My Lords, I begin by declaring my interest as the recently departed chair of NHS Improvement. I support these amendments, especially those that seek to extend the triple aim, such as Amendments 14, 65 and 94, as the noble Lord, Lord Kakkar, just set out so eloquently. It seems there is no disagreement in the Committee about the importance of addressing health inequalities. Anyone who has lived through the past two years can see that plainly and clearly, as Covid has so cruelly highlighted the health inequalities in this country. The question is how we make sure this Bill genuinely tackles the issue that we all agree about so passionately. Why is it important, as just set out by the noble Lord, Lord Kakkar, to put the duty to address health inequalities in the Bill?
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I want to make as my contribution a short story about a visit that I made recently in my capacity as chair of NHS Improvement with the noble Lord, Lord Mawson,
to north-west Surrey last summer. We visited the team from the NHS trust, Ashford and St Peter’s, as well as the local authority and a number of local community organisations. There was a moment in that visit when the medical director of the trust, a cardiac surgeon, said that he had had an epiphany: the NHS was not the most important actor in addressing health inequalities. He said that had hit him like a train; he had realised that he and his trust, by far the biggest organisation in the integrated care system and the largest employer with the most money, needed to play a supporting role rather than the prime-moving, main acting role. That was a huge culture shift for him and for the trust that he was part of. Over the course of the last couple of years, it has led them to do some small but hugely important things, such as relocating their physiotherapy clinics to gyms, which means that people get more into the habit of exercising when their NHS treatment ends. That requires the NHS to be subservient to the local authorities, voluntary organisations and private sector partners in their integrated system. If we are really to address health inequalities, that requires change from our beloved NHS.
The system that I am describing is one of our very best but they would openly admit that they are still in the early stages of that change, which is why it is so important that we put this in the legislation. I know that the Minister and the Secretary of State care deeply and passionately about addressing health inequalities; both have been very public about their commitment. I urge them to hear the spirit of the cross- party agreement in this Committee today and accept the amendments.