Generally, the Bill is to be welcomed as it seeks to promote collaboration and the integration of local health and care services. It aims to give local people, local clinicians and those running local NHS and care services more control over the way that health and care services are delivered. The King’s Fund highlighted that the Bill will remove “clunky” competition rules and make it simpler for health and care organisations to work together and deliver more joined-up care to more people. That said, it is important to recognise that the last 16 months have been very challenging and very exhausting for those working in health and care, and in many respects, the last thing that they now need is yet another NHS reorganisation. Groups such as the BMA have concerns and I urge the Government to look at those closely in Committee.
I wish briefly to highlight two issues. First, I urge the Government to retain the existing boundaries, with the Waveney area remaining in an ICS with Norfolk. To change the boundaries to make them coterminous with the two counties would be highly disruptive and an unnecessary distraction, and it would demotivate hard-working staff. It would place at risk the health integration that has taken place in the area in recent years. To achieve better collaboration with care services, it is better to build on the existing foundations rather than to dismantle them. In many respects, boundary wars have been going on behind closed doors for the past seven to eight months, though I am grateful to both the Secretary of State and the Minister for listening to my concerns in recent weeks. I urge them to retain the status quo.
Secondly, the health issue that has taken up most of my time in recent weeks is NHS dentistry—or rather the lack of it. Many of my constituents are in agony and local NHS dentists urgently need the funds to see more
patients. We are gradually moving towards a short-term solution, but it has taken far too long. In the longer term there needs to be greater accountability; dentists need to have a voice on integrated care boards; dental budgets should be protected; and steps must be taken to tackle the staffing crisis.
In conclusion, the Bill provides a statutory footing to ways of working that are in many respects evolving naturally. However, there are potential pitfalls, particularly —from my perspective—the changing of ICS boundaries, which I urge the Minister to avoid at all costs.
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