Commons Sense

House of Commons · Ministerial Statement

Integration White Paper

09 February 2022 · 16 other contributors

Opened by Edward Argar Con Melton and Syston

Social CareNHS

Summarised by AI from the official record, so it can contain mistakes.

Read the full transcript on Parliament.uk

At a glance

Edward Argar raised concerns about integration white paper in the House of Commons. A government minister responded. Other MPs also contributed.

Key points

  • The minister announced the publication of an integration White Paper focusing on health and care services in England.
  • The White Paper aims to improve outcomes by fostering better collaboration and reducing system fragmentation.
  • The document seeks to establish clearer leadership and accountability for shared outcomes in local areas.

How the debate unfolded

MPs spoke in turn to share their views and ask questions. Here's what each person said.

Government Statement

Edward Argar

The minister announced the publication of an integration White Paper, focusing on making health and care services more integrated to improve outcomes for people in England. He highlighted the importance of collaboration during the pandemic and emphasised that despite progress made, there is still fragmentation within the system. The White Paper aims to create a clearer leadership structure with local leaders accountable for shared outcomes; increase transparency through better data sharing; streamline care delivery; enhance digital capabilities including shared health records by 2024; improve workforce training and mobility across health and social care roles; and overall, prioritise patient-centred care. The statement concluded with an acknowledgment of the need to build on existing legislation such as the Health and Care Bill.

Other contributors (16)
  • Karin Smyth Lab Bristol South

    Question

    Ms. Smyth criticised the White Paper's lack of detail on accountability, resource allocation, and how it aligns with existing legislation like the Health and Care Bill. She also pointed out that despite 30 years of similar aspirations, there is no new thinking or evidence to support its claims.

    Minister reply

    The Minister responded by emphasising the importance of learning from past experiences and building on current frameworks such as the Health and Care Bill. He highlighted plans for clearer leadership roles, better data sharing, and joint health and care workforce planning among other initiatives aimed at fostering integration and improving patient outcomes.

  • Karin Smyth Lab Bristol South

    Question

    The White Paper is criticised for being vague, lacking clear strategy, evidence, analysis of necessary resources and organisational changes, failing to address the relationship between health and social care systems, accountability, funding allocation, management of a joined-up system, and issues concerning children, young people, working-age adults with disabilities, informal workforce, and carers. There are no concrete plans to reduce waiting times or improve care quality despite pressures from austerity and the COVID-19 pandemic.

    Minister reply

    The White Paper sets out clear next steps for integration through integrated care boards, providers, and systems, building on existing legislation. It promotes place-based solutions and organic development, acknowledging best practices in localities. The paper explores further budget sharing beyond current section 75 of the National Health Service Act 2006. Despite criticism, it is noted that previous Labour governments had limited reform efforts compared to this Government's White Papers on social care and NHS funding.

  • Jeremy Hunt Con Godalming and Ash

    Question

    As one in the long line of former Health Secretaries with scars on their back, I warmly welcome this White Paper. There are three central elements to overcome: pooled budgets for vulnerable people, public access to electronic health records, and a single professional responsible for someone’s care.

    Minister reply

    On pooled budgets, section 75 of the National Health Service Act 2006 has worked well, encouraging cooperation between NHS and local authorities. On data access, individuals should be able to see their own data as it is their information. Regarding a single professional responsible for care, GPs are central; we need to encourage more people to choose general practice.

  • Martyn Day

    Question

    England is late compared to Scotland and Wales in moving towards integrated health and social care. What lessons have been learned from the devolved nations? Will the Minister discuss loosening Brexit and immigration controls with his fellow Ministers?

    Minister reply

    We are open to learning from the devolved Administrations. Since 2010, there has been a significant growth in NHS workforce numbers including around 30,000 more doctors and 38,000 more nurses.

  • Lucy Allan

    Question

    How will these plans ensure that local NHS bodies are accountable to the local people they serve?

    Minister reply

    These plans build on what we propose in our legislation. At the heart of the Bill are integrated care systems, bringing together elected local authorities, Healthwatch and the local NHS.

  • Stephanie Peacock Lab Barnsley South

    Question

    The clinical commissioning group in Barnsley says that it is struggling with unprecedented capacity issues. Can the Minister explain how we will tackle the crisis in waiting times through this White Paper?

    Minister reply

    Our plan to tackle waiting lists, published yesterday, includes investment and an approach to the workforce to bring down waiting lists. The White Paper builds on these plans and looks to improve how systems work together.

  • Andrew Murrison Con South West Wiltshire

    Question

    Can the Minister explain what practical consequences this will have? Can he end the awful business of people waiting for weeks in acute hospital beds?

    Minister reply

    Discharge of patients safely is vital. Through the national discharge taskforce, we are bringing together acute hospitals and local authorities to improve this situation.

  • Daisy Cooper Lib Dem St Albans

    Question

    My constituent Lynn is a powerful advocate for her husband Andy but has to repeat information time and time again. When will the White Paper make her life easier? Why is the Minister refusing to put that commitment to a workforce strategy into the Health and Care Bill?

    Minister reply

    Through care records, we seek to reduce unnecessary or duplicative interactions with the system. Since 2010, under this Government, there have been over 30,000 more doctors and 38,000 more nurses; in just the past year, around 11,000 more nurses and about 5,000 more doctors.

  • Philip Hollobone Constitutional Conservative/Democratic Unionist Party Kettering

    Question

    Inquired about Northamptonshire's proposals to provide domiciliary care by the NHS itself, highlighting issues with hospital beds being occupied by elderly patients awaiting discharge.

    Minister reply

    Acknowledged the innovative idea and expressed willingness to hear such propositions for improving patient outcomes.

  • Liz Twist Lab Blaydon and Consett

    Question

    Highlighted successful local initiatives in Gateshead regarding joint commissioning directorship, questioning the Government's claim of no action despite workforce shortages in both NHS and social care.

    Minister reply

    Acknowledged the importance of workforce planning and noted that government actions have encouraged collaboration through funding.

  • Richard Fuller Con North Bedfordshire

    Question

    Called for a special taskforce to look at quick wins in integration and asked about patient control over their medical records.

    Minister reply

    Agreed on the importance of outcomes-focused reform and expressed willingness to consider taskforces and data ownership by patients.

  • Margaret Greenwood

    Question

    Questioned the Government's privatisation agenda regarding delegated functions to private providers, citing concerns over intellectual property transfer.

    Minister reply

    Defended NHS principles while acknowledging a role for both voluntary and private sectors in service provision.

  • James Sunderland

    Question

    Thanked the Minister for retaining Frimley integrated care system boundaries and inquired about sharing successful practices across ICSs.

    Minister reply

    Confirmed that mechanisms exist for best practice dissemination and indicated openness to improving such systems.

  • Rachel Hopkins Lab Luton South and South Bedfordshire

    Question

    Inquired about democratic accountability of the single accountable person within health and care integration.

    Minister reply

    Confirmed that local authorities will be more directly involved with NHS at ICB level, maintaining importance of health and wellbeing boards.

  • Kerry McCarthy Lab Bristol East

    Question

    Asked about the impact of the statement on nursing professionals.

    Minister reply

    Emphasised ongoing efforts to increase nurse numbers and skills as part of broader NHS integration strategies, stating local flexibility in professional development.

Shadow Comment

Karin Smyth

The shadow responded critically, questioning the clarity and feasibility of the White Paper in delivering integrated health and care services. She criticised its lack of concrete plans, evidence-based analysis, resource allocation strategies, and accountability mechanisms. The Labour representative highlighted persistent challenges such as different governance structures for social care and NHS, underfunding, workforce shortages, and delayed patient access to care. She dismissed the White Paper as lacking substantial new ideas or effective management approaches, concluding that it does not address fundamental issues nor offer a solution to reducing waiting times.

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