First and foremost, please be assured that I have the highest admiration for everyone who works in the NHS. The NHS saved my life when I was 24. It was there for me in my hour of need, and I always want to make sure that it will be there for everyone else who needs it, irrespective of the ability to pay. I also have two children who work in the NHS, so we are deeply committed to it as a family.
I completely agree that the unprecedented threat of the COVID-19 pandemic reminded us how vital our health and care system is to all of us. I want to assure you that the NHS will always be free at the point of use, and any proposed reforms will aim to continue to improve the quality of these services and patient outcomes.
As we build back better from this pandemic, it is right and necessary that our health and care services are at the forefront. The pandemic underlined not only the dedication and skill of those in this sector, but also the necessity of a broader, more integrated health and care system. I welcome the intention to develop more integrated care between the NHS, Local Government and other partners including the voluntary and community sector, which will be vital in tackling the factors that affect the long-term sustainability of patient services. The Bill will make permanent some of the innovations brought about by the pandemic. I understand that these proposed reforms will also include proper accountability mechanisms and give patients and the public the confidence that they are receiving the best care from their healthcare system.
I am proud to support a Government that is providing historic investment in health and our NHS, and is committed to funding our health and public services properly. Following the 2021 Spending Review, NHS England’s day-to-day budget is set to grow by 3.8 per cent on average up to 2024/25, supporting the NHS to tackle the elective backlog, deliver its Long Term Plan and ensure it has the resources needed to fight COVID-19. Spending on health services will increase from £133 billion at the start of this Parliament, to over £177 billion by the end: an increase of over £44 billion. Despite difficult financial circumstances, NHS investment has increased every year since 2010.
However, it is irresponsible scaremongering to suggest that Integrated Care Boards and Partnerships are being used to support privatisation, or cuts to NHS funding. The NHS will always be free at the point of use, and I believe these reforms will continue to improve the quality of NHS services and outcomes for patients. Ensuring every part of England is covered by an Integrated Care Board and Partnership is key to promoting local collaboration.
Service provision by the independent and voluntary sectors has been, and continues to be, an important and valuable feature of our healthcare system, which I fully support. That said, I do appreciate that there are concerns about private sector involvement in Integrated Care Boards (ICB). It is important that people are assured that the work of ICBs will be driven by health outcomes, not by profits.
I welcome therefore that the Government has amended the Health and Care Bill, putting beyond doubt that Integrated Care Boards will not be controlled in any way by the private sector. No one that could potentially undermine the NHS due to their involvement in the private healthcare sector should sit on an ICB. The Government’s amendment makes clear that no one may be appointed to an ICB who would undermine the independence of the NHS, either as a result of their interests in the private healthcare sector, or otherwise.
The Bill also includes proposals to give local people, local clinicians and NHS organisations more control over the way health and care services are delivered. However, in a democracy, the public and Parliament, rightly, expect to be able to hold to account the decision makers who oversee the health system and the performance of the NHS, so I welcome measures in the Bill to allow for this. Importantly, I am assured that individual clinical decisions are explicitly exempt from the scope of the powers for the Secretary of State.
The reforms set out in the Bill are vital to help our NHS build back better from the COVID-19 pandemic. Those in the system are telling Ministers that they are ready to implement the reforms and there should be no delay, and so, while I appreciate the concerns raised and will bear these in mind, I am satisfied that now is the right time to proceed.
Furthermore, primary care commissioners have long had the choice to commission services from a range of primary care providers. I believe it is crucial that local health commissioners have flexibility to commission partnerships, individuals and private and third sector organisations to deliver GP services to meet the specific healthcare needs of their local populations. Alternative Provider Medical Service Contracts (APMS) offer greater flexibility than national standard contracts, allowing commissioners to better meet local need and fill any gaps not covered by core general practice. Private and third sector providers play a vital role in the delivery of local services and must adhere to the same quality and safety standards as any other form of GP contractor.
I know that concerns were raised about the impact the Health and Care Bill may have on the commissioning responsibilities and I am glad that the Government amended the Bill at Committee Stage to ease these concerns. In the Bill as introduced, there was no specific reference to medical services. Instead, non-primary services were considered to be covered by broad provisions already in the Bill. The Government acknowledged at Committee Stage that the equivalent duties for clinical commissioning groups (CCGs) reference theses services and so the removal of an express reference to non-primary medical services generated concern. I am assured that there is no cause for concern. To avoid potential confusion, the Government decided to amend the Bill to put beyond doubt that ICBs are responsible for these services and replicate the current language applicable to CCGs, which I warmly welcome.
On procurement, the Bill proposes the repeal of a number of clauses in the Health and Social Care Act 2012, including Section 75 which placed requirements on local health bodies to competitively tender for some health care services “where it adds no or limited value”.
The Kings Fund, an independent charity, has said about the reforms: “This Bill will remove cumbersome competition rules and make it simpler for health and care organisations to work together to deliver more joined-up care to the increasing numbers of people who rely on multiple different services.”
The purpose of the data provisions in the Bill are to promote more effective data sharing across the health and care system, whilst requiring high standards of data protection (such as Clause 81) and ensure that data is only shared for the promotion of health.
In relation to changes to social care assessments outlined in the Health and Care Bill, I want to reassure you that the purpose behind Clause 80 of the Health and Care Bill is to avoid delays when people are ready to leave Hospital, which can lead to poorer patient outcomes.
As the Local Government Association - the body that represents local councils - has said, “the repeal of legislation related to delayed discharges is good news and paves the way for the continuation of discharge arrangements which have worked well during the pandemic.”
Overall, the measures set out in the Health and Care Bill deliver on the NHS’s own proposals for reform in its Long Term Plan. I believe these proposals have been developed in consultation with key stakeholders in this sector, and I am encouraged by the preliminary positive feedback received. In particular, the comments from the former Chief Executive of NHS England, who said that this Bill “will support our health and care services to be more integrated and innovative so the NHS can thrive in the decades to come”, are reassuring. The Bill is currently before the House of Lords for their consideration and will return to the House of Commons in due course. I look forward to scrutinising the changes that have been made and have taken note of the points raised with me.