Health Bill

Baroness Pidgeon Excerpts

Committee stage
Wednesday 28th October 2026 Lords Chamber

It is a salutary reminder that one of the reasons why we wish to have central interventions is that the local NHS seems incapable of sorting out things such as this. I am not sure about the noble Lord’s amendments, but I think his aims are very important.

[Baroness Pidgeon (LD)]

My Lords, these amendments tabled by my noble friend Lord Rennard raise some important points and are intended to safeguard national diabetes services following the planned abolition of NHS England, and to ensure that patients do not lose access to proven programmes during that transition.

This is a point that has come to me time and again from different charities representing different disease groups. They are concerned that the specialism and some of the services that are commissioned will be lost. I am sure we will discuss this again on other Committee days.

As we have heard, diabetes is one of the greatest health challenges facing us all. According to Diabetes UK, over 12 million people in the UK are living with diabetes or prediabetes, and it costs the NHS around £10.7 billion every year. That expenditure is linked to complications that can often be prevented through early intervention, effective treatment and consistent monitoring, as well as routine diabetes care.

The amendments would therefore require the Secretary of State to maintain, at a minimum, the current provision of key national programmes. As we have heard, these include the NHS type 2 diabetes prevention programme, the diabetes path to remission programme, continuous glucose monitoring, the rollout of hybrid closed-loop technology and the national diabetes audit programme. I flag that the type 2 diabetes prevention programme is recognised as a world-leading prevention intervention. We do not want to see that lost with this reorganisation.

The amendments would also strengthen transparency and accountability. Before any transfer of functions, the Secretary of State would be required to set out how continuity of these services would be guaranteed. Annual reports to Parliament would then provide clear information on patient access, waiting times and outcomes, while separate assessments over the first four years following the abolition would monitor the impact on funding, workforce capacity or clinical audits, and access to technologies.

At a time when diabetes continues to rise and the impact felt both by individuals and financially throughout the NHS is so significant, it is essential we have confidence that these vital national programmes will not only survive the organisational change but continue to improve outcomes for people living with diabetes. I look forward to hearing the Minister’s response.

[Earl Howe (Con)]

My Lords, I too am grateful to the noble Lord, Lord Rennard, for bringing forward these amendments and for drawing the Committee’s attention to the important issue of diabetes prevention, treatment and care. I particularly welcome the focus in these amendments on innovation, because this is an area in which we see some genuinely promising developments. One example, mentioned by the noble Lord, Lord Rennard, and the noble Baroness, Lady Pidgeon, is the emergence of hybrid closed-loop systems. For people living with type 1 diabetes, this technology has the potential to make an enormous difference.

In April 2024, NHS England began a five-year programme to roll out this technology to eligible children, young people and adults living with type 1 diabetes. That was a very welcome development, and I hope we will continue to see the programme expanded so that more patients who would benefit from the technology are able to access it. It would be helpful to hear from the Minister about that, and about how the rollout of the programme is progressing and how many patients have received the technology so far. As with any issue like this, improvements in accessing the technology are always forefront of commissioners’ minds, so it would be helpful if the Minister can say anything about that. I would also be interested to hear what assessment the Government have made of the availability of specialist staff to support this rollout. Developing an effective new technology is one thing; ensuring that patients can access it, and that clinical teams have the resources and expertise to provide it, is another.

More widely, these amendments raise an important question about the future scale and impact of diabetes in this country. The noble Lord, Lord Rennard, highlighted the statistics and predictions from the International Diabetes Federation. Those predictions present a considerable challenge for not only patients and their families but for the health service. They also reinforce the importance of prevention, particularly in relation to type 2 diabetes, where earlier intervention can make a considerable difference. Can the Minister tell us what steps the Government are taking to strengthen prevention and early diagnosis and to support the wider adoption of new technologies?

Finally, I want briefly to touch on Amendments 225 and 226, which raise a wider point about the abolition of NHS England and the continuity of existing national diabetes programmes. During our consideration of the Bill, we have discussed at some length the importance of ensuring that the abolition of NHS England does not disrupt the delivery of essential services or lead to the loss of programmes and expertise that are already delivering benefits to patients. The noble Lord is absolutely right to raise that concern in the context of diabetes. I am not necessarily persuaded that we need to place each of these requirements in statute, but he raises some entirely legitimate questions. I would welcome assurances from the Minister that these programmes will continue to receive the attention and support they require throughout the transition. I look forward to what the Minister has to say.

Health Bill

Baroness Pidgeon Excerpts

Committee stage
Wednesday 28th October 2026 Lords Chamber

[Baroness Finlay of Llandaff (CB)]

My Lords, I welcome the Minister’s discussions with the devolved Governments and her saying that nothing is going to be potentially imposed on them, particularly having had those discussions. But can she clarify what will happen to some of the prevention agendas that have been in place—such as the Couch to 5K programme, for which I understand no outcomes have been collected, but which has been part of NHSE and the department’s promotion of exercise—and whether these programmes will be increasingly promoted across England as part of the prevention agenda, and in discussion with the devolved Governments, so that we get consistency in prevention across the United Kingdom?

[Baroness Pidgeon (LD)]

My Lords, we welcome these Government amendments, which ensure that the devolved Administrations’ boundaries are protected and that there is proper consultation and agreement. But devolution must be integral to any legislation from the start, rather than an afterthought. Granted, there has been consultation with the devolved Governments, but these amendments were tabled very late and this is a worrying sign. It is an indication that aspects of the reorganisation and its governance implications had not been properly thought through at the start—through the lens of the devolved Administrations, rather than simply through that of Whitehall and civil servants centrally. The Minister’s words have provided some assurance, and I look forward to the devolved Administrations being at the start and the heart of legislation such as this in the future, rather than an add-on at a late stage.

[Earl Howe (Con)]

My Lords, it is a pleasure to begin our Committee consideration of the Health Bill, and I look forward to the discussions over the coming days. I am grateful to the Minister and to the Government for bringing forward these amendments, which we understand to be principally technical in nature, although there are questions we shall want to ask in later groups about cross-border patient referrals and related issues. We welcome the clarification these amendments provide regarding the consent of the devolved Administrations and the exercise of powers by devolved health bodies, and we are content to support them.

I hope the Committee will allow me to take this opportunity to acknowledge the letter sent by the Minister this morning concerning Healthwatch. Noble Lords across the House will welcome the Government’s decision not to proceed with its abolition, and I am grateful to the Minister for listening to the concerns raised in this House and elsewhere. This is a very positive example of the Government engaging constructively with the scrutiny of this Bill and showing a willingness to reconsider their proposals where legitimate concerns have been raised. That is precisely the spirit in which I hope we can continue our consideration of this legislation, and I welcome the approach the Government have taken on this occasion. I look forward to the Minister’s response.

--- Later in debate ---

[Lord Mawson (CB)]

My Lords, I found this an interesting debate, and I am sympathetic to the amendment of the noble Baroness, Lady Bennett, and particularly that of the noble Lord, Lord Patel, because he is right that very little is actually being learned. My colleagues and I have listened, over the years, to lots of conversations about health inequalities. When you spend your life in very challenging housing estates and see very little changing, you know about the distance between all the words and the practice.

That is why, many years ago, we decided to focus on practice and the doing of things, rather than the talking about things. We began to realise what every parent knows: that you only really learn by doing. When I started to work with GPs, originally in east London, they began by telling me that was how you became a GP. You saw one, you did one and then you taught one; it was a very practical matter. Businesses and entrepreneurs nowadays know that you learn by doing things. Yet in the state, which often feels so out of date in the NHS, there is no learning by doing culture. There is a learning by writing very fine reports, often at 60,000 feet, that seem very unengaged with practice.

Over the years, it has been interesting to observe what happened through practice. The Bromley-by-Bow model is well known, so I will not use it, but the noble Earl, Lord Howe, knows that I was also responsible for the transformation of a street following a murder and 10,000 illegal injections being given out in a housing estate. There were some terribly violent circumstances going on at the time. When I brought the first key people on the street together, all of them—the GP, the school and the housing association—were saying, “We cannot deal with this on our own. We need to do it together. These things are so interconnected”, and we built together the St Paul’s Way Transformation Project, which started with nothing and led to a new £40 million school, a £16 million health centre, 600 homes and now a new primary school.

We joined it up, and Professor Brian Cox and I led our 14th science summer school in June this year, with a masterclass at the end of it on quantum physics, for the children from the same housing estates. It is the same children and same families, and now they have one of the best performing schools in Tower Hamlets. The noble Earl, Lord Howe, helped us greatly at one key point with learning by doing, when he met the whole group—housing, health and education—when the NHS was getting in the way of us completing on the deal for the health centre. He was very helpful in enabling that to actually happen.

It was Duncan Selbie, the chief executive of Public Health England in 2015, who gave me £20 million and said, “Andrew, take this culture that you’ve been developing into the north of England”. We built 10 learning by doing innovation platforms in Rotherham, Bradford, Doncaster and Bootle, all of which were about bringing people together to learn about these matters. It was interesting that when I met the public health officials in each of these places, who were lovely people quoting all the same data that I had heard many times before, and said to them, “What are you actually going to do about that data?”, there was absolute silence. It was not their fault. They did not have the skills to know how to turn fine words into practice for some of the most challenging communities in this country.

It is my view that one of the things being missed in this moment is the serious need to get real about innovation and learning by doing. My colleagues and I—I declare my interests—are at the moment creating at place, on the ground, with local people and professionals, what we call these learning by doing innovation platforms, so that we bring together the actual GP, business person and local resident, and you begin to explore these issues together because in the modern world, health is everybody’s business. It is not just a matter for GPs. It is interconnected and we need to explore what that means.

My concern about where we are at the moment in discussing this Bill, which is a fantastic opportunity for this Government, and this country, to move into a form of health that is of this century and not last century, is that we are going to end up building a lot of biomedical boxes around this country that do not explore these interfaces in some of our most challenging communities. The noble Lord, Lord Patel, is right; we need to worry about why he is right and why things are not being learnt.

I finish with the thought that it is our experience over the years that, sadly, we have to say that, in so many respects, the NHS is not a learning organisation. We must have hosted 70 Government Ministers to our work over the years. They all come and say, “Wow, this is fantastic, we need to do more of it”. I can name the four who did anything practical about that, and the other 66 sit on a list in this pocket. This is not to do with bad people. It is about whether, as a nation, we are now going to get upstream into prevention and health creation and create a learning by doing environment in which we all learn together, and in which local people are part of all of that process.

[Baroness Pidgeon (LD)]

My Lords, this is a very important group of amendments, and it has been a really excellent debate. One of the most pressing issues facing us is the widening gap in health outcomes between different communities. Healthy life expectancy has fallen in recent years and the gap between the most and least deprived areas of England, as we have heard, now stands at almost 20 years.

The point made earlier by the noble Lord, Lord Crisp, when he talked about the role of the department being one of leadership for health across government, not just running the NHS, is really important as we approach this group of amendments. We have heard clearly that the current legislative framework places relatively weak duties on government to address these wider determinants of health and tackle inequalities.

The House of Commons Health and Social Care Select Committee, in its scrutiny of the Bill, called for a stronger focus on improving the nation’s health and tackling inequalities, emphasising the need for clearer accountability and a more robust approach to prevention across government. Many of the amendments in this group would help to achieve that aim by ensuring that reducing health inequalities becomes a central objective of health policy, and that progress is measured and reported transparently.

My noble friend Lady Walmsley’s amendments, spoken to by my noble friend Lady Tyler, and Amendment 7 from the noble Lord, Lord Patel, would strengthen the duty on the Secretary of State to take steps or action, rather than simply “have regard to”. That is really important. Amendment 14, tabled by the noble Lord, Lord Patel of Bradford, and supported by so many Members of the House today, would require the Secretary of State

“to have specific regard to reducing inequalities”

in coastal communities. The point has been made clearly about the added complexities for such communities, whether those are workforce related or in local service provision. Those are really important.

My Amendment 20 looks at health inequalities in urban areas and requests a strategy and an annual report. Impact on Urban Health, which is part of Guy’s & St Thomas’ Foundation, recently reported its State of Urban Health research and found that preventable mortality is 2.7 times higher in the most deprived urban neighbourhoods in England than in the least deprived. Urban areas also face some of England’s starkest health inequalities, with people living just streets apart experiencing significant differences in health. You have only to look over the river to the London Borough of Lambeth, where Impact on Urban Health is based: females who live just over a mile apart face an eight-year gap in life expectancy. As we have heard, these inequalities are driven by unfair and avoidable differences in everyday environments. These include exposure to air pollution, differences in housing quality and access to healthy, affordable food. I pulled this area out for specific attention: rather like the coastal communities amendment, it needs specific action.

My noble friend Baroness Tyler spoke strongly to Amendment 18, which would require a cross-government health inequality strategy and subsequent annual reports to Parliament on progress. That would focus minds and energy across government and would address the key point from the Health and Social Care Select Committee, as well as many of our suggestions in amendments and today’s debate.

If we are serious about narrowing the gap in healthy life expectancy and giving everyone the opportunity to live a healthier life, then action on the wider determinants of health and tackling health inequalities must sit at the heart of the Bill, not at its margins. I look forward to hearing the Minister’s response.

[Baroness Cash (Con)]

My Lords, I begin by thanking all noble Lords who tabled amendments in this important group and for the high quality of debate. At this time in the evening, it falls to me to be as brief as possible. As the quality of debate and the points made have been so thorough, I will try not to repeat anything.

We are all very much agreed: from these Benches, we have heard from the noble Lord, Lord Lansley, from the noble Baroness, Lady Manzoor, and from the noble Baroness, Lady Hodgson. We care a great deal about the inequalities in health outcomes in this country, but I am very grateful to the noble Baronesses, Lady Gerada and Lady Royall, for drawing the distinction between healthcare inequalities and health inequalities. It is important, and it is important for the purpose of the Bill and the duties that ought to be placed on the Secretary of State for Health.

It is incredibly challenging and painful to hear the data regarding ongoing inequalities. We know, of course, that healthcare is not the reason why it is in that state. The factors that play a part sit in different departments, which is why these Benches welcome the amendments which ask for a strategy. I hope that the Minister will consider joining up some of the significant work being done by the Government in the Fonagy review and the Milburn review to look at all these issues together.

It would be helpful to hear from the Minister about the specific actions the Secretary of State would be expected to undertake to ensure the duty as it is currently drafted, and how Parliament would be able to assess those decisions. We have heard from the noble Lord, Lord Lansley, about how we might improve on the current legislation, and it is important that we hear how that might be done. The inequalities in general practice are significant and challenging, and I look forward to hearing from the Minister about the Government’s plans to address them, such as through incentives to serve in different areas, targeted work plans and ensuring that enough training, development and recruitment is going on in those areas. I hope that all these issues will be subject to consideration by the Minister.

We cannot expect to reduce health inequalities without addressing these disparities in primary care. We look forward to hearing what might be done and what might be included in this Bill to do that. In the end, we must judge success by whether patients have access to the healthcare needed at the point of delivery. I look forward to the Minister’s response.

LED Lighting: Health Effects

Baroness Pidgeon Excerpts

Wednesday 28th October 2026 Lords Chamber

[Baroness Merron (Lab)]

The DfT is undertaking independent research and is approaching this with regulatory changes and through international safety standards. The noble Lord raised the question of why glare is a problem. The Which? report on this, published only yesterday, talked not just about brighter LED but the height of vehicles and beam alignment. The DfT has just this week updated driver advice in the Highway Code on this very point, encouraging people to get it checked.

[Baroness Pidgeon (LD)]

My Lords, the Advertising Standards Authority upheld a complaint in June about an LED face mask that claimed it was clinically proven it could reduce wrinkles in four weeks.

[A noble Lord]

Who bought it?

[Baroness Pidgeon (LD)]

Exactly. Given there are numerous adverts for at-home LED beauty devices in the run-up to Christmas, will the Government urgently assess whether existing regulation adequately protects consumers in terms of product safety and the evidence supporting claims about health benefits?

[Baroness Merron (Lab)]

This is ongoing work. If it was a true claim, I am sure that many noble Lords would have been very keen to benefit—me included.

Fracture Liaison Services: National Coverage

Baroness Pidgeon Excerpts

Tuesday 27th October 2026 Lords Chamber

[Baroness Merron (Lab)]

I agree with the noble Baroness that that is one of the most important functions, because of course prevention and recovery are also key. As I have mentioned, ICBs are focused on providing services closer to home. Also, we are working with NHS England so that we can improve frailty services in acute settings as a priority, including through same-day emergency care and through comprehensive geriatric assessments.

[Baroness Pidgeon (LD)]

My Lords, what assessment have the Government made of the workforce and funding required to deliver national coverage? Will those requirements be reflected in the delivery plan?

[Baroness Merron (Lab)]

I refer the noble Baroness to the forthcoming 10-year workforce plan, which will make sure that the NHS has the staff that it needs, including in frailty services. Fracture liaison services deploy multidisciplinary teams to ensure prompt diagnosis and appropriate treatment. We have made available, through the Department for Education, loans for living costs to support students from the lowest income families to make sure that they can train and be part of the workforce. That is one area where we are developing recruitment and training.

Corridor Care

Baroness Pidgeon Excerpts

Tuesday 20th October 2026 Lords Chamber

Asked by

[Baroness Pidgeon]

To ask His Majesty’s Government what progress they have made on their commitment to end corridor care.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, corridor care is unacceptable, and we are tackling its causes by preventing avoidable admissions, improving patient flow and accelerating safe discharge. Just this weekend, we announced almost £140 million for 14 urgent care schemes, alongside 25 new or expanded sites, which are due to open for winter. Despite unprecedented summer demand, around 50 trusts reduced corridor care. We are working to end corridor care by the end of this Parliament.

[Baroness Pidgeon (LD)]

My Lords, the Royal College of Emergency Medicine has reported today that two-thirds of clinical leads say their trust does not count as corridor care patients on chairs in corridors, patients who have been put on chairs in waiting rooms or even patients in corridors on the way in. What action will the Government take, and by when, to make sure that every trust counts every patient, so that we have a true picture of corridor care in this country?

[Baroness Merron (Lab)]

We are a lot closer to having a true picture, because in March this year we introduced a consistent national definition of corridor care, which I know the noble Baroness has been very keen on. In addition, for the first time monthly national data has been published since June, which is giving us greater visibility of where corridor care is occurring and, in particular, allowing support to be targeted at the most challenged hospitals.

Neighbourhood Health and Social Care

Baroness Pidgeon Excerpts

Tuesday 15th September 2026 Lords Chamber

[Baroness Merron (Lab)]

The noble Baroness is quite right to talk about people having more complex needs, and, indeed, we are also living longer. However, the current health system is organised around institutions and services that are complex, disjointed and difficult to navigate, as she said. On housing, for example, I know that the health and well-being boards, which are the key to this, can design themselves to bring in services. I can think of a number which have already done that and included people from housing in the way that she describes. It is absolutely encouraged and health and well-being boards across the country are already doing that.

[Baroness Pidgeon (LD)]

My Lords, a recent workforce assessment by Skills for Care found that adult social care in England still had around 96,000 vacancies and projected that a further 410,000 posts will be needed by 2040 to meet demand. What are the Government doing to address these shortages and deliver genuine integrated patient services?

[Baroness Merron (Lab)]

We recognise the continuing challenge that we inherited in terms of workforce, but that is why we are investing in the adult social care workforce. In 2028, the first ever fair pay agreement will come in, which will be backed by £500 million of funding. It will improve pay and conditions for the workforce, which is crucial. We are also implementing the first ever universal career structure for the adult social care workforce, as well as investing up to £10 million this year in the learning and development support scheme. This, along with all the other changes, will make a massive difference to the workforce in terms of retention, recruitment and development.

NHS: Agency Medical Staff

Baroness Pidgeon Excerpts

Wednesday 9th September 2026 Lords Chamber

[Lord McColl of Dulwich (Con)]

My Lords—

[Baroness Pidgeon (LD)]

My Lords—

[Captain of the King’s Bodyguard of the Yeomen of the Guard and Deputy Chief Whip (Baroness Anderson of Stoke-on-Trent) (Lab)]

My Lords, we will hear from the Liberal Democrats.

[Baroness Pidgeon (LD)]

My Lords, CQC inspections repeatedly warn that caring for unmonitored patients in hospital corridors carries severe safety risks. What assessment have the Government made of the use of agency staff in corridor areas and the clinical risks of deploying such staff in non-designated care areas?

Integrated Care Boards: Access to Services

Baroness Pidgeon Excerpts

Tuesday 8th September 2026 Lords Chamber

Asked by

[Baroness Pidgeon]

To ask His Majesty’s Government what assessment they have made of access to primary and community health services by integrated care boards.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, access to primary care is improving. The year June 2025 to June 2026 saw nearly 14 million more GP appointments compared with the same period in the previous year, and satisfaction when contacting a GP increased by over 14% compared with July 2024. For the first time, we have introduced a waiting time standard for community health services, and 37.6 million NHS dental treatment courses were delivered in 2025-26, which is 6.2% higher than in 2024-25.

[Baroness Pidgeon (LD)]

My Lords, more than 600,000 people are waiting for hospital eye appointments, yet on our high streets there are optometrists who can provide urgent and minor eye care services, ensuring faster, more convenient access for patients. Will the Government require all ICBs to commission these basic community health services?

[Baroness Merron (Lab)]

The requirement on ICBs now is to focus on the strategic commissioning of health services and to be responsible for all but the most specialised services. Looking particularly at improvement of access to eye care, which is extremely important, the Government recently announced some £20 million to improve digital connectivity between primary care, optometry and secondary eye care. In all these ways, people will be far better served in their eye care.

Neighbourhood Health Services

Baroness Pidgeon Excerpts

Monday 7th September 2026 Lords Chamber

[Baroness Merron (Lab)]

The noble Baroness set out exactly what the plan is, and I am grateful to her for doing so, but I emphasise that the whole point of the independent national evaluation is that it will evaluate the whole breadth of neighbourhood health. It started in April and will run for three years. I further emphasise that it is about continual engagement and developing different ways that neighbourhood health can be successful. It will also model what the long-term outcomes and improvements can be, depending on how you do it. All that will mean working with the local ICBs to see about their progress, but they are well aware of the expectations upon them, and they will set their own ways forward.

[Baroness Pidgeon (LD)]

My Lords, if neighbourhood health services are to succeed, more care will be delivered through general practice and community settings, yet NHS funding allocated to general practice has fallen over the last decade. Will the Government consider introducing a primary care investment standard to ensure primary care can grow in line with this ambition?

[Baroness Merron (Lab)]

We do not intend to bring forward the investment standard that the noble Baroness seeks. I am aware that a discussion is going on—probably as we speak—through the Health Bill, which is about to be introduced to your Lordships’ House. That is about increasing accountability and responsiveness to local needs and improving outcomes. I say to the noble Baroness that our fear is that bringing in yet another approach, through an investment standard, risks undermining that.

Childbirth-related Post-traumatic Stress Disorder

Baroness Pidgeon Excerpts

Wednesday 2nd September 2026 Lords Chamber

[Baroness Merron (Lab)]

While I cannot give the specifics here and now, I will be pleased to get that information to the noble Baroness. She is right to highlight the need to make sure that all women have access and that all women who have PTSD or experience of birth trauma are identified. Record numbers of women are now accessing specialist perinatal mental health services—66,500 women last year in England alone. The figures I can get the noble Baroness will, however, give a much better flavour of how we are reaching groups who may well be marginalised in the way that she describes.

[Baroness Pidgeon (LD)]

My Lords, given that six out of 10 maternity units have been assessed as unsafe by the Care Quality Commission, it is not surprising that this research identifies thousands of women experiencing birth trauma. Will the Government now guarantee one-to-one midwifery care during labour and a consultant on every maternity ward 24/7 to support women giving birth?

[Baroness Merron (Lab)]

Safety is key, and so are the experiences of women and their families. The noble Baroness and the House will be well aware of the national maternity and neonatal plan, which will drive proper, sustained improvement across the system. This is what I believe we have been lacking for years, and it is why we asked the noble Baroness, Lady Amos, to conduct an independent review. She has reported on that and the maternity and neonatal plan will be announced by the end of this year. I certainly look forward to that; it is being worked on as we speak, involving both clinicians and those with lived experience, as well as campaigning organisations and all those with an interest. I am feeling positive about how we move forward, and the point made by the noble Baroness about staffing and ratios will of course be part of that.