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Andrew Selous

South West Bedfordshire

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Health and Care Bill

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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.

Campaign Responses

  • Access to Waterways
  • Adult Dependant Relative Visa
  • Adult Social Care
  • Afghanistan and Pakistan
  • Afghanistan: Nowzad
  • Afghanistan Refugees
  • Afghanistan Refugees (Christians)
  • Afghanistan Withdrawal
  • Age UK's Winter Warmth Campaign
  • Air Passenger Duty
  • Air Quality
  • Alcohol Duty
  • All-Party Parliamentary Groups (APPGs)
  • Animal Research
  • Animal Testing - Dogs
  • Animal Welfare Legislation
  • Animal Welfare (Kept Animals) Bill
  • Animal Welfare (Kept Animals) Bill: Cats
  • Animal Welfare (Kept Animals) Bill: Dogs
  • Animal Welfare (Sentience) Bill
  • Arms Exports
  • Arms Exports: Israel
  • Arthritis
  • ASRU Change Programme
  • Asylum Seekers and Refugee Resettlement
  • Asylum Support and Employment
  • Avian Influenza
  • Aviation Industry Concerns
  • Badgers and Bovine TB
  • BBC Funding
  • BBC World Service
  • Behaviour in Schools
  • Bite Back Better Campaign
  • Bomb Disposal and Whales
  • Bowel Cancer Awareness Month
  • Boycotts, Divestment and Sanctions
  • Breast Cancer
  • Building Safety Bill
  • Bus Deregulation
  • Business and Human Rights
  • Caged Farm Animals
  • Campaign - #CatchUpWithCancer
  • Cancer Research
  • Cancer Treatment
  • Carers and Unpaid Carers
  • Cash Availability and Acceptance
  • Child Deaths Worldwide
  • Child Maintenance Service (CMS)’s Collect and Pay Service
  • Child Poverty
  • Childhood Cancer Outcomes
  • Children Affected by Humanitarian Crises
  • Children with Sight Loss (Education)
  • Climate and Ecological Emergency Bill
  • Climate Change
  • Commercial Energy Prices
  • Consular Services in Afghanistan
  • Conversion Therapy
  • COP26
  • COP26 Commitments (100 Days)
  • Coronavirus: Clinically Extremely Vulnerable
  • Coronavirus: Coronavirus Act
  • Coronavirus: Debt Cancellation
  • Coronavirus: Face Coverings
  • Coronavirus: Face Coverings in School
  • Coronavirus: Hospitality Support
  • Coronavirus: International Travel
  • Coronavirus: Mandatory Vaccination
  • Coronavirus: NHS and Social Care Staff (Vaccines)
  • Coronavirus: Provision of Tests
  • Coronavirus: Regulations and Living with COVID
  • Coronavirus: Self Isolation
  • Coronavirus: Support for the Self-Employed
  • Coronavirus: Testing (Childminders)
  • Coronavirus: Travel Industry Support
  • Coronavirus: Vaccines (Developing Countries)
  • Coronavirus: Vaccine Passports
  • Coronavirus: VAT Threshold
  • Cost of Living
  • Courier Employment Rights
  • Cyprus
  • Dangerous Dogs Act
  • Deaths Related to the Benefits System
  • Defibrillators and the Automated External Defibrillators (Public Access) Bill
  • Dementia Research and Diagnosis
  • Democratic Freedoms in the UK
  • Deportation Flights
  • Derby County Football Club
  • Diabetes
  • Disability Benefit Assessments
  • Domestic Abuse (Serial Abusers & Stalkers)
  • Domestic Abuse (Time Limits)
  • Dr Liam Fox’s Down Syndrome Bill
  • Early Years Funding
  • Education and Development Globally
  • Elections Act
  • Elections Act - Blind and Partially Sighted Voters
  • Elections Act - Electoral Commission
  • Elections Act - First Past the Post
  • Elections Act - Joint Campaigning
  • Electric Scooter Trial Concerns
  • Electronic Communications Code
  • Elephants and Ivory Sales
  • End Child Poverty Coalition
  • Endometriosis and Polycystic Ovary Syndrome (PCOS)
  • Energy Charter Treaty
  • Energy Price Cap
  • Energy Security Strategy
  • Environment Bill
  • Epilepsy
  • Epilepsy: Personal Independence Payment (PIP)
  • Fairtrade Fortnight Campaign
  • Fire and Rehire Tactics
  • Fireworks
  • Football Governance
  • Football Index
  • Fracking
  • Free Trade Agreement with Australia
  • Fuel Duty and Prices
  • Fuel Shortages
  • Fur and Foie Gras
  • Future of the TV Licence
  • Gambling with Credit Cards
  • Gambling Regulation
  • Gas Boilers
  • Gaza
  • Gene Editing and Animal Welfare
  • Genetic Technology
  • Glue Traps
  • Good Law Project & Runnymede: Mike Coupe & Dido Harding
  • Government Contracts
  • Green Alternatives to Gas Boilers
  • Green Finance
  • Green Investment - 2021 Spending Review
  • Green New Deal
  • Guidance on Boycotts (Stop BDS)
  • Hamas
  • Hate Crime (Misogyny)
  • Health and Care Bill
  • Health and Care Bill: Integrated Care Boards and Private Sector Providers
  • Health and Care Bill: Privatisation
  • Health and Care Bill: Workforce
  • Health and Disability Green Paper
  • Heat Pumps
  • Hedgehogs
  • Hedgerows
  • HGV Driver Shortage
  • HIV and AIDS
  • Holiday Lets
  • Housing and the Queen’s Speech
  • Housing Emergency (Shelter)
  • Housing First
  • HS2 and the Environment
  • HS2: Cost Transparency
  • HS2: General
  • Human Rights Act
  • Hunting Act 2004
  • Illegal Immigration (Nationality and Borders Bill)
  • Improving Access to the Countryside
  • Independent Review of Children's Social Care
  • Intellectual Property
  • Interest on Student Loans
  • Introducing Extended Producer Responsibility: Glass
  • Islamophobia
  • Israel: Amnesty International
  • Ivory Sales
  • Jagtar Singh Johal
  • Jerusalem
  • Jim Fitton
  • Judicial Review
  • Julian Assange
  • Junk Food Advertising Ban
  • Keeping Primates as Pets
  • TV Licence Fee
  • Live Animal Exports
  • Liver Disease
  • Living Wage and Key Workers
  • Loan Charge
  • Local Electricity Bill
  • Maternity Services
  • Meadows and Grasslands
  • Medicinal Cannabis
  • Menopause
  • Mental Health
  • Mental Health Facilities
  • Mental Health Hubs (Children and Young People)
  • Midwifery Units
  • Migrant Channel Crossings
  • Modern Slavery
  • Motor Neurone Disease
  • Multiple Sclerosis
  • National Insurance Contributions
  • National Security
  • Nationality and Borders Act (Accommodation for Asylum Seekers)
  • Nationality and Borders Act (Clause 9)
  • Nationality and Borders Act (Clause 11)
  • Nationality and Borders Act (Overseas Asylum Processing)
  • Nationality and Borders Act (Unaccompanied Children)
  • Nazanin Zaghari-Ratcliffe
  • Neonicotinoids
  • New Plan for Immigration
  • NHS Pay
  • NHS Preparations for Winter
  • NHS Privatisation
  • Nigeria: Mubarak Bala
  • Non-Religious Belief (Human Rights)
  • Occupied Palestinian Territories
  • Offshore Wind
  • Oil Drilling and Cambo Oil Field
  • Online Marketplaces (Regulation)
  • Online Safety Bill (Internet Regulation)
  • Online Safety Bill (Misinformation)
  • Online Safety Bill (Pornography)
  • Online Safety Bill (Private Communications)
  • Online Safety Bill (Protecting Children from Online Porn)
  • Online Safety Bill (Suicide and Self-Harm)
  • Online Safety Bill (Women and Girls)
  • Onshore Wind
  • Onshore Wind (Planning)
  • Palestinian Human Right Defenders
  • Palliative Care
  • Pancreatic Cancer
  • Parental Bereavement
  • Parkinson's Disease
  • Pavement Parking
  • Peat
  • Plastic Pollution
  • Police and Sarah Everard Case
  • Police, Crime, Sentencing and Courts Bill
  • Police, Crime, Sentencing and Courts Bill (Climate Protesters)
  • Police, Crime, Sentencing and Courts Bill (Courts and Tribunals)
  • Police, Crime, Sentencing and Courts Bill (Data Extraction)
  • Police, Crime, Sentencing and Courts Bill (Parliament Square)
  • Police, Crime, Sentencing and Courts Bill (Protection of Retail Workers)
  • Police, Crime, Sentencing and Courts Bill (Protests)
  • Police, Crime, Sentencing and Courts Bill (Protests and Noise)
  • Police, Crime, Sentencing and Courts Bill (Protests Tactics)
  • Police, Crime, Sentencing and Courts Bill (Unauthorised Encampments)
  • Polluter Pays Bill
  • Prescription Charges
  • Primary School Assessments
  • Prisons (Violence) Bill
  • Private Rented Sector
  • Processing Asylum Claims in Rwanda
  • Proportional Property Tax
  • Prostate Cancer
  • Protection of Pollinators
  • Protests - Abortion Clinics
  • Public Inquiry on COVID-19
  • Public Sector Pensions
  • Public Service Pensions and Judicial Offices Bill
  • Puppy and Kitten Sales
  • Queen's Speech - Bill of Rights and Brexit Freedoms
  • Radiotherapy
  • Rail Vs Air Travel
  • Reforming Taxi and Private Hire Vehicle Licensing
  • Right to Work Checks
  • Royal Mail
  • Sarcoma UK Drop-In Session
  • Save Our Pubs (CAMRA)
  • Schools Bill
  • Schools Bill - Home Schooling
  • Sentencing (Dangerous Driving)
  • Sexual Harassment
  • Shared Parental Leave
  • Social Care Cap (Means Test)
  • Stamp Duty Land Tax
  • State Pension
  • State Pension Age
  • Statutory Sick Pay
  • Stop and Search
  • Support for Deaf Pupils
  • Support for People with Disabilities
  • Support for Renters
  • Support for Road Hauliers
  • Support for the Pig Industry
  • Support for the Travel Industry
  • Sustainable Fishing
  • Tax Avoidance
  • Teachers’ Pay
  • Tourism and VAT
  • Training Collars for Dogs
  • Transport for Disabled People
  • Trophy Hunting
  • UK Foreign Aid
  • UK Trade and Business Commission’s First Annual Report
  • Universal Credit and Working Tax Credits - £20 per Week Uplift
  • Universal Credit Standard Allowance for Those Under 25
  • Universal Credit (Under 25)
  • Universities: Antisemitism (IHRA Definition)
  • Uplands
  • Vaccinations for COVID-19
  • Valerie's Law
  • Vaping
  • VAT on Electric Vehicle Charging in Public Places
  • Violence Against Women and Girls
  • Voter ID
  • Voting System
  • Water Fluoridation
  • Water, Sanitation and Hygiene in Developing Countries
  • Wealth Tax
  • Welfare of Farm Animals
  • Women’s Health Strategy - Miscarriages
  • Young People’s Wellbeing

Andrew Selous MP South West Bedfordshire

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