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 the proposed reforms in the Bill aim to continue to improve the quality of these services and patient outcomes.
As we build back 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. 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.
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 Nigel Edwards, the Chief Executive of the health policy think tank the Nuffield Trust, that these proposed reforms would allow GPs, hospitals, community services and social care to “work better and more effectively together” in the longer term are reassuring.
It is irresponsible scaremongering to suggest that Integrated Care Systems 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.
Let me be absolutely clear: this Conservative Government will never privatise the NHS.
The use of private providers and the voluntary sector in the delivery of NHS services is not a new concept, with the previous Government introducing the independent sector and competition into the NHS between 1997 and 2010.
The NHS is something to be valued and protected which is why I support the commitment to properly funding the NHS. Since 2010 the NHS budget has increased every year, and I am happy to say that despite challenging financial circumstances, the annual budget of the NHS is being increased by £33.9 billion by 2023/24, which has been enshrined in law. In addition, the NHS Long Term Plan commits £4.5 billion in primary and community care to help strengthen local healthcare networks.
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 Bill 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.
Competition in the NHS should act as a means to an end in improving services for patients, never as an end in itself.
I spoke in the Second Reading debate on this Bill in the House of Commons, and you can read my speech below. I have also set out my views on some specific amendments to the Bill below.
New Clause 49 – Cap on Care Costs
I am extremely supportive of the Government’s determination to reform, update, and make fairer social care. Indeed, Andrew Dilnot has welcomed the Government’s reforms.
However, while the Bill has some details of the proposed new social care system, at present the promised White Paper and Impact Assessment containing full details to allow for detailed analysis have not yet been provided.
This is disappointing and means it is highly difficult for me to ensure that the reforms will benefit everyone in Wimbledon, Raynes Park, Morden and Motspur Park.
Overall, the Social Care reforms will make the existing means test far more generous. The upper capital limit will increase from £23,250 to £100,000, which will make many people with moderate assets eligible for some state support towards the cost of care earlier, and the lower capital limit will also increase, from £14,250 to £20,000. Below that level, people will contribute only from their income, fully protecting their savings and assets below £20,000.
In addition to this, the Government put forward an amendment to the Social Care Bill to clarify that, for the purpose of calculating the new £80,000 cap on the costs that individuals face in paying for their care, only direct contributions from individuals, and not local authority funding, will not contribute towards the cap.
I had a meeting with the Secretary of State for Health to ensure I understood the Government’s intentions.
I abstained on this amendment. Although there is a reasonable argument for this policy, in that the cap is designed to recognise individual expenditure, not state expenditure, I could not verify the claim that no-one would be worse off. Had the full proposals been published in September, this would have given us an opportunity to assess the policy fully and holistically.
As and when the White Paper is published, I will reconsider the New Clause with all available evidence.
I am urging the Government to fully set out their plans as soon as possible, and I hope this will be done before the House of Lords has returns the Bill to the House of Commons.
Amendment 10 – NHS Workforce Planning
Jeremy Hunt tabled Amendment 10, which would require the Government to publish independently verified assessments every two years of current and future workforce numbers required to deliver care to the population in England.
I supported the aims of this amendment, as this was an issue I worked on as Minister of State for Health.
However, I was concerned about the lack of specificity in the technical wording of the amendment, and therefore I abstained on the vote.
The amendment did not set out a precise definition of an “independently verified assessment”, therefore it was not clear who should provide such verification.
I hope the House of Lords will re-examine this amendment and propose new wording which defines in in more detail the process and threshold required for the assessment to be truly independently verified.
If an amendment is flawed, or unworkable, I cannot vote for it, even if I support its overall aims. I have always tried to be a pragmatist, and as a Member of Parliament I have a duty to ensure legislation is as clear and effective as possible.
New Clause 19 – Cancer Diagnosis
I was one of the signatories to New Cause 19, tabled by John Baron MP.
This new clause aims to improve cancer survival rates by encouraging the NHS to diagnose cancer earlier – which greatly increases the chances of successful treatment. New Clause 19 also places outcome measures (e.g. one-year survival rates) over process targets (e.g. 62-day waits).
This new clause was accepted by the Government and as a result no vote on it was necessary.
Various Amendments – Virginity Testing
In July, the Government promised in the violence against women and girls strategy that virginity testing will not be tolerated in the UK and will be banned
I was pleased therefore that the Government have kept this promise and have introduced amendments to create three offences:
- conducting a virginity test;
- offering virginity testing;
- and aiding or abetting another person to conduct a virginity test in the UK or on UK nationals overseas.
Each offence will carry a maximum penalty of five years’ imprisonment and/or an unlimited fine. This sentencing reflects the long-term physical and psychological damage that this repressive practice can cause.
Amendment 25 – Independence of the NHS and Integrated Care Boards
Some constituents have contacted me with concerns about the independence of Integrated Care Boards.
In response to these concerns, New Clause 25 was tabled by the Secretary of State for Health, prevents the appointment of a member of an integrated care board if they could reasonably be regarded as undermining the independence of the NHS because of their involvement in the private healthcare sector or otherwise.
This amendment was approved by the House of Commons without a vote.
Amendments relating to Abortion
The amendments on abortion were not selected by the Speaker for a vote. I have always believed that any proposed changes to our current law will need careful and specific examination. I believe it was not appropriate to try to add them to this Bill.
Stephen Hammond MP - (Wimbledon)
Health and Care Bill Speech - Wednesday 14 July 2021
I want to make three quick points in my short contribution today.
The NHS is a great institution because it has wonderful, dedicated and selfless people working in it. That was recognised by the Department in the people plan, on which clause 33 builds. I had wanted to make other comments about the workforce but, frankly, they have made more ably by my right hon. Friend the Member for South West Surrey (Jeremy Hunt). I support exactly what he said. I encourage the Minister to listen to his comments about the need for a long-term plan and perhaps for the duty to be shortened in time, as well as about Health Education England. All my right hon. Friend’s comments were admirably sensible, as we have come to expect.
I welcome the new powers of direction, and I want to counter some of the criticism in the House about them. The newly merged NHS England and NHS Improvement have a range of new functions. Despite what the shadow Secretary of State, the right hon. Member for Leicester South (Jonathan Ashworth), said, it is clear that the powers of direction will apply only if they are in the public interest and if they relate to the functions. Given the new scope and scale of those functions, it seems right that accountability—and possibilities for the accountability needed in the future—be put in place.
Likewise, I encourage the Secretary of State not to listen to criticisms of political expediency and political interference with respect to reconfiguration. All too often, it is not political expediency but political acrimony that trumps political need. All too often, reconfiguration that would benefit our constituents and the health of this nation is held up. Far from meaning that every bedpan in the NHS will be looked at, reconfiguration is a sensible move. Quite rightly, the reconsideration will still be done by the Independent Reconfiguration Panel, and it is right that if the Secretary of State has the chance to look at those reconfigurations earlier, it should too. I strongly encourage my right hon. Friend to ignore the criticism and to proceed with that power.
My third point is on the prevention aspect of the Bill, which I warmly welcome. Obesity is a UK-wide health crisis. More than 60% of adults in the United Kingdom are above a healthy weight. Some of the measures may well be discussed in Committee, and there may well be some changes in Committee, but the thrust of the measures is correct. We in this country need to recognise that health outcomes and inequalities are affected by not tackling prevention. The Bill starts that; I warmly welcome it, and I will be happy to support it.