My Lords, I draw attention to my entry in the register, in particular as a long-standing partner at the international commercial law firm DAC Beachcroft. Unlike the noble Baroness, Lady Jones of Moulsecoomb, I warmly welcome the Bill. In its broad architecture and intent, as the noble Lord, Lord Stevens of Birmingham, pointed out in his superb maiden speech, it goes very much with the grain of what healthcare professionals want, building on existing and emerging best practice—in particular non-statutory integrated care systems. Among the innovations in the Bill, I welcome in particular the proposed new Health Services Safety Investigations Body, extended to encourage learning across the whole sector rather than just in the NHS.
Some argue that it might have been better to delay these reforms until the Covid-19 pandemic was truly a thing of the past. Ultimately it is for the Minister to allay those concerns, not me, but if anything I think the Bill is overdue. The pandemic has put the system under unprecedented strain, and although the NHS and its independent sector colleagues co-operated brilliantly to continue to deliver healthcare, some cracks understandably did begin to show.
I have been in Parliament for 45 years now, and the holy grail for me has always been a so-called seamless robe of health and social care. There are always people in hospital who would be better off elsewhere, always shortfalls in at-home care staff, and always breakdowns in communication between healthcare and the social care system. It is an age-old problem, and one that came into sharp—indeed, horrifying—focus during the first wave of the Covid-19 pandemic.
The biggest concern across both healthcare and social care is still staffing. The ability to meet demand through recruitment and, within social care especially, reducing the current unsustainable level of churn, remains the key to delivering the world-class health and social care of which we are capable. The availability and accessibility of alternative care settings—for example, at-home care—also require dramatic improvement. This will all require more people, more training and more money.
In another place there was an attempt to amend the Bill to make it provide for regular, authoritative workforce projections. Perhaps such an amendment might ultimately find its way into the Bill. I hope so.
Those who experience health inequalities have also been disproportionately affected by the pandemic. Might it be beneficial for the Secretary of State to be able to place specific requirements on the new NHS commissioning bodies to have regard to particular aspects of inequalities?
Of course, the Bill is now buttressed by the proposals in the Government’s White Paper on social care, which I also welcome. I would be delighted to hear from the Minister whether anything from the White Paper might yet find its way into the Bill, here or in another place, because we must move more quickly.
No one, though, wants the NHS to live in a state of permanent revolution, so there must be no change for change’s sake. Now more than ever, change must be purposeful, rational and highly effective, capturing the positives in cross-sector co-operation that we all recognise.
Many of the principles in the Bill have long been adumbrated by the opposition parties themselves, in particular the vital principle of affirming that the Secretary of State must have overall responsibility for the NHS. I therefore very much hope that we can now all work together to achieve a degree of consensus across all parties and beyond. The NHS is far too important to be a party-political football.
I already like the Bill very much indeed, and I fervently hope that we all grow to like it more and more as it progresses through all its stages, in particular in this House.
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