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Health and Care Bill

Volume 820: debated on Wednesday 23 March 2022

Third Reading

Clause 189: Commencement

Amendment 1

Moved by

1: Clause 189, page 152, line 3, leave out subsection (8)

Member’s explanatory statement

This is a technical amendment necessary to remove a defective reference to a non-existent Clause (Cap on care costs for charging purposes), following its removal at Report stage.

On behalf of my noble friend Lady Wheeler, I will move Amendment 1 and speak to Amendment 2, which are grouped together. This should not take very long, as we speed the Bill on its way to the Commons.

I just want to say one thing: we entered lockdown two years ago today, and I stood here for the next two days, helping to put through the emergency legislation. Some 186,000 deaths later, we are not finished yet. Now is not the time to discuss this, but I just note that that is what happened. I can hear an alarm—I thank the noble Earl for turning it off. I thought that it was mine for a moment, but that is not the noise mine makes.

Amendment 1 is a technical amendment—I thank the Public Bill Office for sorting us all out on this—necessary to remove a defective reference to a non-existent clause, “Cap on care costs for charging purposes”, following its removal on Report.

Amendment 2 leaves out Schedule 6. This is also a technical amendment, necessary to remove Schedule 6, “Intervention powers over the reconfiguration of NHS services”. It was previously introduced by Clause 40 of the Bill as introduced, “Reconfiguration of services: intervention powers”; again, this was removed on Report. I beg to move Amendment 1.

My Lords, the Government will not oppose the minor and technical amendments tabled by the noble Baronesses, Lady Wheeler and Lady Thornton. We respect the fact that both amendments are necessary to reflect, and are consequential on, the removal of the care-cap metering clause and the reconfigurations clause, respectively, even though the Government are disappointed that noble Lords chose to remove these clauses from the Bill.

Amendment 1 agreed.

Schedule 6: Intervention powers over the reconfiguration of NHS services

Amendment 2

Moved by

2: Schedule 6, leave out Schedule 6

Member’s explanatory statement

This is a technical amendment necessary to remove Schedule 6 (Intervention powers over the reconfiguration of NHS services). It was previously introduced by Clause 40 (Reconfiguration of services: intervention powers), which was removed at Report stage.

Amendment 2 agreed.


Moved by

As noble Lords know, I am still learning. I will take a moment to mark the end of the Bill’s passage through your Lordships’ House. Its size reflects the Government’s ambitious agenda for change and the NHS’s requests to help to deliver this change. The Bill intends to strip out needless bureaucracy, improve accountability and enhance integration, and it will form the bedrock for the NHS to build on in years to come.

I will express some words of gratitude. In many ways, the many meetings, the debates and even the late nights during the passage of the Bill have, I believe, shown this House at its best—informed, collaborative and considered. I am grateful to all noble Lords for their intense scrutiny over the nine days of Committee and four days of Report.

I pay tribute to the willingness of noble Lords, right across the House, on all Benches, to engage with me and my officials to find ways to improve the Bill. As well as being grateful to the Labour and Liberal Democrat Front Benches for at times challenging us and at other times agreeing and co-operating, I thank a number of Cross-Bench Peers, including the noble Baronesses, Lady Finlay of Llandaff, Lady Watkins of Tavistock and Lady Hollins, and the noble Lords, Lord Stevens of Birmingham and Lord Patel—who sends his apologies—for their always constructive contributions. I should perhaps also thank noble Lords on the Benches behind me and reflect that the challenge was sometimes from them.

As a relatively new Minister, thrown in at the deep end—your Lordships can see how new I still am from my asking, “Am I on yet?”—I also thank my colleagues on the Government Benches, who have assisted, advised and, I have to admit, consoled me at times throughout the passage of the Bill. I pay tribute to the kind support and advice of my noble friends Lord Howe, Lady Penn and Lady Chisholm of Owlpen.

I also put on record my thanks to the wide range of stakeholders which have engaged with me and many noble Lords, including the NHS Confederation, NHS Providers, the King’s Fund, the Nuffield Trust, the Health Foundation, the Academy of Medical Royal Colleges and the Local Government Association, for their sustained and constructive engagement over several years. I am sure that noble Lords will agree that the Bill is better for all their work.

It would be remiss of me not to pay tribute to the work of colleagues across the NHS, government and the devolved Administrations, who have worked so hard behind the scenes. In particular, I thank my fantastic Bill team and the departmental policy teams supporting them, all of whom have been assiduous, helpful and uncomplaining at all times, despite very long hours. Perhaps I should give a special shout-out to 10 month-old Teddy Povey, son of the Bill team manager. You say that you are getting old when the policemen look younger, but I must say that I felt very old on seeing that the policy officials are getting younger. I pay a special tribute there, on his early introduction to politics.

I thank officials across government, including the Department for Culture, Media and Sport, the Department for Education, the Department for Levelling Up, Housing and Communities, the Ministry of Justice, the Cabinet Office and the Foreign, Commonwealth and Development Office. That shows the sort of cross-government dimension to this Bill.

There is no doubt that your Lordships have improved the Bill. I hope that noble Lords across the Chamber will recognise that the Government have listened, considered and responded positively to suggestions where we were able to. However, I also recognise that there are some areas still to be resolved and where, to use my oft-used phrase one more time, we were unable to close the gap between our positions, including on social care, workforce planning and reconfigurations, on which the House of Commons will want to make its voice heard—and to which we may return in debate. But the areas of disagreement should not overshadow the improvement that all noble Lords have made to the Bill. Together, as a House, we have banned hymenoplasty; introduced a power to create a licensing regime for non-surgical cosmetic procedures; extended the gamete and embryo storage limits; made important commitments to safeguarding children; and strengthened the NHS’s commitment to net zero. On a subject close to my heart and that of my right honourable friend the Secretary of State, we have included specific references to tackling inequalities.

We send to the other place a Health and Care Bill that is improved with its three underpinning principles reinforced: embedding integration, cutting bureaucracy and boosting accountability. I beg to move.

My Lords, I was rather hoping that we would do one of these. I agree with the Minister that we have improved the Bill; it is a much-improved Bill that we are sending back to the Commons, and I hope that they have the good sense to accept all the wise amendments that this House has made.

I also say to the noble Lord, Lord Kamall, that this is his first Bill, and it has been a baptism of fire for him. It is a very large Bill to cut your teeth on. I think that he has had a bit of a masterclass on legislation and legislative processes, but I compliment him on how he has risen to the occasion and thank the whole ministerial team, including the noble Earl and the noble Baroness, Lady Penn; I was about to call her Baroness Jo-Jo, sorry. I also observe that this is a three-baby Bill. The leader of the Bill team and the noble Baroness, Lady Penn, have had babies, and our adviser who started out on the Bill, Rhian, has also had a baby. That is probably quite unusual in your Lordships’ House.

I say thank you, of course, to my wonderful colleagues, my noble friends Lady Wheeler and Lady Merron, and also to the Labour team behind me, particularly my noble friend Lord Hunt, who has been especially active on the Bill—and very welcome that has been, too. We have worked very well across the House, and we have been very pleased to work with the noble Baroness, Lady Walmsley, as well as the noble Baroness, Lady Brinton, at a distance, and with many colleagues on the Cross Benches. If I start listing them, I know that I shall forget someone, but I need to mention the noble Lord, Lord Patel. He has not been with us for as much of the Bill as he would have liked, but of course his wisdom has been with us all the way through the Bill.

We are sending the Bill back to the other place, and I suspect that we are all going to be busy when it starts pinging and ponging back.

My Lords, this Bill is of great significance to the NHS, care services and, in particular, patients and residents in the care system. As the noble Baroness, Lady Thornton, and the Minister have said, it has been improved by your Lordships’ usual scrutiny.

I am very grateful to the noble Lord, Lord Kamall, and the other two Ministers working on the Bill. By my calculations, the Government have given us either changes or reassurances on 13 different areas in this Bill. It certainly shows that the ministerial team and the Bill team—to which I am also grateful—have been listening. They have devoted an enormous amount of time to hearing our concerns and responding to them. I thank them for that.

This Bill has been a model of how people can work across parties in this House. I am grateful to the noble Baroness, Lady Thornton, and her team for the way that we have been able to collaborate on issues on which we agree, and indeed to the Cross-Benchers, many of whom have enormous expertise in health issues and have helped us all to understand the significance of the issues that we have been discussing. It has really been a model of how we can work together, and I am most grateful for that.

I am particularly grateful to the wonderful team behind me and my noble friend Lady Brinton, who unfortunately has to participate virtually. When the Chief Whip asked me to be the Front-Bench anchorwoman on this Bill, because my noble friend, our spokesperson, has to participate virtually, I said that I would do it as long as I could put a team together. Well, my colleagues have stepped up magnificently and I am most grateful to them; I could not have done it without them. In particular, my noble friend Lady Brinton, with her tremendous knowledge and conscientious scrutiny of this Bill, has been wonderful.

As we now unhook the hawsers, put the sails up and send this Bill sailing down the Corridor to the other end, I hope I will be forgiven for suggesting that I hope we do not see too much of it coming back.

My Lords, I hate myself for this, but I forgot two people. Half way through the Bill, we acquired a new advisor, Liz Cronin, who has done an excellent job, and there is Richard Bourne, who has been sat by my side, right through the Lansley Bill and this one. They have my thanks.

From these Benches, I very briefly thank the Minister, the noble Baroness, Lady Penn, the noble Earl, Lord Howe, the whole Bill team and all the officials who have worked with them for the way that they have listened—repeatedly listened—as we made our points over and again and as they sought sometimes to try to understand what we were trying to get across and why. I also thank everyone across the House, on all the Opposition Benches, the Cross Benches and the Government Benches, who have worked with us as Cross-Benchers in a very collaborative way and made their own offices available for background support to all of us.

I echo the words of the noble Baroness, Lady Thornton: this Bill leaves us better. It has been a genuine pleasure to work on it. Some of us have worked on previous Bills, and I have to say that this was a more enjoyable and rewarding experience because the dialogue involved a better interchange at many points.

We have made some points of great significance, one of which was over palliative care, which has been dear to my heart. Palliative care has come of age. I think the House will be pleased to know that, on Friday morning, the annual meeting of the Association for Palliative Medicine has a specific session dedicated to understanding the changes and what it now needs to do in the light of those. The word goes fast from here, and that is very welcome.

I hope that I have not forgotten anybody in my thanks, which are open and sincerely expressed.

My Lords, I rise very briefly, with the Green group having made quite a large contribution—certainly in hours—to this Bill.

This House has improved the Bill, but I feel I need to say that I have received in the last few days a significant number of emails. They are not part of a co-ordinated campaign; they are cries from the heart, many from long-term NHS campaigners who I have known for a long while. I quote just one of these, which says that:

“The Bill is still not in the interests of the public or indeed of the NHS itself as a comprehensive, universal public service”.

That is an expression of feeling that I am hearing very strongly. I hope that the Minister will listen to that and understand that there are very grave concerns out there among the public about the direction of the NHS.

The improvements that we have at least delivered, as other noble Lords have said, should stay, but the Government really need to safeguard this universal public service.

Bill passed and returned to the Commons with amendments.