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Future of Health and Care
11 February 2021
Lead MP
Matthew Hancock
Debate Type
Ministerial Statement
Tags
NHSTaxationEmploymentMental HealthChildren & Families
Other Contributors: 33
At a Glance
Matthew Hancock raised concerns about future of health and care 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
Mr Speaker, I present a White Paper based on two years of work with the NHS, local councils, and the public. This White Paper aims to enhance integration between different parts of the health and care system, reduce bureaucracy, strengthen accountability, and support innovation and modern technology adoption. It proposes an integrated care system responsible for funding and supporting population health in each part of England. The legislation removes barriers that hinder decision-making flexibility while preserving division between funding decisions and provision of care. A unified national leadership structure is outlined through merging three bodies overseeing the NHS into one as NHS England, with clinical independence but Ministerial oversight to ensure public confidence in the system's responsiveness to needs. This White Paper supports ongoing reforms in social care, public health, and mental health services.
Paul Burstow
LD
Sutton and Cheam
Question
Given your aim to strengthen local decision-making in health and care, how will you ensure that decisions are not taken by a national government with little knowledge of local needs?
Minister reply
The White Paper aims to devolve more decision-making power locally while maintaining national oversight. It ensures that integrated care systems can operate autonomously on matters affecting their regions.
Kawsar Ali
Lab
Worsley and Eccles South
Question
Will the Secretary of State use his new powers to intervene in reconfiguration decisions, such as at North Manchester General Hospital?
Minister reply
The proposals enable national intervention when necessary, but it is a matter for local decision-making with oversight from central government.
Jon Ashworth
Lab
Delyn
Question
The MP questioned the timing of the reorganisation during a severe public health crisis, raising concerns about staff morale, wasted opportunities from previous reforms, financial accountability, governance structures, and lack of long-term plans for workforce, inequalities, and social care. He also asked how the new powers would improve patient care and narrow health inequalities.
Minister reply
The minister thanked Ashworth for his support and encouraged him to engage with the details in the White Paper. He emphasised the success of the vaccination programme due to effective teamwork and integration. The minister argued that now is the right time to remove bureaucratic barriers, enhance system integration, and ensure accountability.
Jeremy Hunt
Con
Godalming
Question
The MP welcomed the reorganisation but questioned how public knowledge of care quality, waiting list management, and overall performance can be ensured. He suggested that Ofsted ratings for ICSs could provide clarity.
Minister reply
The minister acknowledged Jeremy Hunt's predecessor work in setting up integrated care systems and emphasised the importance of transparency and clear accountability mechanisms. He stated that the combination of high levels of transparency, CQC inspections, and accountability to Parliament are critical elements of the proposed reforms.
Central Ayrshire
Question
Health and social care staff always do their best for their patients and residents, regardless of legislative systems. She welcomes the Government’s recognition of the damage caused to the NHS in England by the Health and Social Care Act 2012, and the proposal to reverse some of its most obstructive aspects. Which model of integrated care is proposed? Will he merge organisations or create new public NHS bodies? What additional funding is committed for this reorganisation?
Minister reply
The core measures of the Bill have been built on the asks of the NHS, working with local government. The reforms aim to spend money better to improve health outcomes and remove bureaucracy.
Bob Stewart
Con
Beckenham
Question
When I was in the Army, I received care from both the NHS and private practitioners. Many people ask if the Government intends to privatise the NHS. How much of the NHS is privatised as a percentage? Are plans to increase it?
Minister reply
The NHS is not privatised at all; it delivers care free at the point of use, according to need, and does not charge based on ability to pay.
Barry Sheerman
Lab
Huddersfield
Question
Supporting a review that makes NHS the best healthcare centre in the world. Why rush these reforms? Why not consult more across party lines and listen to those who work in or benefit from it?
Minister reply
The measures in this Bill have been built on consultations over two years, and we will continue to consult with parliamentarians before, during, and after passage of the Bill.
Wansbeck
Question
Supporting the drive for innovation and technology in healthcare. Could he look at making sites such as Burnley Hospital regional centres of excellence in areas like surgical robotics?
Minister reply
Yes, we care about technology to improve patients’ lives; it frees up clinicians' time and enables more high-quality surgery.
Tony Lloyd
Lab
Manchester Central
Question
Involvement with the Greater Manchester model of health and social care. Will he guarantee that there will be nothing that prevents the successful model already being pioneered in Greater Manchester?
Minister reply
The changes proposed will help areas like Greater Manchester to go further by ensuring fewer legislative barriers to actions they want to take.
Danny Kruger
Reform
East Wiltshire
Question
Frontline health and social care providers have shown flexibility, innovation, and collaboration. Will he assure that unlike Nye Bevan, he does not want to hear the sound of dropped bedpans in his office?
Minister reply
Yes, local decision making across a range of partners is important for serving local needs.
Feryal Clark
Lab
Enfield North
Question
The pandemic has highlighted health inequalities and the need for public health improvement functions. Why are there no clear arrangements for these vital elements in today's announcement?
Minister reply
Health improvement is embedded within the integrated care systems proposed in the White Paper, which aims to improve population health and reduce health inequalities. The precise organisational structure will be announced shortly.
Question
How does the White Paper address parity of esteem between mental and physical health as committed in the Health and Social Care Act 2012?
Minister reply
The integrated care systems will have responsibilities for both mental and physical health services, bringing together silos to provide comprehensive support, especially crucial given multi-morbidities.
Jim Shannon
DUP
Strangford
Question
How will the White Paper ensure cancer patients receive necessary scans and treatment during the pandemic?
Minister reply
Cancer alliances are working to improve outcomes and manage backlogs. The reforms aim to provide timely care, addressing patient concerns like those mentioned by the MP.
Question
Will the White Paper address inequalities through prevention measures as outlined in the previous Green Paper?
Minister reply
The White Paper includes proposals based on the previous Green Paper's work, emphasising prevention and personal responsibility to improve public health.
Munira Wilson
Lib Dem
Twickenham
Question
Why is there another NHS reform announcement without concrete social care reforms despite past failures?
Minister reply
The White Paper covers the integration of health and social care, which was crucial during the pandemic. Further funding work will be part of the upcoming Health and Care Bill.
Question
Can we have more pilot schemes to support the Isle of Wight's unique healthcare challenges?
Minister reply
Yes, I am keen to remove legislative barriers to closer integration on the Isle of Wight and work closely with local services.
Derek Twigg
Lab
Widnes and Halewood
Question
How will these plans address cancer backlogs in Halton and promote local accountability?
Minister reply
Devolving decision-making to integrated care systems aims to improve service delivery and accountability, working with the MP's constituents for high-quality healthcare.
Question
How will public health measures address obesity without increasing inequality?
Minister reply
Education is a key focus in tackling obesity. Personal responsibility and shared support are crucial to ensure that measures genuinely improve public health while being accessible.
Lilian Greenwood
Lab
Nottingham South
Question
A decade ago the Minister and his Conservative colleagues pushed through the Lansley reforms, even though NHS staff warned us that they would lead to fragmentation and waste. Why should we trust him now, given that he and his party got it so wrong then? How will he gain the trust and confidence of all NHS workers for his plans, and for the timing of these reforms?
Minister reply
The reforms set out were initiated from within the NHS and have received a strong positive reaction. The White Paper aims to increase innovation, integration, accountability, and better care delivery.
Lee Anderson
Reform
Ashfield
Question
Covid has changed the way we live and work. We have all had to adapt, and our NHS has been forced to find better ways of working. Can my right hon. Friend reassure me that our NHS will learn from our covid days, adopt some of the new measures in place and improve its performance over the coming years, while delivering on our commitment to recruit 50,000 more nurses and build 40 new hospitals?
Minister reply
Absolutely. The commitments to hire 50,000 more nurses and build 40 new hospitals are on track. The White Paper aims to foster a flexible and modern working culture within the NHS.
Imran Hussain
Lab
Bradford East
Question
A year and a half ago, we halted the dangerous back-door privatisation of key services in Bradford’s hospitals while Ministers sat on their hands and ignored the outcry of NHS staff and local people. The proposals in the press confirm what I and many others have long said about the disaster and waste of privatisation in our NHS—[Inaudible.]
Minister reply
The proposed changes were halted due to legal impossibility without a whole process, but the White Paper aims to make it easier for collaborative work on projects while maintaining accountability.
Gareth Davies
Con
Grantham and Bourne
Question
Can my right hon. Friend assure my constituents that bringing health and social care much closer together will help to provide a more efficient, higher-quality service? Can he specifically outline how an integrated care model may help to reduce demand for emergency services in Lincolnshire?
Minister reply
The goal is to deliver services according to local need, supporting people to stay healthy and reducing the need for emergency treatments.
Diana R. Johnson
Lab
Kingston upon Hull North and Cottingham
Question
Having been in Parliament in 2010, I voted against the Tory-Lib Dem coalition’s flawed reorganisation, the failure of which has led us to today’s announcement. As well as sharing concerns about having another reorganisation during a pandemic, what guarantees can the Secretary of State give that these changes will improve the health of my constituents when, under his plans, Hull will be lumped into an artificial hotch-potch of the Humber Coast and Vale ICS: an area of 1,500 square miles with cities, market towns and remote rural and coastal communities, with little transparency and no clear lines of accountability to local people in Hull, with our stark health inequalities?
Minister reply
Improving accountability is at the heart of the White Paper. We aim to implement measures by April 2022 and will need to ensure that ICS geographies are correct.
Question
The demands of the pandemic on Stockport Council, GP services and my constituency hospital, Stepping Hill, have shown the benefits of joint working and data sharing to improve care and health outcomes. We know that when bodies work together, people receive better care. Will my right hon. Friend confirm that the proposals will deliver a more streamlined system that will give seamless care and healthier outcomes for my Cheadle residents?
Minister reply
The goal is to have high-quality data sharing among GPs, hospitals, and care homes without repeatedly diagnosing patients.
Mohammad Yasin
Lab
Bedford
Question
In my constituency of Bedford and Kempston, patients are being left in unimaginable pain as they struggle to access even emergency dental treatment. Dental practices are struggling to stay open with the impact of covid on their businesses, and those who have survived are struggling to cope with the backlog. Imposing targets is not working, so will the Secretary of State include oral health in his future plans and agree a sustainable funding solution with NHS dentists to end the crisis in oral healthcare?
Minister reply
The Minister for dentistry will meet with the hon. Gentleman to discuss concerns.
Question
I welcome the proposals for more integration and collaboration between the NHS and social care. However, it is vital that these important reforms do not get in the way of investment in NHS capacity and the commitment to recruit 50,000 more nurses. Will the Health Secretary assure the House that they will not and that the Government remain committed to the badly needed new urgent care centres at Stepping Hill Hospital and Tameside Hospital?
Minister reply
Absolutely. The urgent care centres are important for access to treatment closer to home, and we have also introduced 111 First.
Dan Jarvis
Lab
Barnsley North
Question
Shamefully, the poorer people are, the younger they will die. That link between economic deprivation and health outcomes means that Barnsley is suffering one of the highest covid mortality rates in England. Health inequality is an incredibly complex problem, but it is avoidable. Does the Secretary of State agree that a key test of the reforms is whether they will tackle that injustice?
Minister reply
Tackling health inequalities is part of our levelling-up agenda and moving to a population health approach can help.
Question
A key element of the statement today is that it strengthens accountability to this House, which I very much welcome. Will my right hon. Friend confirm that this will mean that, as local Members of Parliament, we are better placed to represent our constituents in this place when it comes to communicating any concerns that they might have about unpopular local reorganisation of key services at their local hospital?
Minister reply
Yes, the White Paper aims to strengthen accountability and ensure that reforms are there to serve constituents.
Question
Expresses concern that the introduction of integrated care systems might lead to private health insurance promotion using NHS patient data and seeks a cast-iron guarantee that this will not happen.
Minister reply
The Minister reassures her that integrated care systems in the UK are focused on NHS provision and do not involve private healthcare insurance. He expresses his commitment to ensuring free at-the-point-of-use healthcare, but offers to look into the specific concerns raised regarding data usage.
Question
Welcomes the statement's promises relating to obesity policy and asks for detailed timelines on associated legislation, particularly concerning a level playing field between British TV broadcasters and overseas online services.
Minister reply
The Minister acknowledges the importance of these measures and expresses his support for James Davies' expertise. He provides an indication that reforms are planned by April 2022 but cannot provide further detail due to parliamentary restrictions.
Debbie Abrahams
Lab
Oldham East and Saddleworth
Question
Critiques the timing of NHS reorganisation amidst high covid death rates and questions how the White Paper addresses socioeconomic inequalities, particularly in light of Professor Sir Michael Marmot’s recommendations.
Minister reply
The Minister disagrees with her pessimism about NHS improvements closing health inequalities. He argues that acting on what the NHS has asked for is essential to addressing these challenges.
Question
Asks how the aspirations of spreading financial burdens and enhancing choice in adult care fit into the plans described today, referencing a previous committee report.
Minister reply
The Minister states that the White Paper takes forward proposals for integration between health and social care. He mentions commitment to funding reforms as set out in the manifesto, although not included in this Bill.
Shadow Comment
Jon Ashworth
Shadow Comment
The Labour Party warns that this reorganisation during a major public health crisis is misguided. It questions the effectiveness of the proposed structures regarding accountability, financial control, and integration among partners. Jon Ashworth emphasises the need for long-term workforce planning, cross-governmental health inequalities plans, and sustainable social care solutions before considering structural changes. He critiques the lack of consultation with NHS staff on these reforms and questions the Secretary of State's intentions behind his proposals.
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