will my hon. Friend give way?

--- Later in debate ---

[Steve Barclay]

Will the Minister give way?

[Karin Smyth]

I will not. The right hon. Member was Secretary of State for Health twice, so he had his chance to put all the right things into legislation. [Interruption.] I am not helping my own sore throat.

As my hon. Friend mentioned, the Bill is about returning that democratic accountability directly to the Secretary of State. We have had a lot of pushback in different places, but that is what this Bill does. It returns accountability to the Secretary of State, it devolves that responsibility for delivering on the ground to NHS organisations, and, crucially, it empowers patients. Our new clause strengthens the Bill, and I commend it to the House.

Question put and agreed to.

New clause 96 accordingly read a Second time, and added to the Bill.

New Clause 97

Care and support: involvement of others and visitors

“In section 1 of the Care Act 2014 (promoting individual well-being), in subsection (3)—

(a) after paragraph (e) insert—

“(ea) the importance of the individual being able to involve other people in such decisions and of those people receiving the information and support necessary to facilitate that involvement;”;

(b) after paragraph (f) insert—

“(fa) the importance of the individual having appropriate opportunities to receive visitors;

(fb) in the case of a person who is provided with accommodation in a care home, the importance of them having appropriate opportunities to take trips outside of the care home;”.”—(Karin Smyth.)

Section 1(3) of the Care Act 2014 lists matters to which local authorities must have regard when exercising functions under Part 1 of that Act. The amendments refer to the importance of an individual being able to involve other people in decisions and to receive visitors etc.

Brought up, read the First and Second time, and added to the Bill.