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 joined up, 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 we have seen as a result of 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.
More broadly, I am pleased at the Government’s clear commitment to supporting the NHS and our wider healthcare system. The Government will provide the NHS with £33.9 billion in funding by 2023/24, which is the largest, longest funding settlement in the history of the NHS, and is confirmed in law by the NHS Funding Act. In addition, the NHS Long Term Plan commits £4.5 billion in primary and community care to help strengthen local healthcare networks.
However, it is irresponsible scaremongering to suggest that ICSs 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 ICS is a key way of promoting local collaboration.
Integrated Care Boards are given a range of powers and duties under the Health and Care Bill, and will oversee the local NHS in their area. This will help to improve care and integration between health and social care locally. They are statutory bodies controlled by NHS England. I welcome the ability, set out in the Bill, of local NHS leaders to propose their own constitutions for choosing members of the Boards. This means that Boards could include companies that provide major local NHS services. Boards must also include NHS leaders, GPs, council leaders and independent non-executives. Meetings will be held in public and decisions must be transparent. Any conflicts of interest will have to be declared and managed.
The Bill 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 on this and will bear these in mind, I am satisfied that now is the right time to proceed.
I completely agree that NHS managers have played a vital role throughout this pandemic. I am pleased that Chris Hopson of NHS providers, which represents NHS managers, agrees with these reforms that will end the “unnecessarily rigid NHS approach to procurement”. It is also welcome that this White Paper enacts the recommendations of the 2019 Kark Review for stronger measures to ensure that NHS senior managers have the right skills, behaviours and competencies. I understand that there are no plans at this stage to statutorily regulate senior NHS managers and leaders, and I will continue to monitor this closely.
NHS England and NHS Improvement are also working to ensure that senior managers and the wider leadership team represent the diversity of the NHS by refreshing the evidence base for action.
Separately, I wholeheartedly support the Government's commitment to recruit 50,000 more nurses, 6,000 new GPs, and 6,000 more primary care professionals in addition to the 7,500 further nurse associates and 20,000 primary care professionals announced previously. These commitments are vital to ensuring our NHS is fit for the long term. Progress is already being made in this area, with more than 6,500 more doctors, almost 10,600 more nurses and over 18,700 more health support workers compared with a year ago.
I am happy to say that there are approximately 70,000 nurses and midwives in training, including 29,740 who began courses this academic year, an increase of 26 per cent on last year. The introduction of the new Nursing Degree Apprenticeship and nursing associate roles will significantly bolster the nursing workforce in the short term, as we continue to build an NHS workforce for the future.
Further, the NHS Long Term Plan focuses on retaining staff by ensuring that they are well supported and able to develop their own careers; this ethos will underpin all planning for the NHS workforce.
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 Chief Executive of NHS England, who has 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.