Neighbourhood Health Services

Lord Kamall Excerpts

Tuesday 10th November 2026 Lords Chamber

[Baroness Merron (Lab)]

By expanding urgent community care, we will reduce avoidable emergency department attendances, hospital admissions and ambulance conveyances. That is why we are engaging not just an urgent community response but virtual ward services. I also point to the fact that we are supporting patients to book the most appropriate urgent care service through NHS 111 or the NHS app before attending emergency departments. There are a number of very good examples around the country of how people are doing that. Winter is going to be hugely challenging, and that is why, for example, we are putting in £190 million to help the NHS manage winter pressures and £140 million for new urgent care schemes.

[Lord Kamall (Con)]

My Lords, we all agree with the shift from hospital to community but, as we discussed on the Health Bill in Committee last night, we are still waiting for details of how it will all fit together. Can the Minister explain whether existing primary care providers, especially local GP practices, will be expected to rebrand as neighbourhood health centres and maybe offer some additional services, particularly secondary services, or will existing GP practices be told to physically move from their current premises into a neighbourhood health centre, and how will they be consulted?

[Baroness Merron (Lab)]

We are supporting ICBs, providers and everyone across the NHS to work together differently. That is the main point I want to get across. In March this year, we published Fit for the Future: Towards Population Health Delivery Models, which set out three new population-based contract types. They aim to bring various aspects of services into a single contract, and they will deliver a shift from what is currently fragmented, service-by-service commissioning to end-to-end pathways around the patient. That is where we need to get to. GPs are very much part of that, and we have involved them throughout.

Health Bill

Lord Kamall Excerpts

Committee stage
Monday 9th November 2026 Lords Chamber

[Lord Scriven (LD)]

My Lord, when we started this group, I did not expect the phrase “the Soviet model of healthcare” to be mentioned, but the noble Baroness, Lady Murphy, used it. It is always surprising what one hears and learns in Committee. From these Benches, our starting point is simple: the principle that defines the NHS is that care is free at the point of use and based on need, not ability, to pay. That is a line that I think most noble Lords would never wish us to cross.

Who owns the building matters less to a patient than whether they get good care in good time, and a good outcome without paying for it. As Liberals, we start from individual patients. We ask what power the patient has, who can take it away and why. I respect what the noble Baroness, Lady Bennett, is trying to do. She is right to raise concerns about profit and public money, but her amendments are the wrong answer. They would take choice from patients, and those with the least would lose most.

Let us take Herefordshire. It is a large, rural county with one NHS acute hospital: the county hospital in Hereford. The next-nearest NHS acute hospitals are in other counties, or even across the border in Wales. Many villages have few buses. The county’s own draft transport plan is still working towards better links between Hereford and market towns. Nuffield Health also has a hospital in Hereford, which provides some NHS services free at the point of use to patients. Under the noble Baroness’s presumption, that option exists only if there is no reasonable public alternative within a clinically appropriate timeframe. The test asks, “how soon?”, but not “how far?”, nor how a pensioner with no car gets to an operation in another country or county, and home again. Care is free at the point of use; the journey is not. For someone on a low income, a free operation that they cannot reach is not much use, nor is it right. A patient on a long waiting list at the only public hospital in their county should be able to choose another provider nearby, free at the point of use—whether that be private or NHS provided. Someone with money can already pay to leave the queue. Taking away that free option would not abolish the two-tier system; I believe it would deepen it.

This also goes well beyond hospitals, as other noble Lords said. The new clause in the amendment after Clause 11 says a service is not publicly provided if it is contracted to a private body, and only public bodies may provide it. As noble Lords said, most GP practices are private contractors, as are many community pharmacists, high street dentists and opticians. They are the front door of the NHS. What about hospices? There are 135 independent adult hospice charities in England. The National Audit Office says the sector cared for about 251,000 people in 2023-24, with the Government funding around 29% of its income. Are those to be taken out or shut down under this amendment? As has already been pointed out, in 2023-24, over half of NHS cataract operations were done by independent providers. Bringing them back at speed into NHS public bodies would lengthen waits for older people to have their cataracts done. The term “private sector body” is not defined in the amendments, so we cannot tell which of these would fall under the presumption.

The review in Amendment 36 is the most useful idea in this group from the noble Baroness, Lady Bennett, but it is framed around returning services to public provision. It should ask a neutral question: which providers—public or independent—give quality, value and fair access, with provision free at the point of use? None of this is a blank cheque for the private sector. Independent providers delivering NHS care must meet the same standards and publish the same data. They should train staff and not pick off the simple cases while the NHS keeps the complex ones. That is part of what ICB strategic commissioning needs to pick up. Independent providers delivered only around 7.5% of NHS planned care in February this year, based on their own trade body’s figures. They are a useful supplement, but they are no substitute for NHS care that is properly and publicly funded.

This brings me to Clause 10. What is the point of it? What problem is it solving? Can the noble Baroness give the Committee an example of what a Secretary of State cannot do now that they could do with this clause? We need to be clear that this clause changes a provision in the 2006 Act which stops the Secretary of State from swinging between private and public. The new clause would allow to happen the very thing that the 2006 Act stopped, depending on how the Secretary of State felt when they got up that morning and decided whether they were in the mood for public or private healthcare. The Committee needs to understand what problem this is solving, because, I think like most noble Lords, I have no idea why this provision is in the Bill and what it is trying to solve.

The noble Baroness, Lady Coffey, rightly asks in her amendment for us to think of patients rather than the organisation. The noble Lord, Lord Kamall, goes further, and I find his approach the most persuasive in the group. It is that, basically, a change would have to be necessary to improve patient outcomes. Surely that is the test against ideology from either a public or a private direction. The Secretary of State would also publish the reasons and lay them before Parliament.

The amendments from the noble Baroness, Lady Bennett, raise serious concerns in terms of completely undermining what a public health service—the NHS—should be about. It should be about quality, about outcomes and about patients having choice. The Secretary of State should not dictate which type of hospital a patient should go to, as long as the basis is free at point of use, the quality of care is monitored, and outcomes are the same as in a publicly funded body. I really look forward to the Minister explaining the reason for Clause 10, because I believe that most noble Lords would like to understand exactly what problem it is trying to solve.

[Lord Kamall (Con)]

My Lords, I am grateful to all noble Lords who have spoken on this group of amendments. Let me begin by speaking to the amendment in my name and that of my noble friend Lord Howe and to the clause stand part notice in our names as well as those of the noble Lords, Lord Hunt of Kings Heath and Lord Patel of Bradford.

This group of amendments seeks to query the future provision of NHS services and, in particular, the principles that should govern decisions about the balance between state or taxpayer-funded and independent providers. There is a straightforward principle here: decisions about healthcare and the provision of healthcare should be guided, as the noble Lord, Lord Scriven, said, by what is best for patients rather than by some predetermined preference for one type of provider over another. This should not be about ideology; it should be about the interests of individual patients.

We know that the NHS seeks to serve patients. Its success should therefore be measured not by organisational arrangements or ownership but by the quality, accessibility and timeliness of care, and how it improves the health and well-being of patients. As such, Amendment 35 seeks to give effect to that principle by ensuring that any variation in the balance between publicly and independently provided health services is undertaken only where the Secretary of State is satisfied that it is necessary to improve patient outcomes.

That is important because, as it stands, Clause 10 permits the Secretary of State to dictate that balance in what they consider to be

“the interests of the health service”.

Sadly, as we know, the interests of the health service are not always the same as the interests of patients. The focus must remain on the best possible patient outcomes, but the interests of the health service might be interpreted in terms of organisational priorities or administrative convenience. Can the Minister explain why the Government have not created a specific duty for the Secretary of State to justify decisions in terms of patient outcomes? Does she accept that

“the interests of the health service”

may be seen as too broad?

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[Baroness Merron (Lab)]

I am not sure that I can answer that right now, but I will certainly review the various clauses and come back on that point.

The noble Lord, Lord Patel of Bradford, raised a point about publishing reasons where an exception is made. I will look at that because, as he knows, we are very much committed to transparency.

I turn to the amendments from the noble Baroness, Lady Coffey, the noble Lord, Lord Kamall, and the noble Earl, Lord Howe, which I will discuss together. The phrase

“the interests of the health service”

reflects the Section 1 duty to the health of all people in England—both those currently using the NHS and those who might want to use it in the future. That said, I understand the points noble Lords are making and, as with all things, I will certainly look at them. But we believe that substituting the phrase so that the test may be used in the interests only of patients, as spoken to by the noble Lord, Lord Kamall, is a narrower approach that risks excluding the potential benefits to the service over time, and it excludes the interests of people who are not currently patients—which I know is not the noble Lord’s intention.

I would also caution against using an additional requirement that exceptional action must be

“necessary to improve patient outcomes”.

This might prevent the rescue of a failing service, given that it relates to improving, and not stabilising, services. For example, if a dialysis provider serving a large area failed, stepping in would clearly be necessary to keep treatment going, before any action to improve it. It therefore risks failing the proposed test at a time when decisive action is needed.

[Lord Kamall (Con)]

Surely stepping in to continue that dialysis service is in the interests of patients.

[Baroness Merron (Lab)]

It is, and that is why I said I understand the point that noble Lords are making. We are not talking about the interests of the health service for the interests of the health service; it is there to promote the right outcomes for patients and their interests, too. That is why I acknowledged the points that the noble Lord and others made.

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[Baroness Bennett of Manor Castle (GP)]

I am aware that there are charities and there are charities, but yes, as long as something is operating for a genuinely charitable purpose, I would exclude that from a for-profit definition.

[Lord Kamall (Con)]

I am sorry to intervene, but we are probing the noble Baroness’s amendments. I made a point about some for-profit providers, such as Specsavers, which are often able to provide services much more cost-efficiently, particularly audiology and optometry services, in local communities, often closer to the patient than some distant hospital, which frees up money to be spent on other services in the NHS. Would the noble Baroness oppose that sort of for-profit service, which is clearly in the interest of patients?

[Baroness Bennett of Manor Castle (GP)]

Here, I would cross-reference the noble Lord to what the noble Baroness, Lady Nargund, raised in her intervention on the Minister, which was really important. I should perhaps declare an interest: I confess that my glasses are from Specsavers, where I went for practicality. However, in that kind of context, we also see significant upselling and pressure on patients that would not apply in an NHS not-for-profit context. That is something that we need to think about carefully. Is there alternative provision where that pressure is not applied?

I am at risk of turning into a Minister here, so I am going to try not to do that; I will later on, but not right at this moment. I want to pick up a point made by the noble Lord, Lord Kamall. I think it is fair to say that the noble Lord embraces the fact that more people are taking out private health insurance and paying for private provision. For me, it is a cause for concern if people are forced into that situation because they feel there is not the NHS provision there. If there is no provision of, say, a hip replacement within a reasonable time, so people put possibly a large chunk of their savings into that, that is a cause for concern, not celebration. From my native Australia, I know what happens when you have, in essence, a two-tier health system where many people feel the need to have private insurance. Then it is the leftovers, and the quality of public provision falls away significantly.

The noble Baroness, Lady Nargund, spoke about the importance of provision in disadvantaged areas. One problem that we have with private sector providers is they may see less opportunity to make profits from more disadvantaged areas and be interested in operating in areas that are more for profit.

I am not going to run through every contribution, because that would take too long, but one thing that has come out of this debate in a broad sense is that the Government—any Government—have to make a decision. I come to the challenge to me from the noble Lord, Lord Hunt, about the balance between local and national decision-making. Are the Government going to solve short-term problems by destroying a structure so that it is not there for the future? I would argue that they have a responsibility not just to the patients of today but to maintain an entire functioning health system that will be there with appropriately trained people, appropriate resources and the ability to deal with acute circumstances.

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[Baroness Barker (LD)]

My Lords, as I said at Second Reading, I have spent a lot of time over the last five years with people who are caring for people with severe neurological conditions. I want to tell one story, because I think it is the apposite, right moment to do it.

I know a carer who cares for her elderly mother, who has a very rare neurological condition. Her mother also has dementia—I do not know whether that is part of her condition or whether it is unrelated. With the assistance of their very supportive GP, she managed to get her mother an appointment at an acute hospital for a physical procedure. The carer got her mother to the hospital, which is no mean feat when somebody cannot move or stand, has to be taken in a wheelchair to get there and would have had to be hoisted on to a bed had things gone as they should have. When they got there and started to talk to the doctor, the doctor queried the fact that the mother could not consent to the procedure. She could not consent to the procedure because she had dementia. Because the carer could not at that moment produce evidence of an LPA, which she did in fact have, the procedure did not happen.

I was thinking about that this morning when I was sitting in an NHS waiting room and I looked at a sign that said, “If you don’t turn up for an appointment, that costs money”. Well, having systems that are so disconnected and acute hospitals that believe they are the be-all and end-all and do not understand that the majority of caring happens before somebody gets to their door and when they leave, is one of the most expensive ways of treating individuals. We will go on to talk about corridor care and all of that.

I listened with great care to what the noble Baroness, Lady Ritchie of Downpatrick, said. She talked all the way through about dementia services. The majority of health treatment for people with dementia will not be dementia services at all. It will be all the rest of the services they need: everything from dentistry onwards. So we cannot focus just on data in dementia services. We need all sorts of things. We need changes to the forms that people have to fill in before they go for assessment, so they can put down the fact that they have access needs and so on. That was the result that came out of that, because the carer just about lost it and was articulate enough to go and see somebody and say, “This is wrong”. They have actually changed the admission forms for that.

We need a wholesale cultural change throughout acute care if we are to cope with dementia, or else we are all going to break.

[Lord Kamall (Con)]

My Lords, I am grateful to noble Lords for bringing forward this group of amendments. They raise a number of important questions about the future of social care, ministerial accountability and the support available to those who depend on care services. Of course, although the previous Government proposed an integrated health and social care service, the British people decided not to give us a chance to deliver it. Therefore, when a new Government came in, they decided they were going to have a separate national care service. That deserves a number of questions to be asked. I fully respect the fact that there is a commission at the moment, but we do not seem to be getting much detail. We also know that you cannot fix healthcare until you fix social care, which is one of the many reasons why I tabled Amendment 180, and I will focus some of my comments on that.

We on these Benches recognise the importance of reforming the social care system. We understand all the reasons behind the proposal for a national care service: to raise the profile of social care, and to do many of the things that the other amendments in this group suggested to do so. To answer one of the questions from the noble Baroness, Lady Thornton—I feel like a Minister again, just as the noble Baroness, Lady Bennett of Manor Castle, did, but on the other side; I am happy to rehearse that if we are ever back in government—we will support the Government where they demonstrate that their proposals are affordable, sustainable and deliverable. We are not going to oppose for the sake of opposition. I hope the Minister will recognise that, as an Opposition, we have always tried to be constructive, particularly when it comes to health and social care.

While we welcome the Government’s ambition to improve social care, as I said, we remain concerned by the lack of detail. We have been told that the groundwork for this service will be laid during this Parliament and its establishment will take place in the next one, yet we know remarkably little about how it will operate in practice, what it will cost, whether the end of the triple lock will provide enough money to fund it and what it will mean for those delivering care.

All that Amendment 180 would do is require the Government, within six months of the Bill passing, to set out some intended functions and the scope of the national care service. We are not asking for a detailed funding plan for the next 15 years or anything like that—we just want a little more detail. This is a probing amendment to tease out a bit more detail from the Government and, hopefully, help them to clarify some of their thinking around social care and what the national care service means. What will the functions and scope of the national care service be? We are not yet clear about that. What about its relationship with the NHS? We are going to have not an integrated national health and care service but a separate national care service, so what does that mean for the interface between the National Health Service and the national care service? What about its proposed commissioning arrangements, its estimated costs and its sources of funding? As the noble Lord, Lord Scriven, said, what we are really asking is how it will all fit together. It is as simple as that.

My concern is affordability. The Government have indicated that the money will come from changes to the state pension triple lock, but that is not the same as providing an implementation plan. Has any assessment been made of what this new service would actually cost, what proportion of that cost will be met by central government and what responsibilities will remain with local authorities? We do not need a commission to answer some of those questions.

There is an important question about whether the savings anticipated from the triple lock will materialise in time to meet the ramp-up costs of establishing a national care service. As the Minister will appreciate, major reforms of this kind usually require an awful lot of up-front investment and then, in time, the annual costs hopefully will stabilise once the infrastructure and systems are in place. Is the Minister yet in a position to tell us whether the Government are confident that we will have sufficient funding available when it is needed? While I admire optimism, it seems to me rather optimistic to assume that the cost of establishing an entirely new service will neatly coincide with and be offset by the savings arising from the changes to the triple lock.

We must also be clear about what services the national care service will actually provide. We know that free personal care is not the same as free social care. Residential accommodation, nursing provision and other essential forms of support can represent substantial costs for individuals and their families. While the Government have provided some welcome clarification on accommodation costs, important questions remain on eligibility, the precise scope of support and the position of working-age adults who currently have care needs.

My second concern is the future of existing care provision. Our social care system is supported by a remarkable range of providers, charities, social enterprises, mutuals, co-operatives, family-run businesses and independent care providers, and they all provide essential services, often with deep roots in the community they serve. We welcome the Minister’s recent recognition that there will continue to be a role for different types of provider and that this will be commissioned at the local level, but we need to understand how that commitment will work in practice. Once again, is the Minister in a position to tell the House what the establishment of a national care service will mean for these existing organisations? What about the relationship with local authorities? Will that change?

As the noble Baroness, Lady Pitkeathley, said, there are important questions about the workforce. We all recognise the important dedication of those working in social care, as well as the millions of unpaid carers who provide indispensable support to their loved ones. We welcome the efforts to improve pay, training and career progression, but these commitments will have to be met with a credible assessment of their costs. In establishing the NHS workforce plan, will there be a corresponding national care service workforce plan? How will these two things fit together?

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[Baroness Merron (Lab)]

The reason is that we consider that these parts can sit on their own, and the Bill allows us to look forward too. It would not be acceptable—the noble Lord is not suggesting this—if we stopped all our work while we waited until everything was in place. Although my noble friend is right, I cannot really remember a time when we did not have a lot moving parts—or perhaps we had some parts that should have been moving more but were not, to be more precise.

I go back to the commission on adult social care of the noble Baroness, Lady Casey, about which the noble Lord, Lord Kamall, asked further questions. First, its work has already been brought forward by a year by Prime Minister Andy Burnham. We have already actioned the initial recommendations. As a reminder, we worked at pace on that and I emphasise that the review is independent, which by definition means that we are allowing the noble Baroness, Lady Casey, to do her work.

The other point, which has been absent in previous iterations of attempts at this work, is that we are committed to making this an all-party answer that can survive Governments. All Governments previously have failed to do that, and this is too big and too important an issue to fail to secure that backing. The early recommendations that we put straight into place were—oh, I see the noble Lord standing up; I thank him for being very specific.

[Lord Kamall (Con)]

I want to ask specifically what that cross-party approach means. For example, many noble Lords on all Benches have spoken about social care in this debate and at other times. There is great expertise in this House. When will they—including me, if I am considered worthy enough of “expertise”—be engaged in this cross-party approach?

[Baroness Merron (Lab)]

How might I put it? That will be down to the appropriate levels of the parties to decide who is included. However, I can say to noble Lords that, after the contributions that have been made not just in this Chamber but in the reports that have been made, I have been a number one advocate to my ministerial colleagues, including Secretaries of State, of looking to the expertise in this House—because the work that has gone on and continues to go on is extremely significant. The noble Lord can be assured of that.

I do not think that I referred to what the earlier recommendations were from the noble Baroness, Lady Casey, but, if I did, forgive the repetition. On dementia, adult safeguarding and motor neurone disease, we are also driving significant progress through £4.6 billion of additional funding available for adult social care in 2028-29, compared to 2025-26, which includes £500 million for the first ever fair pay agreement for care workers. We have said we will establish a national care service in the next Parliament, providing free personal care for older people.

On funding, I can only repeat what the Prime Minister and Chancellor have said, which is that it will be fully funded and made possible through adjusting the triple lock from 2030. I give the confirmation that we will not borrow to pay for reform, and we will continue to meet our fiscal rules. I think there is a proper conversation to be had, as the noble Lord, Lord Kamall, said, on the choices and trade-offs necessary to deliver a system that can work for everyone into the long term, as well as the immediate. That is exactly why the Prime Minister is continuing cross-party talks to achieve this. The other thing I would emphasise is that we are determined to deliver rapid progress on social care, and we want to work, and are working, in partnership with those who draw on care and support.

On Amendment 180, tabled by the noble Lord, Lord Kamall, as I have already indicated, I do not believe that we should pre-empt the commission’s recommendations on fundamental reform questions ahead of building a public consensus as well as a political one. We should not legislate for an implementation plan within a fixed timeframe.

With regard to a national care service work plan, the review from the noble Baroness, Lady Casey, will have important implications for the shape and skills of the future adult social care workforce. Noble Lords will recall that this Government have committed to a long-term workforce plan for adult social care, which will therefore need to be linked with the outcome of that review. I certainly welcome that workforce plan.

On the amendment on dementia tabled by the noble my noble friend Lady Ritchie, and spoken to by a number of noble Lords, including the noble Lord, Lord Weir, dementia, as with social care, touches the lives of many in and outside this Chamber. That is why I am glad that my noble friend welcomes the development of the modern service framework for frailty and dementia. We plan to publish the full MSF by the end of this calendar year, which was recommended by the noble Baroness, Lady Casey. The framework will set new national standards. However, until we finalise those standards, I think it would be premature to propose introducing a new annual report. The reason for that is that it would lack the necessary measurable metrics to support the meaningful analysis that I know noble Lords are looking for, as indeed I am. It is not about denying the role of data; it is about the process. We are looking at options for how we can reduce waiting times and improve diagnostics and care, including reviewing targets and metrics and, importantly, to the points raised by noble Lords, data. We will seek to develop a list of best evidenced interventions following analysis of this area.

Some of the data requested and referred to in the amendment is already available through the NHS or provided by charity partners. A new report would, unfortunately, be something of a duplication of this work. We must also have some regard to the demands of additional data collection. The assessment is that the additional data collection that would be required for this work would be somewhat onerous and would distract from the core task of improving dementia care. That said, I understand why noble Lords are raising this, and I can assure them that the points they have made will be considered as we look at our development of the modern service framework.

Health: Women and Pain

Lord Kamall Excerpts

Monday 9th November 2026 Lords Chamber

[Lord Kamall (Con)]

My Lords, the Minister said that women’s pain and pain management will be addressed by the forthcoming women’s health strategy. What specific goals and objectives have been set and what accountability will there be if those goals and objectives are not met?

[Baroness Merron (Lab)]

Action 4 commits to testing patient power payments, and we are prioritising gynaecology services as a test. That will mean that if a woman’s feedback, which will be actively sought, is not what it should be based on their experience—and that includes pain—then payments can be withheld and invested to improve the situation. I am sure the House appreciates that often it is finance which drives change, and this is just one of our new ways of doing that.

National Brain Cancer Lead

Lord Kamall Excerpts

Tuesday 3rd November 2026 Lords Chamber

[Baroness Merron (Lab)]

The noble Lord is right. That is why we have to work so much more quickly to move discoveries from research into treatments and clinical care. That has been sadly lacking, which is why the points that the Prime Minister announced include an accelerated review by the MHRA of the regulatory arrangements for rare disease medicines, known as orphan drugs—I mention that just as one example—that would see that work completed in two years rather than three. We understand the need for speed and acknowledge that we are in a position, sadly, where not enough progress has been made in this area.

[Lord Kamall (Con)]

My Lords, I too welcome the Government’s commitment to establishing a dedicated national brain cancer lead. My question is about accountability, going back to the question from the noble Baroness, Lady Pidgeon. Will the Government publish a set of measurable objectives for the national lead, particularly for access to treatment and patient outcomes, so that this House and others can assess whether the role is achieving the real progress that patients and families want to see?

[Baroness Merron (Lab)]

I mentioned a national action plan that will be informed by the three-month review, and I confirm that the Government will publish that national action plan. I would expect to see the markers that the noble Baroness and the noble Lord have called for within that.

Health Bill

Lord Kamall Excerpts

Committee stage
Tuesday 3rd November 2026 Lords Chamber

[Baroness Pidgeon (LD)]

My Lords, I thank the noble Lord, Lord Patel, and my noble friend Lady Barker for their very personal and raw contributions, as recent carers, on the recent losses of loved ones.

I am grateful for the support from the noble Baroness, Lady Thornton, for my Amendment 230 in this group, which also has the support of Marie Curie and Hospice UK. At its heart is the principle that people approaching the end of life should be able to have their wishes, preferences and priorities for care understood, recorded and respected. Advance care planning enables people with terminal illness to express how and where they wish to be cared for. It supports more proactive and personalised care and, as we have heard, it has been shown to improve patient and family satisfaction while reducing the likelihood of crises, avoidable hospital admissions and the need for emergency care out of hours. I have seen at first hand how, in Devon, the system seems fairly well set up to support people in their own homes, and to have these very difficult conversations with a hospice at home service, with people who have real skill in communicating and talking about these difficult topics at a time when someone may have just learned that they have a terminal illness and when lots of things are going around their mind. It is important for them to be able to get some clarity, going forward, about what they wish for and do not wish for. As we have heard, other parts of the country do not work so well.

Importantly, the evidence suggests that advance care planning does not increase costs to the health and care system, and may in some cases reduce healthcare expenditure by ensuring that care is delivered in accordance with patients’ wishes. We will come on to the single patient record on a later date, but I flag here that advance care planning can be effective only if the information is available to those providing care when it is needed. The single patient record offers a significant opportunity to improve co-ordination and continuity of care, but its success will depend not simply on sharing data but on ensuring that advance care planning is routinely embedded in clinical practice so that people’s wishes can be accessed, understood and acted upon, wherever and whenever care is provided.

The other amendments in this group from the noble Baronesses, Lady Finlay and Lady Coffey, highlight the many issues with the current landscape of palliative care and specialist palliative care services, and the difficulty in getting access to those services. I look forward to the Minister’s response to that, and her response to the trick or treat challenge.

[Lord Kamall (Con)]

My Lords, this has been an important and timely debate, coming not long after the Terminally Ill Adults (End of Life) Bill and the Prime Minister’s remarks. While these amendments address a range of issues, they all point to the same conclusion: palliative and end-of-life care must have a central place in this conversation.

If the Government are serious about shifting care from hospitals into communities, supporting people to remain closer to home—notwithstanding the comments from the noble Baroness, Lady Barker—and delivering truly patient-centred care, palliative care must be part of that vision from the outset. The need for action is clear. Marie Curie estimates that each year around 170,000 people in England die with unmet palliative care needs, equivalent to almost one person every three minutes. We must ensure that those approaching the end of their lives can access the support they need, when and where they need it. This is closely linked to my noble friend Lady Coffey’s amendment. She spoke movingly of her mother’s experience and the need to ensure that patients have access to high-quality palliative care, wherever they happen to live and choose to die.

If the Government’s proposed national care service is to succeed, it cannot simply be a discussion about structures, responsibilities and reorganisations. It must be about the experience of those who rely on care. No group demonstrates that more clearly than people approaching the end of their lives. Palliative care is perhaps one of the clearest examples of where health and social care are inseparable. While clinical support may be provided by the NHS, the ability of a person to remain at home or close to home, to maintain their dignity and spend time with loved ones, often depends just as much on the availability of social care. For many families, social care provides the day-to-day support on which good end-of-life care depends. Evidence shows that when effective support is available in the community, people are more likely to be cared for and pass away in a place they choose, rather than in hospital. As the noble Baronesses, Lady Finlay and Lady Hollins, said, this will also reduce hospital deaths, save the NHS money and make more beds available.

Palliative care does not begin and end with the NHS; it depends upon social care providers, community services, carers, local authorities, hospices and voluntary organisations working together around the individual and their family. When those services are joined up, people are more likely to receive care in the setting they choose and with the support they need. When they are not joined up, it can profoundly affect those approaching the end of their lives.

In that context, I welcome the amendment from the noble Baroness, Lady Finlay, which recognises that good palliative care depends not on any single organisation but on effective collaboration across the NHS, adult social care and the voluntary sector. Too often, services that support people approaching the end of their lives are commissioned, funded and delivered separately, despite the fact that patients and families experience them as part of a single journey. The amendment would help to ensure that integrated care boards take active steps to bring those services together, whether through access to specialist hospice care, shared equipment, medicines, workforce development or closer collaboration between providers.

Crucially, the amendment recognises the vital contribution of hospices and charitable organisations to the delivery of palliative and end-of-life care. These organisations are not peripheral to the system; they are an essential part of it. If the Government are serious about creating a national care service and a neighbourhood health service that are genuinely joined up for patients, the expertise and capacity of the voluntary sector must be properly integrated into the way care is planned and delivered.

Indeed, some of the most important services available to people at the end of their lives are delivered by hospices and charitable organisations. For decades, as the noble Lord, Lord Hunt, said, the voluntary sector has not merely supplemented statutory services but has been fundamental to the provision of specialist palliative care. But too often it is forced to operate at the margins of the system, dependent on local arrangements, local funding decisions and local fundraisers, and subject to tax rises, such as employers’ national insurance, from which state providers are understandably exempt. The noble Baroness, Lady Bennett, shared examples of recent hospice closures.

If the Government wish to build a neighbourhood health service and develop a national care service, integration must mean integration not only within the NHS but between the NHS, adult social care and the voluntary sector. Ultimately, the measure of success will not be the structures we create but whether individual patients receive seamless support at one of the most difficult moments of their lives and for their families.

The issue of patients having a conversation about their end-of-life care, addressed in the amendment in the name of the noble Baroness, Lady Pidgeon, was illustrated by the very moving stories from the noble Lord, Lord Patel, the personal experience of the noble Baroness, Lady Barker, and the concerns raised by the noble Baroness, Lady Grey-Thompson. These amendments seek to move us towards that goal. I hope that the Minister will give careful consideration to the issues that have been raised during the debate.

[Baroness Merron (Lab)]

My Lords, I can certainly confirm to the noble Lord, Lord Kamall, that I will give complete consideration to the points raised.

As other noble Lords have acknowledged, I thank the noble Baroness, Lady Barker, and the noble Lord, Lord Patel, for bringing their loved ones’ stories into the Chamber for the benefit of others, and for their willingness to share with us such a painful but realistic time. I believe that many people will identify with what the noble Baroness and the noble Lord said, and it will mean so much to so many.

--- Later in debate ---

Moved by

[Lord Kamall]

27: After Clause 6, insert the following new Clause—
“Access to health innovation networks(1) The Secretary of State must make arrangements for a wide single national point of access to the health innovation networks in England.(2) The arrangements must enable a person to—(a) make a single request for support,(b) be directed to the appropriate health innovation network or networks, and(c) receive coordinated support where an innovation has potential application in more than one region.(3) The Secretary of State must publish information about the operation and performance of the arrangements.”Member's explanatory statement
This new clause would require a single national point of access through which innovators and other organisations could obtain coordinated support from the health innovation networks in England.

[Lord Kamall (Con)]

My Lords, let me make it clear that I recognise that what I am asking for does not need to be in the Bill and does not need legislation. However, my frustration at the lack of progress, both when I was the relevant Minister and as shadow Minister, has forced me to table this probing amendment.

I often meet entrepreneurs and tech companies who claim that they have an innovative product or solution that could transform healthcare. They ask me how they can have a conversation with the relevant person within the NHS. When I was a Minister and I asked my officials about this, they would give me an email address I could share. However, two things stayed with me. First, why was this email address not widely advertised and known by more people? Secondly, when I asked such entrepreneurs whether anyone from DHSC or NHS England had replied, the answer was no.

In opposition, I began thinking, “How can I help more innovators into the NHS?” It was suggested that I meet the Health Innovation Network, which told me that it is the front door for innovation. However, once again, many tech entrepreneurs have never heard of it. I was surprised to read on the Health Innovation Network’s LinkedIn page that it has “501-1K employees”. How about that for precision? Speaking to noble Lords and others interested in health innovation, I have heard a range of opinions about the local networks—that some are good, some are bad and some are in the middle. While some regional health innovation networks are good, others are not so good and coverage is patchy. This brings me to my question. What is the Health Innovation Network’s remit, and what assessment have the Government made of local networks’ effectiveness? What plans do the Government have for the networks in the reorganisation?

I recognise that there is a fantastic clinical entrepreneurs programme led by Tony Young, an NHS surgeon and clinical entrepreneur. He has always been very open and has encouraged me to send on to him clinical entrepreneurs who have approached me, in order to have further conversations. The question relating to this amendment is: what about entrepreneurs who are not clinicians, but who have an innovative solution that could transform health or social care? For them, there is no obvious front door to the NHS or one-stop shop. What do they do? They spend ages trying to get into the system at primary care, trust or ICB level, sometimes wasting their time but also clinicians’ precious time. Sadly, they then give up or go abroad, meaning that the UK loses out on British innovation.

In July, during an Oral Question, I asked the Minister to ask the DHSC Minister for technology and innovation to create such a front door or one-stop shop to triage those who approach it. That front door could distinguish those salespeople who have no minimum viable product, telling them what they need to come back with to be taken seriously. Secondly, what about those who have a solution but need more support, so that they can be signposted to someone who can advise them on coming up with a more feasible approach? Thirdly, there are those who have potentially a fantastic solution that could transform healthcare and need to be piloted as quickly as possible.

I was grateful when noble Lords from all Benches later told me that they agreed that this was a practical idea. Has any progress been made since I asked that question in July. If not, what are the reasons why? Time and again I hear the same concerns from entrepreneurs, researchers and businesses: the system is difficult to navigate, and numerous organisations are involved in supporting innovation, all with different remits, processes and points of entry. Expertise clearly exists throughout the system, but identifying the right door to knock on can be a challenge in itself.

This amendment seeks to address that problem through a simple but important principle: that there should be a single national point of access through which innovators and other organisations can obtain co-ordinated support. The purpose is not to create another bureaucratic layer; on the contrary, it is intended to reduce complexity, improve co-ordination and ensure that innovators spend less time navigating the system and more time developing solutions that could benefit patients. The principle behind the amendments mirrors one that the Government have embraced elsewhere in the health service. The concept of a single point of access, or a single front door, is designed to simplify routes into services, triage inquiries effectively and direct people to the most appropriate expertise at the earliest opportunity. Rather than forcing patients to navigate multiple pathways, the system assumes responsibility for guiding them to the right destination.

My Amendment 27 applies precisely that same logic to innovation. Instead of requiring innovators to work their way through a maze of organisations and programmes, a single front door would provide a clear route into the system, supported by intelligent triage to the most appropriate person in the Department of Health and Social Care or the NHS. It could be, but not necessarily, one of the 501 to 1,000 people who work for the Health Innovation Network. I beg to move the amendment.

[Lord Scriven (LD)]

My Lords, I thank the noble Lord, Lord Kamall, for moving this amendment and for the very short debate that has followed. I believe that the frustration is real, but the Committee deserves answers to two questions: what is in place now and would the proposed new clause make it better?

As the noble Lord, Lord Kamall, said, there are 15 health innovation networks, each serving its own region, but there is already a national point of access. The NHS Innovation Service, as the noble Lord, Lord Kamall, said, has been running since 2022, when it was set up by a very forward-thinking junior Health Minister—the noble Lord, Lord Kamall. NHS England describes it as a single entry point. An innovator completes one record. Experts from within the network review it within 10 working days, give tailored advice and can refer the innovator to one or more local networks. More than 2,000 innovations have had support through that service.

Proposed new paragraphs (a) and (b) of proposed new subsection (2) in this amendment largely describe something that already exists. Does it work? As a front door, it appears to do so in some regions for some people. The problem is that if the amendment from the noble Lord, Lord Kamall, was accepted, it would create two front doors for people to come through, which would probably not be a wise thing to do.

I believe that the front door is not the main problem here; the problem is spread. Adoption is one trust taking up a good idea; spread is that everything gets to the patient, no matter where they live. The Health Innovation Network’s own evidence to Parliament says adoption is

“slow, uneven and overly dependent on local early adopters”.

It describes what it calls

“a postcode pattern of spread”,

and warns that

“proven technologies do not spread through evidence alone”.

An innovation proven in one place can face the same hurdles all over again in the next, so I do not believe that we have a front door problem.

Therefore, I must be honest. As drafted, this proposed new clause would help only at the margins and it could hinder. It could create a second door beside the one we have, unless it simply puts a statutory label on the existing service. It would write an operational arrangement into primary legislation, when the way innovators are supported should be one that changes quickly. It would place duties around networks that neither the Bill nor the proposed new clause define.

There are two parts that I welcome. Proposed new subsection (3) would require published information on performance, and we should be told how many innovations spread beyond their first site and how far. Proposed new subsection (2)(c), on co-ordinated support across regions, goes closer to the real issue, but the network says that spread needs systems with

“the resource to redesign pathways, train staff and evaluate impact in practice”.

A referral service does not provide that.

The amendment’s most important contribution is the question it raises. NHS England runs the innovation service. The network’s national commission comes from NHS England, with the Office for Life Sciences. However, the Bill abolishes NHS England. Clause 6 gives the Secretary of State a duty to promote innovation and a power to award prizes, but it says nothing about the networks. A prize will not help a company stuck between a successful pilot and its second trust.

I have a few questions for the Minister. Who will run and fund the innovation service, and commission the networks, once NHS England has gone? Can she guarantee that there will be no gap? Will the Government publish performance data, including on adoption and spread, which is lacking, whether this amendment is accepted or not? Who, after abolition, will be responsible for making sure that proven innovation spreads across the whole NHS, not just to the early adopters?

A single door is a reasonable aim and we largely have one. What patients need is for it to work in one part of the NHS and then to reach all of it. I look forward to the Minister’s reply.

[Baroness Merron (Lab)]

My Lords, I am grateful to the noble Lord, Lord Kamall, for bringing this debate before the Committee. I commend his honesty that this is born out of frustration and a wish to improve things, rather than seeking a legislative response—something the noble Lord, Lord Scriven, also observed in looking at the amendment. I agree with the noble Lord, Lord Scriven, that the amendment raises important points to be considered more broadly, so I assure the noble Lord, Lord Kamall, of that consideration.

I will make a few points that may be helpful. The NHS Innovation Service already provides a wide national point of access. The way it works is that an innovator makes one request, creates one product record and is referred according to product type, maturity and location. More than 2,200 products have been registered with and have received support through the service, including 710 innovations in the 2025-26 financial year. All health innovation networks participate alongside 11 other organisations. That means that innovators have access to a broad range of expertise through a single service. Almost all products reach at least one health innovation network and are referred to four organisations on average. Innovators may also approach a network directly. Support can span several networks and regions, with onwards referral requiring no new application. Uptake is already reported at a high level while, of course, protecting commercial confidentiality.

I hope that the noble Lord, Lord Kamall, will understand that funding a second route—or, as I believe the noble Lord, Lord Scriven, said, a second front door, which would confuse us—where an effective national service is already in place may not exactly represent what we might call the most effective use of public resource. The amendment’s core aims are therefore already met. Prescribing an operating model in legislation could limit its ability to evolve—something I know the noble Lord understands.

The noble Lord, Lord Kamall, asked about health innovation networks. I can confirm they are subject to performance and impact monitoring. They also produce impact reports to show what their local impact is. The noble Lord, Lord Scriven, asked what would happen following the abolition of NHS England. Nationally funded health innovation networks’ work will continue and will be overseen by the Secretary of State. I will look at the other points that have been raised, because they are all certainly relevant and will be drawn to the attention of my colleague, the relevant Minister, Chris McDonald.

[Lord Kamall (Con)]

My Lords, I am grateful to the very many noble Lords who queued up to speak in this debate—I obviously raised a very important point. I am also grateful to the noble Lord, Lord Scriven, for reminding me how innovative I was when I was the Technology and Innovation Minister. In fact, I set up the very service that I am now asking for many years later. It does beg a question, because even I, as the person who set it up, still did not know that this service existed. When I speak to people in NHS England and elsewhere and say, “You know what you need? You need a front door for innovators”, they say, “You’re absolutely right; we haven’t got one”. So even people in NHS England do not know that this exists.

I was up front that I knew this was not meant to be in the Bill. I just wanted to get discussion. It probably helped to prompt my memory as well—my thanks to the noble Lord, Lord Scriven—but it is really important that more people know about the NHS Innovation Service. Perhaps the Minister could write to me and the many other noble Lords who are interested in this topic to let us know what the Government intend to do to promote the NHS Innovation Service, so that more people are aware and so I do not ask for the same thing next time we have a health Bill.

[The Deputy Chairman of Committees (Lord Young of Cookham) (Con)]

Does the noble Lord wish to withdraw his amendment?

[Lord Kamall (Con)]

I thought the logical conclusion would be that I beg leave to withdraw my amendment.

Amendment 27 withdrawn.

--- Later in debate ---

[Baroness Pidgeon (LD)]

My Lords, since taking over as our spokesperson, I have lost count of the number of times the Minister has talked about the workforce strategy that will at some point emerge from the department. I am not sure whether we will be given a season this evening, but hopefully it will be published soon.

My Amendment 253, which the noble Lord, Lord Stevens of Birmingham, and the noble Baroness, Lady Gerada, have added their names to, would require the Secretary of State, within 12 months of Royal Assent, to publish

“a health and care workforce strategy for England”.

I have included “care” on purpose because the two are so importantly linked. It must assess the staff needed to meet current and projected demands, expressly including registered nurses and primary care practitioners, and it must contain a funded plan to close staffing gaps. Annual progress reports would be laid before Parliament, keeping that issue on the agenda for us all. Putting staff in is an important marker too. We need to properly plan and invest in our workforce, both health and care, hand in hand.

The Royal College of Nursing supports this amendment, as do a number of representatives of primary care. Too often, primary care seems to be forgotten in the debate on workforce, but it is critical: GPs and district nurses—we have just heard passionately from the noble Baroness, Lady Gerada, about their role—as well as optometrists, dentists and pharmacists. As the Government look to shift services into neighbourhoods and hospitals—something I think we all support—this is really important. The early years workforce is important as well, as are health visitors.

The other amendments in this group, including that of the noble Baroness, Lady Shawcross-Wolfson, all require similar reports, perhaps on different timescales. Some are focused on really important areas such as the mental health workforce, the education and training that is needed alongside a workforce plan, and continuing professional development. Noble Lords have flagged the current vacancy rates in a number of roles, as well as skills shortages and the need for independent scrutiny of the workforce plan.

My noble friend Lord Scriven rightly stressed, using his personal family experience, the need for nurses for people with learning disabilities and the investment in that workforce, as well as the need to understand the whole workforce, looking at models in, for example, the Netherlands. The noble Lord, Lord Stevens, and the noble Baroness, Lady Gerada, talked about the complexity around primary care and the challenges with part-time workers, with perhaps more women coming into the workforce, as well as the challenges of work-life balance. Some people want to work part-time rather than full-time. These are key questions for the Government on this issue of workforce. I look forward to a comprehensive response from the Minister, and possibly a date, a season or a hint of when we might at last see that workforce strategy.

[Lord Kamall (Con)]

My Lords, this has been a crucial debate, and I am grateful to noble Lords for tabling and speaking to their amendments, which raise fundamental questions about the future of the NHS workforce, the quality of care patients can expect and the Government’s ability to deliver health service reform.

The amendments from my noble friend Lady Shawcross-Wolfson and the noble Baroness, Lady Pidgeon, go to the heart of a simple but vital question: how can this Government, or indeed any Government, credibly plan for the future of the NHS without an independently verified assessment of the workforce that we need? As my noble friend said, the previous Conservative Government, albeit belatedly, recognised the importance of this challenge when we published the first NHS Long Term Workforce Plan in 2023. This was a baseline step in establishing a long-term approach to workforce planning, with clear ambitions to expand domestic training, improve retention and reduce our reliance on international recruitment.

We recognised then, as we must recognise now, that workforce planning cannot be conducted from one spending review to the next. Training doctors, nurses and other healthcare professionals takes years, and decisions made today will determine the quality and availability of care for patients a decade, or decades, from now. Yet we are still waiting, as other noble Lords said, for the Government’s new 10-year workforce plan. The noble Lord, Lord Patel, offered some possible reasons for the delay.

Fracture Liaison Services: National Coverage

Lord Kamall Excerpts

Tuesday 27th October 2026 Lords Chamber

[Baroness Merron (Lab)]

I suggest some caution about the situation under the devolved Governments. Without any wish to disregard any improvements that have been made, the situation is not quite as the noble Lord describes, and I would be very pleased to write to him to confirm why. We certainly liaise closely and regularly with the devolved Governments to ensure that we can see progress across the whole of the United Kingdom.

[Lord Kamall (Con)]

My Lords, the Minister has just told the House that decisions on fracture liaison services will be made by local ICBs, yet at the national level the Government have made a welcome commitment to universal coverage in England by 2030. Does she accept that leaving delivery to the discretion of individual ICBs risks creating inconsistencies? Would such disparities be an example of where the Secretary of State could use their power of direction, as proposed in the Health Bill?

[Baroness Merron (Lab)]

I am sure we will discuss that at great length in Committee. While I absolutely accept there is a difference in the service level across the country—that is not acceptable, as I am sure we would all agree—it is not the hands-off approach that is often suggested. We have made, through the medium-term planning framework, the neighbourhood health framework and the 10-year health plan an identification that those at risk of frailty are a priority cohort. Our best practice guide was recently updated to give the NHS and local government joint ownership of delivery. In all these ways and a number of others, we support local decision-making and provision.

Corridor Care

Lord Kamall Excerpts

Tuesday 20th October 2026 Lords Chamber

[Baroness Merron (Lab)]

I pay tribute to the service provided by hospital chaplains, because they extend support to those of all faiths and none, and that is crucial. Corridor care is not an acceptable normalisation. We want to end it by the end of the Parliament. I agree that dignity is very much part of it. The guidance given to hospitals is that, in exceptions where there has to be corridor care, they must take account of supporting the patient in the best way possible. For example, that can, of course, include support from hospital chaplains.

[Lord Kamall (Con)]

My Lords, the Minister said that the department, or maybe NHS England, has been able to identify the hospitals where corridor care is at its worst levels. What specific targeted support does the Minister’s department or NHS England intend to offer to those particular hospitals in order to reduce the high levels of corridor care?

[Baroness Merron (Lab)]

We are putting in specialist teams to work with those particular hospitals. The Secretary of State has made it quite clear that ending corridor care for children is an absolute priority. As I said to the noble Baroness earlier, we are ensuring that best practice is applied. Because of the additional funding, we have been able to and will be able to extend capacity. The noble Lord will have looked at the areas that are receiving targeted financial support. Where we have greater levels of corridor care, our teams are working with those hospitals to say, “Why is this the case? This is how to sort it out”, and make sure that they can. The small number of trusts means that there is greater reliance in some areas than others, and that is not all right.

Neighbourhood Health and Social Care

Lord Kamall Excerpts

Tuesday 15th September 2026 Lords Chamber

[Baroness Merron (Lab)]

That is a very good point. Young carers are sometimes left out, to the detriment, as I said earlier, of services and policy. I bring us back to the requirement in the Neighbourhood Health Framework, which we published just in March of this year, and add to that our introduction of neighbourhood health centre schemes across the country. The voices of local people, particularly those in the higher-priority cohorts, which can include young carers, will be heard and be part of the coproduction of how we provide neighbourhood health and social care.

[Lord Kamall (Con)]

My Lords, the noble Baroness said that the health and well-being boards will be responsible for making sure that there are sufficient social care services at the neighbourhood level. Following the question of the noble Lord, Lord John, to whom will they be accountable if they do not deliver sufficient social care at the neighbourhood level?

[Baroness Merron (Lab)]

The Neighbourhood Health Framework published in March, which I mentioned, requires local systems to develop neighbourhood health plans. That will give a very clear basis for measuring impact, which we do not have at the moment. I certainly agree with the noble Lord that it is not about the quality of the plan but about the quality of delivery. That is why the framework empowers local leaders in five minimum national goals that include, for example, as we have discussed many times, improving access to general practice, as well as the join-up with social care.

Patient Data: Research

Lord Kamall Excerpts

Thursday 10th September 2026 Lords Chamber

[Lord Kamall (Con)]

My Lords, I thank the noble Lord, Lord Patel, for securing this debate on using patient data for patient-centred research, health and social care. I also thank all noble Lords who spoke and refer the House to my interests in the register—I will not name them all, because that would be the rest of my three minutes.

We can have the most innovative healthcare systems in the world, but that will be meaningless if patients do not trust the NHS and other health and social care providers with their data. There is some consensus on the need to collect and share patients’ data to improve patient care and research, not only for today but for the research that will drive the innovation of tomorrow. Currently, not all patient data is digitised or shareable. Records do not always follow the patient. Information is often duplicated, delayed or not available when most needed. Although we hope that the single patient record and Health Data Research Service will respond to that challenge, the key will be patient trust.

First, recent events that have been mentioned, such as the UK Biobank incident, have shown how fragile public confidence can be when governance and, outside that, cyber security, are not watertight. How does the Minister’s department intend to address the problem of researchers downloading patient data to work in less secure environments, sharing it on sites such as GitHub, or even perhaps selling or offering to sell it—they did not actually sell it—as we saw? Secondly, can the Minister tell the House whether organisations and individuals accessing patient data for research will be required to meet minimum cyber security standards? Thirdly, how will they address the concerns of civil liberties organisations such as medConfidential, which have found UK Biobank’s response less than reassuring? At this point, I should also thank the noble Lord, Lord Tarassenko, for his reassuring points on that particular incident.

Nowhere is the need to get this right clearer than in dementia, as the noble Baroness, Lady Murphy, said. It is the leading cause of death in the UK, affecting individuals, families and the economy. A recent Alzheimer’s Research UK report tells us that the UK has world-class medical science, major data resources, early-phase trial capability and a trusted regulatory environment, but that progress is constrained by weaknesses in data co-ordination and implementation. Without high-quality data and interoperable systems, researchers and clinicians cannot identify patients early, recruit them into trials, evaluate new diagnostics or scale treatments across health and social care. This is not a technical detail; it is a foundation on which meaningful progress to diagnose and treat dementia will stand or fail. Will the Minister tell the House whether her department has considered how to connect existing initiatives so that dementia data is linked, accessible and usable for research?

Real progress will depend on confidence: from clinicians that systems help rather than hinder, from patients that their data is secure, and from the wider public that data governance is transparent, proportionate and accountable.

NHS: Agency Medical Staff

Lord Kamall Excerpts

Wednesday 9th September 2026 Lords Chamber

[Baroness Merron (Lab)]

I will certainly take away the points that the noble Lord raised, but I do not recognise his description of reshuffling, not least because the requirements on local health providers to reduce agency expenditure are quite clear. They have to report against them and drive further reductions. Those moneys are directed into front-line care. After all, that is what we all want to see.

[Lord Kamall (Con)]

My Lords, I thank my noble friend Lady Davies for raising this important point. I will touch on a number of issues that have been drawn together. Within the NHS, there are three very different categories of non-permanent staff—agency, bank and temporary staff—each with different implications for the continuity of care, as my noble friend referred to. Given that agency staff are supplied externally, bank staff are supplied from the trust’s own books and temporary staff are moved between services, can the Minister tell the House whether her department monitors the impact of each of these differences on the continuity of care for patients, including whether patients can see the same doctor, if possible? If so, where is that data available?

[Baroness Merron (Lab)]

The noble Lord has welcomed our emphasis on the continuity of care. It is the best form of healthcare that we can offer. The only way to do that properly is through an established NHS workforce. The reality is, as noble Lords will be very aware, that there are times that we need to use some type of temporary cover in order to secure patient safety. The main thing is that we are committed—and it will be delivered through the workforce plan—to a more settled workforce and a workforce that can properly provide the care that we need. We are not yet in that place, but the steps that we are taking will get us there.