I welcome the passage of the Bill and congratulate all those who have been involved in bringing it to this place and getting it to Third Reading: the Secretary of State; the Minister, who has worked on it for an awfully long time; and the official Bill team, who were the best team I ever worked with in government. I am not saying that just because they are sitting in the Box.
The Bill gives the NHS what it needs. Critically, it learns the lessons of the pandemic and embeds them in legislation by removing bureaucracy and silos. I can see that the Secretary of State is already acting on that to merge parts of the NHS so that they can work better together.
I want to make a specific point in response to a comment from the shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), about accountability. Although the Bill rightly devolves decision making and discretion more locally to the new integrated care boards and panels, it also gives Ministers the right to make sure that the NHS is accountable to them; it removes the so-called independence. That is right, and it is surprising not to see Labour Members supporting it, because it was in the Labour party’s manifesto as well as the Conservative party’s.
When £150 billion of taxpayers’ money is at stake, imposing apparent independence is not just impractical, but wrong. The NHS should be accountable to Ministers so that they can be accountable to the House, which is accountable to taxpayers through the ballot box. That is right constitutionally, morally and practically, which is why it was in both major parties’ manifestos. It is how the NHS operates anyway in practice, but the Bill will remove some of the unnecessary friction in the senior relationships that resulted from the attempt at independence.
Of course clinical voices should always be listened to, but as we saw during the pandemic, we can listen to clinical voices and then make a decision that is held to account on a democratic basis. The Bill will therefore strengthen not just the running of the NHS, but how we constitutionally govern the huge amount of taxpayers’ money that is spent on it. For that reason alone, it is worth supporting the Bill.
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