NHS Integrated Care System Boundaries

Baroness May of Maidenhead Excerpts

Tuesday 29th June 2021 Commons Chamber

[Mrs Theresa May (Maidenhead) (Con)]

I congratulate my hon. Friend the Member for Harwich and North Essex (Sir Bernard Jenkin) on securing this debate, and thank him and the Minister for their courtesy in agreeing that I could speak briefly in it.

I want to focus, first, on my local integrated care system. The majority of my constituency is covered by the Frimley ICS, as is the rest of east Berkshire. I know that the comments I am going to make are supported by my hon. Friend the Member for Bracknell (James Sunderland), the hon. Member for Slough (Mr Dhesi) and my hon. Friend the Member for Windsor (Adam Afriyie). Frimley ICS is one of the best performing and most effective ICSs in the country—arguably, it is the best performing and most effective ICS in the country. That has been achieved by partnership working across county boundaries and across local authorities. It has been achieved by people coming together, working together in a network of partners whose aim has been to provide the best possible outcomes for our constituents. Yet now the Government want to break it up—why? It is because it is bureaucratically neater to align an ICS boundary with a local authority boundary. I understand that in this instance one local authority leader argued that his local authority should be covered by a single ICS and therefore the boundaries should be the same.

I refer the Minister to the White Paper, which says:

“Frequently, place level commissioning within an integrated care system will align geographically to a local authority boundary”.

It says “frequently”, not in every case, at every occasion or in every ICS we are looking at, so it is not necessary to align every ICS with a local authority boundary. Frimley ICS is supported by all the GPs and healthcare providers in east Berkshire, and by GPs and others in Hampshire and Surrey, which Frimley ICS also covers. Frimley ICS is supported by all the east Berkshire local authorities, all the east Berkshire MPs, who, as my hon. Friend the Member for Harwich and North Essex pointed out, were not consulted as part of these proposals going forward. Our message collectively to the Government is a very simple one: Frimley ICS is working well, it provides excellent services to our constituents, do not break it up. Far from breaking it up, Frimley ICS should be a template for ICSs across the rest of the country. The message can be put more simply: if it ain’t broke, don’t fix it. That is particularly important at this point in time. The NHS has been under intense pressure during the pandemic, but as we come out of the pandemic it is also under increased pressure with the backlogs in surgery and in the provision of other services, and with the increasing pressures there will be on mental health services. Are we to say at this time to people working in the NHS, “What we want you to do is to go away and break up this thing that you’ve brought together and worked very hard to ensure is working so well, and create entirely new ones.”? In the case of Frimley, three ICSs would probably be created as a result. That can only lead to a disruption in services. Who suffers from a disruption in services? The people who suffer will be our constituents.

As we heard from my hon. Friend the Member for Harwich and North Essex and in interventions, Frimley is not the only ICS that is under threat where Members of Parliament are concerned about the impact on their constituents. That brings me to the concept that underpins the White Paper—primacy of place. “Place” is not defined simply by a local authority boundary. A local authority boundary defines the area of the local authority, but primacy of place has a deeper meaning. It involves people’s behaviour and natural networks. In East Berkshire, our acute hospital is Wexham Park in Slough and is part of the NHS Frimley Health Foundation Trust. The natural geographical area for East Berkshire to be part of is the Frimley health trust area. That makes common sense to people—those working in the NHS and our constituents.

So much hard work has gone into ensuring that we have an ICS in our area that delivers for our constituents. I hear the same from other hon. Members in the debate this evening. I therefore ask the Minister to do what reflects the natural networks that define primacy of place and not to destroy the good will that has gone into making those partnerships work. Do not break up Frimley ICS. Just for once, let common sense prevail.