Dr Caroline Johnson
MP for Sleaford and North Hykeham · Conservative · United Kingdom
“Continuity of care is desirable but not always possible, and in circumstances where it is not, a single patient record offers an opportunity to improve care, but it also brings the risk of unauthorised access to notes. We have seen recent high-profile cases where notes have been accessed that should not have been.”
House of Commons20 October 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Support and understanding of what they can do to help their baby is something that I think women and men value, because almost everyone loves their children intently, so they will want to do the best for their baby, and sometimes it is helpful to know what that is.”
House of Commons14 October 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Many of them have merged, and some of those mergers have been paused by the Government. This is all a distraction. NHS England has a role, but it is being abolished too. Apparently, the overall headcount in the DHSC and NHS England is to be halved.”
House of Commons14 October 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“As a paediatrician, I saw the profound effect that children not receiving the care that they need in the early years can have. Some cases were of deliberate neglect, and I saw children who had delayed growth, delayed development or physical changes.”
House of Commons14 October 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“People are sometimes frightened to provide feedback to trusts, but they will be more willing to do so when they have confidence in being heard independently.”
House of Commons14 October 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“How will the Government improve the variability between trusts that do not fall into the bottom cohort? How did they choose the five trusts that were chosen?”
House of Commons14 October 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
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“That is an important issue; indeed, it was raised during the Committee’s evidence sessions, when it seemed that the Government had not yet made a decision.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“How will the Minister convince the House and the public that the contract is being provided fairly, that it will be useful, that it will deliver what it said it would at the prices it said it would, that the data will be held securely once it is delivered, and that provisions will be in place to record access, decide who gets access and limit access? Who gets access to sexual health records is particularly important. At the moment, sexual health records are kept separate. If someone attends a sexual health clinic specifically for sexual health screening, those records do not appear in their general medical record, in order not to disincentivise people from attending those sorts of appointments. If everything will be in one single patient care record, will sexual health records appear within that record?”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“In 2007, the Public Accounts Committee found that the Government had not sought to keep a detailed record of expenditure and there was no evidence that officials had carried out an examination to see whether the benefits exceeded the cost. The Father of the House, my right hon. Friend the Member for Gainsborough (Sir Edward Leigh), described the project as “one of the biggest IT disasters of all time”. Costs ballooned to more than £9 billion, leading a member of the PAC to say in 2013 that it was one of the “worst and most expensive contracting fiascos” in the history of the public sector.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“It has also been reported that Peter Mandelson had links to Palantir, which secured a £240 million deal with the Ministry of Defence. It is important that people have confidence in the contracts. Does the first person to get a contract get locked in? Once the system is set up with one provider, will it be prohibitively difficult to change provider? Will the contracts become more and more expensive as time goes on because of the difficulties in redesigning a system? Who will own the intellectual property of the system that is designed? Will it be the Government or the private company? If it is the private company, how will that work going forwards? The other question is: can we trust this Labour Government to deliver this? In 2005, the previous Labour Government launched a digitisation project called the NHS national programme for IT.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“What plans do the Government have to monetise the data? In December 2025, the then Under-Secretary of State for Health, Innovation and Safety, the hon. Member for Glasgow South West (Dr Ahmed), was reported in the Financial Times as having said that the UK should make money from patient data for the “benefit of the Treasury coffers”. Can the Minister expand on her Department’s plans to monetise patient data? Can she guarantee that personal data will not be exposed or leaked? Can the Minister give assurances that the tendering process for contracts to set up and run the single patient record will be fair and transparent? It has been said that companies that donated to Labour before the general election were awarded contracts worth almost £138 million during this Government’s first year.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“891.] That suggests that the Government are aware of the problem but have not yet nailed down the detail of how to contract the delivery of the single patient record or worked out how they are going to keep data safe once they have. How can patients have confidence when their health data—their most personal data—is on the line and the Government have not yet made the key decisions for protecting it? Does the Minister have any comments on that? What will happen to private providers? The Government are increasingly using private healthcare providers to try to improve the waiting lists, but will they have access to the single patient record? If they will, will they have to contribute to it financially or get it for free? How will the data be protected if it is not in NHS hands and not necessarily under the same regulation?”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“On 30 June—just earlier this week—it was reported that the UK healthcare sector experienced a tenfold increase in attacks during January to May 2026 compared with the whole of 2025, recording 264,000 individual events compared with just 27,000 in 2025. In June 2026, Bedfordshire hospitals NHS foundation trust revealed that data relating to 33,000 hospital patients was stolen and shared online two years ago. Mid and South Essex NHS foundation trust reported the theft of 2,380 records in the same attack. The Secretary of State said earlier in June that “the situation with the single patient record is…different from that of the federated data platform, because it is likely that we will let a series of contracts to de-risk the delivery of the single patient record.” —[ Official Report , 1 June 2026; Vol. 786, c.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Can the Minister expand on the circumstances in which they might want, in essence, to bypass patient confidentiality in pursuit of that provision? In addition, the regulations may make information “available to people involved in the provision to patients of health care or social care anywhere in the British Islands,” which means it will not all be provided in England, and it will not necessarily all be provided within the United Kingdom. Will there be reciprocal arrangements with the self-governing territories? If not, how will the Government ensure that the data is properly protected once it has been shared? I also want to mention cyber-security.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“There is an amendment—amendment 11—that make data available only for patient care, but patient audit and research can be quite important. Does the Minister have any comments on how audits and patient research might be used in a clinical context to improve care using anonymised or non-anonymised data? Proposed new section 250E(3) of the National Health Service Act 2006 says: “The regulations may provide that the processing of information in accordance with the regulations does not breach any obligation of confidence owed by the person processing the information.” As one of my hon. Friends said earlier this afternoon, if the Government put a clause into a Bill, they normally have a reason for wanting to use it.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“The Government say the single patient record will be more efficient, reduce the number of A&E attendances and hospital admissions, and make £20 million in annual savings to the NHS. Those are quite small margins compared with the scale of the project. Is the Minister satisfied that the savings will not be obliterated by the cost of the project running away? The other thing is the public view of this. Polling published in January 2025 by the Tony Blair Institute found that 69% of people are willing for their anonymised data to be used to help plan NHS delivery, 71% are willing for it to be used for research into drugs and new treatments, and 75% are willing for it to be used for speeding up and making better diagnoses.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“If I want to look at the films of an X-ray, they are on a different computer system again. If I want to follow the patient’s pathway through the hospital, see when their next appointment is with me or see who is next in my clinic, I go on to e-Track. There is a different system for maternity, and there is Symphony in A&E. Each hospital trust has a lot of different computer systems and information, and they do not all use the same systems, as I know having rotated through a number of hospitals during my training. How will the single patient record work with that? Will people be able to access all those different systems, and will they need to be trained to use them, or will there be a homogeneous system—and if so, what does the Minister envisage that looking like?”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Will those be added to the single patient record, or will the SPR start from day zero and go forwards? If it does, how will people access their historical records? If it goes backwards, what provision has been made to ensure that the data that is input is accurate, and for the cost and personnel required to do it? Is the intention that the SPR will be one-size-fits-all? The Secretary of State talked about people not being asked to have a one-size-fits-all but being able to access the various systems around the country, but there are so many different systems. In my own practice, if I want to look at the notes of somebody I am caring for, I go to Evolve, where the notes are scanned in and I can look at the pages one at a time. If I want to look at blood results, I go to ICE, which is a different system where I can see the test results.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“In 2025, Healthwatch reported that 23% of adults who had seen their medical records reported inaccuracies or missing details, 12% said they had been refused treatment because of inaccurate information, and 10% said they had received inappropriate medication as a result. This is important. In recent years, there have been several incidents of patients dying after doctors used incorrect medical histories and prescribed medication that they should not have. This information needs to be available, but also accurate. I am interested in what the Minister has to say about that. The other question is: what is going to happen to the records people have now? I am 48. I am sure the Minister is much younger than that, but we have records: our vaccination records, our childhood records, and records of any admissions or treatment we have had.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“957.] I appreciate that it will be subject to the affirmative procedure, but we are being asked to make a decision now on something that is unfortunately very woolly. Will the Minister reassure us that she will address the following questions in the secondary legislation? Who will have permission to edit the information in the single patient record? When will they have access to it? Will it tell us who has edited it—will there be a record of who, when and where? If the record is not accurate when it is edited, how will that be addressed? How will people know that it is inaccurate, and how will it be improved?”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Records may be kept in a particular geographical location or hospital, and if someone is away on holiday and they come in, we may not have access to their records. In paediatrics, we often give the parents of children with complex problems letters to carry that have the necessary information in them. That would not be necessary if the record were more accessible, so there are benefits to the single patient record. There are, however, a lot of questions about it. One problem is that the single patient record has not really been designed yet, so we are being asked to approve something that is a hazy vision in the distance. On 1 June, the Minister said that “although the Bill establishes the legal framework for the SPR, much of the detail will be in secondary legislation.” —[ Official Report , 1 June 2026; Vol. 786, c.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Clause 47 amends the existing legislation to facilitate the single patient record. We have heard about the many benefits that it may bring, for example for patients who find themselves telling the same story again and again and having to repeat themselves because caregivers cannot see the records that they need to see. That can be frustrating and sometimes very distressing for patients. I caution the Minister against saying that the single patient record will completely fix that issue, because from a clinical perspective, particularly in certain presentations, hearing the story again from the individual can be helpful for a diagnosis, but the principle is a good one, and it will make things easier for clinicians, particularly if the patient is in an area away from home.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I am interested in what the hon. Gentleman is saying. Does he agree that, in many ways, the NHS dataset will be one of the most valuable datasets in the world, not only to patients themselves—in terms of the value to them and their privacy—but in the ability to analyse it and perhaps understand parts of medicine that we do not understand at the moment and so improve patient care?”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“My point was that this can sometimes be beneficial. If a clinician sees a young lady who has collapsed at school, she might have fainted or had a fit. There are a lot of different potential causes, such as cardiac syncope, and lots of different potential diagnoses. A lot of the detail in making the diagnosis is in the history. The patient will probably already have been asked their story when they arrived at A&E, but it is still important for a senior clinician to ask for it again. My caution was against presuming that we can, in all cases, prevent repeated asking of questions. There would clearly be a benefit when there are particularly sensitive pieces of information, about which we need not ask two, three or four times, but we cannot stop all cases in which a patient is asked for the same story.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“There is no detail in the Bill. As my hon. Friend the Member for Isle of Wight East said, there is nothing in the legislation requiring the computers in his local area to talk to the computers in my local area.”
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“In the event that someone from Scotland comes into the hon. Gentleman’s hospital near Dover and a doctor wants to look at their healthcare record, does the hon. Gentleman envisage that the doctor will log on to their local system and see the records from Scotland, or that they will have access to the Scottish system to look at the records directly there?”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“The clause says that information could be made available “to people involved in the provision to patients of health care or social care anywhere in the British Islands”. That implies that the English system will be used to share information with people outside England—in the Isle of Man, the Channel Islands, Scotland, Wales or Northern Ireland—but it does not imply that those areas will necessarily have the same systems to share information with us.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Now if the CQC makes a request, it goes to the Secretary of State, and whether it is agreed to is then somewhat more optional. Will the Minister say why she needs to change that power?”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I have a couple of questions. In lots of ways the provisions derive from clause 1 and the abolition of NHS England. Schedule 7 refers to operating a system in the interests of the health service, which is not the same as operating it in the interests of the patients. Does the Minister have any comments on that? The Nuffield Trust has pointed out that schedule 7 would not pass over to the Secretary of State NHSE’s duty to report to Parliament. Is that because the Minister thinks that duty is duplicated elsewhere and is therefore not necessary? Under the previous legislation, the Care Quality Commission was slightly stronger and could make a mandatory request that NHS England establish a system, and NHS England had to comply with that unless it related to an existing exception.”
House of Commons2 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“He said: “The Government have never committed to doubling medical school places.” —[ Official Report, 27 April 2026; Vol. 784, c. 3MC.] Given what was said by so many Ministers before the election, and by the former Secretary of State at the Dispatch Box, how can that be accurate? I raised this issue with the Minister for Secondary Care, the hon. Member for Bristol South (Karin Smyth), in the Health Bill Committee last week, but there has still been no response. How can I establish whether that is still Government policy?”
House of Commons1 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“On a point of order, Madam Deputy Speaker. On 15 October 2024, the former Secretary of State for Health and Social Care, the right hon. Member for Ilford North (Wes Streeting), said: “This Government are committed, as we were in opposition, to doubling the number of medical school places.” —[ Official Report , 15 October 2024; Vol. 754, c. 683.] On 22 April 2026, in a Westminster Hall debate, the current Minister for Care, the hon. Member for Aberafan Maesteg (Stephen Kinnock), said: “Yes, it is still our intention to double the number of medical school places.” —[ Official Report, 22 April 2026; Vol. 784, c. 134WH.] However, on 27 April, some five days later, the Minister for Care issued a somewhat bizarre ministerial correction.”
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“Therefore, I will not go further on that issue.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“If they do not, Parliament will have scrutiny of the bureaucracy being removed but not of the bureaucracy that the Government replace it with. As the Minister once said: “Local taxpayers deserve to know how their money is being spent.” —[ Official Report, 13 June 2023; Vol. 734, c. 122WH.]”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Can the Minister remind me and the Committee of other areas in which local democracy will be able to input into ICB planning once these planning documents are no longer required? Under the Government’s strategic commissioning framework, ICBs have to develop population health improvement plans. Essex ICB published a document that is 148 pages long, with a particular focus on inequality. Is the Minister concerned about the length of some of the plans, the time it takes to produce them and the amount of bureaucracy involved, or does she think this is an improvement? What is the key objective in delivering these plans? Do the Government plan to introduce population health improvement plans through legislation?”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“For example, the Joint Forward Plan covered the integration of services, which the Better Care Fund plan also considers, as does the Joint Local Health and Wellbeing Strategy.” It goes on to note that duplication delivers an administrative burden, as staff “complete parallel planning returns and fulfil competing data requests,” so that is a positive aspect of the clause. Will the Minister please address the following points? Section 14Z52 contains specific requirements to address the particular needs of young people and of victims of abuse. Where do they fall now? The NHS has a large maintenance backlog. What is the new mechanism for transparency of capital prioritisation decisions between the ICBs and the trusts?”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“It must explain how it has discharged its duties under other specified sections of the Act, review the extent to which it has exercised its functions in accordance with the forward plan and its capital resource use plan, review the extent to which it has exercised its functions consistently with NHS England’s views, and review steps it has taken to implement any joint local health and wellbeing strategy. The report must include details of expenditure and be given to NHS England by a specified date and then published. In essence, the clause deletes sections 14Z52 to 14Z57. In some respects, it is legislative plumbing, to remove plans that are no longer necessary. The Government’s impact assessment notes that “there is some duplication across planning documents.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Section 14Z56 sets out that an ICB and its partner trusts must prepare a joint capital resource use plan before the start of each financial year, and that the period may be determined by direction from the Secretary of State. Section 14Z57 sets out that an ICB and its partner trusts may revise the joint capital resource use plan, but if it is revised significantly, it must be published and given to the list of specified authorities. Section 14Z58 sets out that an ICB must produce an annual report on how it has discharged its functions.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“The plan must also cover steps that will be taken to implement the local health and wellbeing strategy, the particular needs of young people, and the particular needs of victims of abuse. ICBs and their partner trusts must publish the plan and give it to a set of specified authorities, and NHS England may give directions for that. Section 14Z54 sets out that an ICB and its partner trusts must consult people when developing such plans and that health and wellbeing boards must be involved. Section 14Z55 sets out that the relevant health and wellbeing board may give an opinion, and that when it does so, it must provide it to the ICB and its partner trusts.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“As the Minister said, the clause removes the need for ICBs and their partner trusts to produce a joint forward plan. The existing legislation requires ICBs and their partner trusts to prepare a plan setting out how they propose to exercise their functions over five years, which is reviewed and/or revised each financial year. Joint forward plans address objectives in the Government mandate regarding the ambitions in the NHS long-term plan and planning guidance. Section 14Z52 of the 2006 Act sets out that an ICB and its partner trusts have to prepare such a plan before the start of each financial year and specifies what the plan must give regard to, including the ICB’s discharge of its duties—general duties and financial duties—under other sections of the Act.”
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“We have a very confusing pattern emerging, which may require further reorganisation of ICBs to line them up, with a further cost down the line.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Overall, it is regrettable that local government does not have the direct feed into ICBs that the design of those integrated care partnerships provided. Whether or not I agree, I can follow the theory or principle behind making the area covered more local, in line with the strategic authority. However, if the Government wanted to do that, I do not understand why they did not decide the mayoral areas first. At the moment, we do not know where the mayors will be, and where they are now is not where the ICBs are. The Government have decided to cut ICB budgets and force mergers before they have decided where the mayoral authorities will be in some cases. Even where there are mayoral authorities already, the Government have not mandated that the ICBs be coherent with them, and, therefore, in many cases, they are not.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Clearly, there will be a cost incurred by the abolition of the process, but there will also be an opportunity cost to services if ICBs and commissioners are not working together in the provision of social care as effectively as they were before. That will cost people in social care, and it will cost people in healthcare. As recognised by the impact assessment that the Government have produced themselves, there is a risk of reduced focus on the wider determinants of health at system level. Committee members on both sides of the House have already stressed the impact that other health determinants can have on the health service and social care, and we have previously considered amendments to that effect.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“As Conservatives, we believe that streamlining bureaucracy is sensible, and I am sure that this is a well-intentioned reform. However, a survey conducted by the NHS Alliance in November indicated that a quarter of integrated care system leaders are likely to keep the integrated care partnerships anyway on a non-statutory basis, and 40% plan to fold them into health and wellbeing boards and working partnerships with the authorities. It is not really a ringing endorsement of the policy if a sizeable number of people intend to keep it anyway. Like many other elements of the Bill, these changes are uncosted—if we read the impact assessment, it says “N/A” for the cost.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Clearly, that would now apply only to guidance issued by the Secretary of the State, because NHS England is also being abolished. An integrated care partnership must publish its integrated care strategy and give it to each local authority and partner ICB. Integrated care partnerships must reconsider and, where necessary, revise the strategy each time they receive a new needs assessment. Clause 23 deletes section 116(5A) of the Local Government and Public Involvement in Health Act 2007. That subsection required the local authorities to give a copy of the needs assessments to the ICBs, which is of course no longer necessary because they are being abolished. Clause 23 also deletes sections 116ZA and 116ZB of the same Act, which established ICBs and defined integrated care strategies respectively.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Section 116ZA of the 2007 Act requires ICBs and local authorities whose areas coincide or overlap to create integrated care partnerships, which consist of a member appointed by the ICB, one from each responsible local authority and any other members that they choose to add; to some extent, they can determine their own procedures. Section 116ZB of the 2007 Act requires ICBs to prepare an integrated care strategy “setting out how the assessed needs in relation to its area are to be met by the exercise of functions of…the integrated care board…NHS England, or…the responsible local authorities”. When developing that integrated care strategy, the integrated care partnerships must have regard to NHS England’s mandate and any guidance issued by the Secretary of State.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“When preparing the assessment, the local authority and its partner ICB must “co-operate with one another…have regard to any guidance issued by the Secretary of State…involve the Local Healthwatch organisation”, and involve local people and the relevant district councils. I note that later in the Bill we will also come to the abolition of Healthwatch. Section 116 of the 2007 Act has been modified by the Health and Social Care Act 2012 and the Health and Care Act 2022 to ensure that references match the current NHS structure. For instance, in 2008 there were primary care trusts, rather than ICBs.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“In essence, the clause abolishes integrated care partnerships and strategies, which are where ICBs come together with local authorities to discuss how they can make their services more integrated. We know that many of the challenges facing the NHS are caused by difficulties in social care provision and some of the difficulties in social care provision are caused by issues with health provision, and that if those commissioning services in those two areas work together, we can see an improvement in both. The Local Government and Public Involvement in Health Act 2007 made changes to local government structures and enhanced public involvement in health services. Section 116 requires local authorities to produce joint strategic needs assessments for the local authority and its partner ICB.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“We have the local authority tasked with delivering social care, which may be led by one political party; the mayor directing the ICB, who may be of a different political party; and the Secretary of State who can also direct the ICB, who may again be of a different political persuasion. How does it work if they disagree? Does the mayor actually have authority, given that the Secretary of State can override them anyway? How does the Minister see that working in practice? It feels like some people will be in power without responsibility and others will have responsibility without the power to exercise it.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“My hon. Friend is, as ever, correct. The mayors are also not all responsible for health and social care—the local authorities are, in most cases. There could therefore be a mayor directing proceedings with the ICB who is a political opponent of those actually democratically elected to look after social care. ICBs are supposed to be apolitical commissioners accountable to the Secretary of State, but now, instead of working with social care directors, they will work with an elected mayor instead. I can see a positive to that in terms of democratic accountability, but what happens if they all disagree? There is some incoherence about who is in charge.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“The consultant will then review that referral and decide whether they think it is clinically appropriate to see the patient, whether a different specialty may be more appropriate, or whether they can give advice or make suggestions about treatment that could be given in primary care instead. When a patient is given an appointment in secondary care, it essentially means that the GP has decided that they clinically need it, and the consultant has decided that they clinically need it too. If the Government want a diversion rate of at least 25% by March 2027 for at least 10 high volume specialties, are they suggesting that patients who the GP and consultant agree clinically need an appointment should not get one? If so, why?”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“In March 2026, the Government produced a neighbourhood health framework policy paper, which identified the goal of reducing non-elective admissions for those with severe frailty. Given that goal, why are the Government not on track to deliver the fracture liaison service improvements that they promised? The policy paper also commits to what it calls “a diversion rate of at least 25% by March 2027 for at least 10 high volume specialties”. What is a “diversion rate”? It essentially requires more GP referrals to be rejected, so let us be clear about what that means. When someone, either hon. Members or constituents, goes to see their GP, they are referred to a consultant for care; I should declare an interest as a consultant in the NHS.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“What mechanisms does the Minister envisage there being for local people—local patients—to contribute to the neighbourhood health plans? A local Healthwatch currently contributes to the equivalent, the joint local health and wellbeing strategy, as a way of ensuring that it captures patient and community voices. How will that be done otherwise? Some 80% of the Government’s new neighbourhood health centres that will deliver these plans are expected to be funded through public-private partnerships. Does the Minister have any comments on that, particularly in the light of the expensive private finance initiative that the last Labour Government entered into and left us stuck with?”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I would appreciate it if the Minister could talk about that. As has been said, Sir Andrew Dilnot told the Committee that “we cannot really address many of the fundamental problems facing the NHS if we do not sort out social care.” –– [ Official Report, Health Public Bill Committee, 16 June 2026; c. 84, Q131.] The Government have asked Baroness Casey to review social care, but they have developed this measure in the meantime. Is that because they have been talking to her and know that it is the sort of thing that she will recommend—or are they putting the cart before the horse, as my hon. Friend the Member for Farnham and Bordon suggested? Later in the Committee’s considerations, we will come to Healthwatch, its benefits and the concerns that I and, I am sure, many other Committee members have about its abolition.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“However, if local authorities and partner ICBs have to give regard to what the centre is doing when developing neighbourhood health plans, to what extent does the Minister envisage that being directed? Local authorities and partner ICBs giving regard to the centre could mean there being a very loose requirement from the centre to provide for the local population, and then they get on with it; it could also be very prescriptive—my right hon. Friend the Member for Godalming and Ash (Sir Jeremy Hunt) has talked about the pros and cons of having targets—with a whole litany of targets in the plans. Whether that squares with the Government’s claim to be devolving power, or whether it strikes as a centralising power, depends on how that is done and to what extent the Secretary of State plans to direct it.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Section 116B of the 2007 Act places a duty on local authorities and partner ICBs to have regard to various strategies when exercising their function, specifically, a joint strategic needs assessment, an integrated care strategy and a joint local health and wellbeing strategy. NHS England also has regard to these when providing healthcare for a specific area. Clause 24 changes the JLHWS to a neighbourhood health plan. In many ways, that aligns with the shift in the Government’s 10-year health plan from hospital to community. As they have described it, more care in the neighbourhood will allow hospitals to focus on the more specialist care that may be needed, so more people can be cared for closer to home, which seems a reasonable aim.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Clause 24 puts neighbourhood health plans on a statutory basis. Currently, section 116A of the Local Government and Public Involvement in Health Act 2007 requires local authorities and partner ICBs to prepare a joint local health and wellbeing strategy once they have received their integrated care strategy. Essentially, that means that the ICBs and local authorities produce their overall strategy, then it devolves down, and then the joint health and wellbeing strategy looks at how it will be delivered. The local authority and its partners must give regard to the integrated care strategy, the NHS England mandate and any guidance issued by the Secretary of State. The strategy must be published and local people and the local Healthwatch must be involved in its development.”
House of Commons30 June 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗