My Lords, Amendment 112 is my name and the names of the noble Lords, Lord Hunt, Lord Scriven and Lord Kakkar. I am grateful for their support. This amendment goes much wider in terms of independence from the Secretary of State than Amendment 80, moved so convincingly by the noble Baroness, Lady Cumberlege, earlier today.
Amendment 112 establishes a new body to help to secure the long-term sustainability of our health and care system. That body is an independent office for health and care sustainability as recommended by this House’s Select Committee on the Long-term Sustainability of the NHS and adult social care. This new body is based on the model of the Office for Budget Responsibility. That body is widely accepted as having worked well over a number of years. My amendment draws heavily on the 2011 legislation setting up the OBR.
The new office of health and care sustainability has three main functions which are set out clearly in the amendment, so in the interests of time I will not repeat them. The new body would look five to 10 to 15 years ahead and publish regular reports which would be laid before both Houses of Parliament. It would produce an initial baseline report within a year of its establishment. Like the OBR, the new body would have an executive chair and five members. The chair and two members would be appointed by the Health Secretary but—and this is a very big but—with the consent of the House of Commons’ Public Accounts Committee and Health and Social Care Committee. The remaining two members would be chosen by the office itself. Like the OBR, the new body would not have a membership controlled by Ministers.
The new office of health and care sustainability would be much more independent of the Secretary of State than is provided for in Amendment 80. It would have a much wider remit in terms of improving the balance between the NHS and social care, on both staffing and funding. The greater long-term independence seems essential given that the Department of Health—now the Department of Health and Social Care—has a political and official track record which was revealed to the Lords Select Committee as pretty unsatisfactory.
The Department of Health has been failing to plan for the future for a very long time. The evidence given by its Permanent Secretary totally failed to convince the Select Committee that it took long-term planning seriously. That Permanent Secretary is still in place. I do not like personal attacks, but in evidence to the Select Committee this person actually said that he did not see long-term planning as part of his job description. So we have a situation where the long-term planning of the NHS and social care is simply not on the agenda of the government department responsible for it.
With this track record and the Covid recovery programme that the Department of Health and Social Care now faces, it seems to me a triumph of optimism over reality to rely on that department and its harassed political head to undertake long-term planning. I say that despite the House passing Amendment 80. We are looking for a situation in which there is more independence of the Secretary of State and, indeed, more independence in the collection of information, the sifting of that
information, and the analysis that that information shows—and that covers funding as well as workforce issues.
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I am pleased to say, however, about the report that was presented to the then Health Secretary, Jeremy Hunt, although it seemed at the time not to get much support from him, that he seems to have had a Damascene conversion since taking up the job of chair of the Health Select Committee. In an interview that he gave to the Times last year, he is quoted as saying that
“he wants an Office for Budget Responsibility-style body to keep his successors ‘honest’ by spelling out how many doctors and nurses are needed.”
The only problem with that conversion is that it fails to consider all the other types of staff that a sustainable health and care system needs, but it is better that he has moved some way towards accepting that there is a need for a body of this kind.
If we want a sustainable health and care system in the decades ahead, we need an independent office of health and care sustainability to do the long-term planning. History has shown that we cannot rely on the departments and their political heads, who are busy doing the day-to-day stuff, to take the time to plan for the future far ahead to sustain our health, our NHS and our adult social care system. I beg to move.