My right hon. Friend is absolutely right. I will come to the financial flows in a few moments. But how on earth can we have a triple aim of trying to improve health outcomes for a population and not even give public health a voice and a seat on the decision-making body that decides health plans for an area?
The Secretary of State talks about integrating health and social care. There is no seat for directors of adult social services on these committees, either. And what about patients? Patients were not mentioned very often by the Secretary of State in his speech. Patients will always come first for the Opposition. They have no mandated institutional representation, either—no guaranteed patient voice—so we have yet another reorganisation of the NHS whereby patients are treated like ghosts in the machine. It is utterly unacceptable. This is fragmentation, not integration, with a continued sidelining of social care.
There is a loss of local accountability as well, because there is no explicit requirement that the boards meet in public or publish their board papers. Although NHS England has stated that that is its preference, it is not required; nor is there any commitment, despite the wide geographical spread of some ICSs, for meetings to be made accessible online. But, of course, the White Paper did indicate that the independent sector could have a seat on an ICS, and the explanatory notes to the Bill state that
“local areas will have the flexibility to determine any further representation.”