Karin Smyth
MP for Bristol South · Labour · United Kingdom
“It is a pleasure to serve under your chairship, Ms Lewell. I thank the hon. Member for Chippenham (Sarah Gibson) for securing this debate and for her well-informed and considered set of proposals about a contract of which I am aware. I will try to address most of her points.”
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“In addition, we are developing a modern service framework for palliative and end-of-life care, which will be a clinically led, evidence-based framework to support sustained improvement in outcomes for patients and carers, including identifying, measuring and reducing health inequalities, and reducing unwarranted variation in access, exper…”
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“That is why this Government are taking action to reduce unwarranted variation, cut waits and improve access to high-quality community services. That is where we want to get to.”
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“I will come on to some of that, because it is also tied up with the Health Bill and the things that we are proposing to do for the future. The hon. Lady also touched on one of my favourite subjects: the accountability of local health systems.”
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“Lady said, now we need to make sure that what was promised is delivered. That is what we all want to see for the people of her community and across the wider ICB. I want to be clear on our general expectations of community services: they are really vital to the left shift, particularly in rural areas.”
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“Lady is saying from her position in Chippenham, and that may be different from other positions—it is a large geographic area. That is one of the issues that we need to get right.”
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“I will begin with Government new clauses 91 to 95. Many hon. Members will know that the current regulatory framework for medicines and medical devices is seen as overly complicated and difficult to navigate. It is also slow and burdensome to amend, limiting our ability to ensure that it keeps pace with developments. Maintaining the safeguards to public health is central to every decision we make. However, the regulatory framework currently slows down innovation and delays patient access to healthcare products. From a market growth perspective, it also places barriers to the UK market, particularly for small and medium-sized enterprises. These new clauses will deliver a more streamlined regime for making and updating secondary legislation.”
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“(3) The person appointed as Commissioner must— (a) be a person with knowledge, expertise and experience relevant to the discharge of functions of the role; (b) have first-hand experience of working in maternity services, so far as reasonably possible; and (c) not be a sitting Member of Parliament.”— (Helen Morgan.) This new clause would require the Secretary of State to appoint a maternity commissioner within the Department of Health and Social Care to oversee national maternity services. This person should be someone with experience and expertise of maternity services, and not a political appointment. Brought up, and read the First time.”
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“(2) The functions of the National Maternity Commissioner are to— (a) oversee NHS maternity services; (b) act as an independent voice for women and families; (c) ensure lessons are learned from identified failures and that the recommendations of maternity reviews are acted upon; (d) promote consistency, safety and accountability across NHS maternity services; and (e) advise the Secretary of State on matters relating to the safety, quality and provision of maternity services in England.”
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“At the moment those regulations are subject to the affirmative resolution procedure. Brought up, read the First and Second time, and added to the Bill. New Clause 1 National Maternity Commissioner “(1) The Secretary of State must, within six months of the passing of this Act, appoint a National Maternity Commissioner, situated within the Department of Health and Social Care.”
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“(1B) In sub-paragraph (1A)(b) ‘the EU medical devices Regulations’ means— (a) Regulation (EU) 2017/745 of the European Parliament and of the Council of 5 April 2017 on medical devices, amending Directive 2001/83/EC, Regulation (EC) No 178/2002 and Regulation (EC) No 1223/2009 and repealing Council Directives 90/385/EEC and 93/42/EEC, or (b) Regulation (EU) 2017/746 of the European Parliament and of the Council of 5 April 2017 on in vitro diagnostic medical devices and repealing Directive 98/79/EC and Commission Decision 2010/227/EU, as they have effect from time to time by virtue of Article 5(4) of the Windsor Framework.”’ —(Karin Smyth.) This allows regulations altering certain fees in relation to medical devices etc to be made subject to the negative resolution procedure.”
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“(b) after sub-paragraph (1) insert— “(1A) Provision falls within this sub-paragraph if it relates to— (a) altering the amount of a fee or charge to reflect changes in the value of money, (b) altering the amount of a fee or charge to be charged in connection with the exercise of a function which a public authority has by virtue of provision made under section 8C in connection with the EU medical devices Regulations, or (c) altering the amount of a fee or charge to be charged under the Blood Safety and Quality Regulations 2005 (S.I. 2005/50).”
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“The changes all relate to regulations about medicines and medical devices (although the procedural provisions relating to certain other matters are restated in the amendment). Brought up, read the First and Second time, and added to the Bill. New Clause 95 Medical devices etc: parliamentary procedure for certain fees regulations ‘In Schedule 7 to the European Union (Withdrawal) Act 2018 (regulations), in paragraph 12— (a) in sub-paragraph (1) for “relate to altering the amount of a fee or charge to reflect changes in the value of money” substitute “fall within sub-paragraph (1A)”.”
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“(3C) Regulations under Part 4— (a) are subject to the negative procedure if they contain only provision of one or more of the following descriptions— (i) provision made in reliance on— • section 17(1)(a) (fees), or • paragraph 9 of Schedule 2 (supplementary provision about civil sanctions); (ii) provision amending or revoking regulation 1ZA of the Medical Devices Regulations 2002 (expiry of certain provisions) or consequential on such provision; (b) are subject to the made affirmative procedure if they— (i) contain only provision made in reliance on section 18 (emergencies), and (ii) contain a declaration that the person making them considers that they need to be made urgently to protect the public from an imminent risk of serious harm to health; (c) are subject to the draft affirmative procedure if they are not within paragraph (a) or (b).”’ —(Karin Smyth.) This changes the parliamentary procedure for certain regulations from the draft affirmative procedure to the negative procedure.”
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“(3B) Regulations under Part 3— (a) are subject to the negative procedure if they contain only provision made in reliance on section 12(1)(a) (fees), and (b) are subject to the draft affirmative procedure if they are not within paragraph (a).”
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“(3A) Regulations under Part 2— (a) are subject to the negative procedure if they contain only provision of one or more of the following descriptions— (i) provision made in reliance on section 6(1)(a) (fees); (ii) provision amending the meaning of ‘appropriate practitioner’ or ‘approved country health professional’ for the purposes of Part 12 of the Human Medicines Regulations 2012 (see regulation 214 of those regulations); (iii) provision amending any of the following provisions of the Human Medicines Regulations 2012— • regulations 217C(3) or 217CA(3) (original pack dispensing for products containing relevant substances: definition of ‘relevant substance’), • Schedule 13 (prescription only medicines for which community practitioner nurse prescribers are appropriate practitioners), • Schedule 15 (requirements for specific products subject to general sale), • Schedule 16 (patient group directions and vaccine group directions), • Schedule 17 (exemption for sale, supply or administration by certain persons), • Schedule 18 (substances that may not be sold or supplied by a pharmacist without a prescription in reliance on emergency provisions), • Schedule 19 (medicinal products for parenteral administration in an emergency), or • Schedule 21 (medicinal products at high dilutions); (iv) provision amending regulation 250 of the Human Medicines Regulations 2012 (restrictions on persons to be supplied with medicinal products: exceptions) for the purpose of changing the products to which any exception from time to time provided for by that regulation applies; (v) provision that is consequential on provision of a description mentioned in any of sub-paragraphs (ii) to (iv); (b) are subject to the made affirmative procedure if they— (i) contain only provision that is made in reliance on section 7 (emergencies), (ii) contain a declaration that the person making them considers that they need to be made urgently to protect the public from an imminent risk of serious harm to health, and (iii) are not within paragraph (a); (c) are subject to the draft affirmative procedure if they are not within sub-paragraphs (a) or (b).”
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“New Clause 94 Medicines and medical devices regulations: parliamentary procedure ‘In section 47 of the Medicines and Medical Devices Act 2021 (regulations: procedure), for subsection (3) substitute— “(3) Regulations under Part 1 are subject to the draft affirmative procedure.”
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“(3) After subsection (1) insert— “(1ZA) Before making regulations under Part 2 or 4 the relevant authority must— (a) carry out a public consultation, or (b) consult such persons as it considers appropriate.” (4) In subsection (3), at the beginning insert “Where a public consultation is carried out”. (5) In subsection (4), in the words before paragraph (a), for “subsection (1)” substitute “subsection (1ZA)”.’— (Karin Smyth.) This amends the duty to consult in relation to regulations about human medicines and medical devices. It gives the option of consulting such persons as the relevant authority considers appropriate instead of a public consultation. Brought up, read the First and Second time, and added to the Bill.”
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“(4) Omit Schedule 2 (mutual recognition agreements).”— (Karin Smyth.) This new clause would amend the definition of “mutual recognition agreement” in the Medical Devices Regulations 2002 (as it has effect in England and Wales, and Scotland) so that agreements are defined by a list published by the Secretary of State, rather than a Schedule to the regulations. Brought up, read the First and Second time, and added to the Bill. New Clause 93 Consultation about medicines and medical devices regulations ‘(1) Section 45 of the Medicines and Medical Devices Act 2021 (consultation) is amended as follows. (2) In subsection (1), for “a provision of Part 1, 2, 3 or 4” substitute “Part 1 or 3”.”
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“(2) For regulation 1A (Schedules) substitute— ‘ 1A Schedule Schedule 2A has effect.’ (3) In regulation 2 (interpretation), in paragraph (1)— (a) in the definition of ‘mutual recognition agreement’, in paragraph (a), for ‘country listed in Schedule 2’ substitute ‘country specified in a list published by the Secretary of State from time to time’; (b) in the definition of ‘third country conformity assessment body’, for ‘established in a country which is listed in Schedule 2 and designated in accordance with a relevant’ substitute ‘designated in accordance with a’.”
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“I thank the hon. Lady for her comments. The purpose of the new clauses is to support our life sciences and medicine sector, in order to make that more streamlined. She will be aware of the proposals about the negative and affirmative procedure. If there were particular issues of scrutiny, normal parliamentary rules and processes would apply if Members wanted to raise any particular issue. Question put and agreed to. New clause 91 accordingly read a Second time, and added to the Bill. New Clause 92 Medical Devices Regulations 2002: mutual recognition agreements “(1) The Medical Devices Regulations 2002 (S.I. 2002/618) are amended as follows.”
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“The role will be discussed urgently with the taskforce and will have a relentless focus on driving those improvements, which will include co-chairing the taskforce. As the Committee knows, these are complex matters. The Government, having accepted the Baroness Amos’s recommendation, intend to legislate as soon as practicable. Our immediate priority is to work quickly through the taskforce to define the scope and responsibilities of the role. I know that the hon. Member for North Shropshire will not press the new clause, but I commit to keeping in touch with her and other hon. Members as this work progresses.”
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“Member for North Shropshire a more detailed timetable at the moment, because we are currently looking at options to legislate at pace, including potentially through this Bill, subject to discussions through the usual channels, while also—this is crucial—giving the taskforce the opportunity to shape the scope of the role. That was one of Baroness Amos’s urgent actions, and we accept it as a crucial first step in overseeing systemic improvements to care and outcomes and earning back the trust of women and families. The maternity and neonatal commissioner will champion the voices of families and drive forward that necessary change. The Secretary of State will remain accountable to Parliament for maternity services.”
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“Baroness Amos brought the findings from past reviews, local rapid reviews and new evidence from families and staff together into one clear national set of recommendations, which as we heard was published last week. The Government also launched the maternity and neonatal taskforce, chaired personally by the Secretary of State, which will translate Baroness Amos’s recommendations into action. As we heard, Baroness Amos recommended the appointment of a statutory maternity and neonatal commissioner. We have accepted that recommendation, and I know there is support for it across the House. To be clear, the Secretary of State stated last week that we are committed to putting the role on a “statutory basis” as soon as possible. I am afraid I cannot give the hon.”
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“I am grateful to the hon. Member for North Shropshire for bringing this discussion before the Committee. I put on record our thanks for the work she has done in this area and for her engagement with me, and indeed with officials at the Department, to help us understand it more clearly, particularly in the light of the new clause. Hon. Members across the Committee are committed, as are the Government, to ensuring that women, families and babies receive the care and support they need. We know that the vast majority of births are safe and that there are outstanding examples of care in the NHS. However, where things do go wrong, it can have a devastating impact on women and their families. That is why the Government launched the national investigation into NHS maternity and neonatal care, chaired by the noble Lady Baroness Amos.”
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“I hope that addresses the comments the hon. Lady made. On new clause 13, we know that the vast majority of births are safe, but the devastating trauma experienced by many through failures in care must be brought to an end. The CQC has an important role in assessing whether patients are receiving safe, effective and high-quality care, and it is essential that it can do that objectively and independent of Government. It is therefore not appropriate to impose a duty on the Secretary of State to ensure particular ratings.”
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“I am sorry, but I did not get the end of that sentence. However, I think the hon. Lady was saying that the Bill essentially abolishes NHS England. Again, as I have said repeatedly, nobody is opposing that. As is well known, the recommendations on the maternity commissioner have come through a separate process. Given the need for public assurance and to earn back the trust of women and families, as well as—I think the hon. Lady said this herself—the shocking revelations that have come through some of this work, Baroness Amos recommended a maternity and neonatal commissioner to drive through these changes and give confidence to the system. That is why we are going to accept her recommendation. Accountability for maternity services obviously remains with the Secretary of State, who will be co-chairing the taskforce.”
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“I do not think it was about the supplier. I think it was about the money. It was about inertia in rolling out some good technology that provides good efficiency. It was also about capacity, capability and an attitude to productivity, which we absolutely need to drive more of.”
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“It does not matter whether it is held by the authority or by one of its commercial partners; what matters is whether it is held for the public authority’s purpose. The Government agree with the principle of transparency, but new clause 5 would not improve the existing framework. It would risk duplicating duties that already exist, cutting across standard contract terms and creating uncertainty about patient information, which is rightly protected. For all those reasons, I ask hon. Members not to press the new clauses. Finally, I say to the hon. Member for Winchester that we have already debated the single patient record. Public trust is key, and there will be multiple suppliers. We are bringing patients and the public with us and will continue to do so. The hon. Member asked about the FDP roll-out.”
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“I understand the concern behind new clause 43, which the hon. Member for Sleaford and North Hykeham spoke to. However, where public money is used to provide NHS services, there should be proper transparency about the contract, the service being delivered and the use of public funds. Patients and the public are entitled to expect that information is not placed beyond reach simply because a service is delivered through a contract. I do not think the new clause necessary, and I am concerned that it could create confusion about the operation of the Freedom of Information Act 2000. The Act already deals with information held by another person on behalf of the public authority. The key issue is not where the information physically sits.”
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“However, ensuring the security of our data and the resilience of our systems is already embedded in everything we do. The new clause is therefore simply not necessary. Hon. Members will accept that we want to see continued growth of digital and tech industries in this country; it is one of our real success stories. However, it will not be achieved by cutting across procurement law and not seeking the solutions that provide the best value for our money and the right service for the NHS. Our approach to securing the best IT and tech solutions should always be to seek the best on offer in a diverse, global market, not to prioritise based on location. Prioritising domestic providers means making a decision on grounds other than the quality, integrity or value for money of a solution.”
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“Our international obligations matter and are an important driver of the UK economy, including the World Trade Organisation agreement on Government procurement, which gives British businesses guaranteed access to £1.3 trillion in public procurement opportunities overseas annually. As the hon. Member will understand, new clause 5 would require the Government to commit to a new programme of work to develop domestic capability, to reduce reliance on overseas suppliers of IT services and technology. The strategy would also require us to set out an approach to managing the risk associated with our current use of technology provided by overseas suppliers. I welcome the notion of encouraging domestic innovation to ensure the security and resilience of our IT infrastructure.”
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“That is not an argument for complacency; we should continue to identify risks before procurement begins. A broad duty of the kind in new clause 3 would risk becoming a reporting exercise and would not necessarily make the highest-risk contracts safer. It could, however, draw time and resource away from the assurance activities that matter most. The right approach is to strengthen the targeted controls, not to create a single statutory risk assessment covering every non-UK supplier. Similarly, on new clause 4, a blanket “buy British” rule would not be the right test for NHS data contracts, although I hope that I have assured the hon. Member for Winchester that home-grown domestic products are absolutely what we are trying to focus on. The UK must treat suppliers from countries with reciprocal procurement access fairly.”
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“That is why the Government’s approach is based on targeted assessment and proportionate control. We already have the tools we need in the Procurement Act 2023, which gives contracting authorities the powers to exclude suppliers and terminate contracts where the legal tests are met, including on national security grounds. They may also refer suppliers for a debarment investigation. The National Security Unit for Procurement supports Ministers in assessing suppliers on national security grounds, working closely with Departments and the intelligence community. In health and digital contracts, those procurement powers sit alongside data protection legislation and data protection impact assessments, in line with the digital, data and technology playbook.”
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“More than 90% of UK public contracts are currently awarded to UK suppliers, and the Government have set out reforms to make procurement do more to support British industry and supply chain resilience. I do not think that new clause 3 is the right way to achieve proper scrutiny. It would require the Secretary of State, within six months, to conduct and lay before Parliament a risk assessment of all contracts between NHS organisations and suppliers based outside the United Kingdom. That would include contracts regardless of the value—we heard a little about that from the Opposition—and of the services being provided, the type of data and whether there is evidence of any sort of concern. Risk is driven by the nature of the data involved, not just where the supplier is located.”
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“I am grateful to hon. Members for tabling these new clauses. I recognise the concerns behind them. Contracts involving NHS data, digital services and technology must be subject to proper scrutiny. Patients expect their medical information to be protected, and NHS staff expect the systems that they use to be safe and reliable. The Government agree that Parliament should be entitled to test how those protections work. I also want to be clear that the Government want British businesses to win more public contracts and build stronger UK capability in digital and technology. The Government are already using procurement to support British businesses, jobs, skills and national security.”
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“I am sure that we will discuss that in more detail, because it is an important area to get right.”
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“That represents a 10.3% uplift on the back of an uplift of more than 19% across 2024-25 and 2025-26, which again was the largest uplift in funding of any part of the NHS at the time. In 2024-25, we invested around £3.7 billion in primary care dentistry, and we reduced the underspend from £392 million in 2023-24 to just £36 million in 2024-25, maximising the treatment provided across all our constituencies from taxpayers’ money. We are investing £20 million to support digital integration between primary care optometry and secondary care, supporting more eye care in the community.”
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“It is a pleasure to serve under your chairship, Ms Lewell. I am grateful to the hon. Member for Winchester for bringing this discussion to the Committee. As has been said, we all know how important investment in primary care is, particularly as this Government shift to neighbourhood health, and that is why we have invested so heavily. Although we are absolutely interested in the outcomes, the inputs merit some attention too. We have provided an additional £601 million for general practice to reinforce the front door of the NHS, bringing the total spend on the GP contract to £14 billion in this year. That builds on last year’s £1.1 billion of investment, which was the biggest increase to GP contract funding in over a decade. In community pharmacy, we have increased funding by £340 million, bringing the total spend to £3.636 billion.”
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“I want to be really clear with the Committee: mental health remains a priority for this Government, and the Government are already making record investments in mental health services. Spending on mental health continues to increase in real terms and is forecast to reach a record £16.1 billion in 2026-27. That represents a real-terms increase of around £140 million, compared with 2025-26 and around £900 million of real-terms growth since 2023-24.”
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“I am grateful to the hon. Member for Winchester for bringing this discussion to the Committee. I will turn to amendments 9 and 10 along with new clause 27, which address similar points. These amendments would require integrated care boards to increase their spending on mental health services at least in line with their growth in their total programme funding. Amendment 10 would enable the Secretary of State to implement financial penalties for non-compliance, and new clause 27 would also place the mental health investment standard, or MHIS, on a statutory footing by requiring the Secretary of State to specify an annual increase in the proportion of mental health expenditure for each integrated care board and require integrated care boards to meet that level of expenditure.”
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“However, workforce increases and funding alone will not deliver the improvements the public and patients rightly expect in mental health care and support. Demand for mental health support has risen rapidly, as we all know from our constituencies, with long waits and too many people unable to access the right support when they need it. We need a new approach that reduces waiting times, improves care quality and promotes early intervention and prevention in mental health. That is why we are developing a new cross-Government mental health strategy for England that will transform mental health care into a system that responds and intervenes earlier, reduces waiting times for support and ultimately supports people to participate fully in education, work and community life.”
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“For this period—2026-27 to 2028-29—the standard has been set on real funding growth, meaning that funding is expected at least to keep pace with inflation. Meeting the mental health investment standard remains essential to delivering the Government’s ambitions on mental health, including achieving full national coverage of mental health support teams in schools and colleges by 2029, and expanding access to NHS talking therapies. The Government’s approach is to maintain strong protections for mental health investment, while giving local systems the flexibility to focus on outcomes and deliver services that meet the needs of their communities, which, as we have heard this morning, are very different.”
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“I thank my hon. Friend for that and for her work on this issue. She is absolutely right: parity of esteem is critical, and we are committed to a spending increase to deliver it. I will come on to some of the points that she quite rightly made. Although I do not think he was speaking on behalf of the Select Committee, the hon. Member for Farnham and Bordon took us through some of the concerns of his Select Committee. The Government have put a formal standard and a financial safeguard in place through the mental health investment standard, and as set out in NHS England’s medium-term planning framework, we expect all integrated care boards to meet the standard over the next three years, and all are currently forecast to do so.”
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“A more effective and overarching approach will be delivered through our cross-Government strategy. For those reasons, a further statutory duty is unnecessary and I ask the hon. Member for Winchester to withdraw the amendment.”
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“Again, my hon. Friend makes an important point. Of course, the rising demand and the ways that waiting lists are managed and supported locally will have to be a critical part of any strategy. Also, as we have said in our elective reform plan, giving people information so that they can understand what is happening in their local systems is part of the wider patient experience work that we are going to do. The Government are committed to prioritising the delivery of mental health services. That is why we have a standard already ensuring that mental health spending keeps pace in real terms, while allowing systems discretion to make additional investment in the way that best meets local needs. The amendments would place an inflexible financial requirement in statute.”
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“For those reasons, I ask the hon. Member for Winchester not to press it. I hope he feels assured that the Government will take forward many of the Committee’s concerns in the mental health strategy.”
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“Friend just said, we know that good mental health and wellbeing requires more than improving NHS services. It requires concerted action to promote positive mental health and tackle the causes of mental ill health. That is why we are developing a new cross-Government mental health strategy for England, to be published later this year. It will take a whole-system approach, recognising the role of schools, employers, the voluntary sector and local government, and representing all parts of the country in promoting positive mental health and preventing mental health ill. The strategy will also go further on reducing the stigma and discrimination associated with mental health conditions, with a focus on improving mental health literacy across the population. Finally, the new clause risks imposing unnecessary burdens on local systems.”
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“My hon. Friend touches on what I will come to as I conclude my remarks on the next new clause. He is absolutely right. The wider determinants of mental health need to be part of developing these services, as with physical health. On new clause 34, I reassure the Committee that the Government are taking significant steps to improve mental health services in this area. We have recruited over 8,500 extra mental health workers since July 2024, we are accelerating the roll-out of mental health support in schools and colleges, and we are investing a record £16 billion in NHS mental health services this year. Furthermore, there will remain a requirement, as introduced in the Health and Care Act 2022, for mental health expertise on local integrated care boards. However, as my hon.”
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“These clauses make a clearer, more disciplined framework, where individual accountability is strengthened, ambiguity is reduced and national oversight is more coherent, while retaining targeted tools to support collaboration where it adds value. I therefore commend clauses 43 and 44 to the Committee.”
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“Clause 44 amends section 223L of the National Health Service Act 2006 to enable the Secretary of State to set joint financial objectives for integrated care boards and their partner NHS trusts and foundation trusts, where local system-wide alignment is genuinely required. This approach supports the wider policy direction for ICBs to operate as strategic commissioners. With clearer organisation and financial accountability, ICBs can focus on population health outcomes, prioritising prevention, reducing health inequalities, shaping services around need, and driving better value for money through more effective commissioning.”
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“By removing sections 223M and 223N, we will ensure that one organisation’s deficit can no longer be obscured by another’s surplus, while preserving the Secretary of State’s ability to set joint financial objectives for integrated care boards and their partner trusts where system-wide alignment is needed. If we are to achieve the ambitious aim set out in the 10-year health plan, of getting most providers to achieve a surplus by 2029-30, we must place the onus back on individual organisations. Each NHS organisation should be unambiguously accountable for managing its own finances, rather than relying on collective system balances to absorb overspends. Importantly, that does not mean abandoning collaboration.”
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“That will include replacing “NHS England” with “The Secretary of State” in section 223GC, which concerns the power to give directions about integrated care board expenditure limits, and repealing section 223K on quality payments, as the Secretary of State can use other powers to deliver payments for quality improvement purposes. Having set out a clearer and more streamlined framework for allocating and directing NHS resources, we now turn to how integrated care boards and providers will be held accountable for managing those resources. Clause 44 will omit sections 223M and 223N from the National Health Service Act 2006, which require each integrated care board and its partner NHS trust and foundation trust to balance their finances collectively.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“That will not remove pooled budgets; they will remain the default where they deliver better outcomes, and local areas will still be able to enter section 75 agreements voluntarily. This clause will introduce proportionate flexibility and enable the Secretary of State to decide, transparently and through published directions, whether funding should be pooled in particular circumstances. That will ensure that we can act quickly when needed, for example in responding to urgent pressures, so that the Secretary of State is not constrained by a blanket legal requirement that does not always add value. Clause 43 will also make necessary consequential changes following the transfer of functions from NHS England to the Secretary of State.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“That will ensure that safeguards can be applied consistently, such as the ability to recover funding where there is a failure to comply with a direction. Transparency will be maintained through the requirement to publish directions. The clause will also introduce new section 223GB, setting how the direction powers in new section 223GA can be used in relation to expenditure on service integration across health and social care. At present, service integration funding must be placed in a pooled budget with local authorities, even if that is not the most effective approach. The current legislation allows for only one model, even where that may introduce unnecessary bureaucracy or delay. The clause will remove that mandatory requirement, giving the Secretary of State discretion each year on whether integration funding should be pooled.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“These clauses will make a series of vital changes to the NHS financial framework following the abolition of NHS England, strengthening funding arrangements and financial accountability. First, clause 43 will enable funding to flow to integrated care boards following the abolition of NHS England while simplifying the powers to direct how resources are used. The first change in new section 223G will transfer the responsibility to fund integrated care boards from NHS England to the Secretary of State, maintaining continuity of allocations and allowing in-year adjustments where needed. We will also simplify the existing power in new section 223GA to direct integrated care boards in how resources are used, making it clearer and easier to use.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗