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Integration White Paper
09 February 2022
Lead MP
Edward Argar
Debate Type
Ministerial Statement
Tags
NHSEmploymentStandards & Ethics
Other Contributors: 16
At a Glance
Edward Argar raised concerns about integration white paper in the House of Commons. A government minister responded. Other MPs also contributed.
How the Debate Unfolded
MPs spoke in turn to share their views and ask questions. Here's what each person said:
Government Statement
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.
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.
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.
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.
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.
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.
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
Shadow Comment
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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