Health Bill

Baroness Merron Excerpts

Committee stage
Wednesday 28th October 2026 Lords Chamber

[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.

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

My Lords, I am most grateful to the noble Lord, Lord Rennard, for tabling this amendment, and to other noble Lords for their contributions. The Government recognise the importance of high-quality diabetes prevention, treatment and care services, and I believe that our actions on this reflect that. Programmes such as the NHS Diabetes Prevention Programme, the NHS Type 2 Diabetes Path to Remission Programme and the National Diabetes Audit all play an important role in improving outcomes for people living with diabetes.

I turn specifically to Amendments 225 and 226. The Bill allows for the transfer of functions and responsibilities from NHS England following its abolition—that means a transfer that will not impact service provision. I say to the noble Earl, Lord Howe, that the Government support effective diabetes services and innovations in various ways, but that includes ensuring the continued commissioning, monitoring and improvement of these programmes without the need for disease-specific provisions in primary legislation. Moreover, specifying programmes at this level of detail would restrict our ability to adapt to new and changing evidence on effective treatments and technologies; I know that is something noble Lords would not want to restrict. Similarly, a diabetes-specific reporting clause would duplicate existing monitoring and oversight arrangements that provide additional assurance without adding administrative burden and additional bureaucracy.

To turn to Amendment 12, improvement of outcomes for people with diabetes absolutely includes reducing health inequalities, which we debated in an earlier group. That is already captured in the general duty to reduce health inequalities set out in Clause 4. Furthermore, the modern service framework for cardiovascular disease, which was published in July, advocates a holistic cardiovascular/kidney/metabolic approach, including finding those with undiagnosed or unmanaged diabetes, initiating treatment and increasing the number of people whose treatment is optimised, with a strong focus on reducing inequalities.

On Amendment 25, I reassure your Lordships that the Secretary of State and the NHS already have powers to promote innovation across the health service. The risk of singling out diabetes technologies in primary legislation is that it would create inconsistency with the approach taken for other conditions. Rollout of glucose monitoring and automated insulin delivery technologies is already supported through NHS implementation arrangements, based on established NICE guidance. Therefore, listing specific technologies in legislation could reduce the flexibility of the NHS to be as truly innovative as we would all want, as new technology emerges.

[Lord Rennard (LD)]

My Lords, I thank the Minister for her sympathy on these issues, and I thank all the people in her department, who I know are sincerely committed to trying to help people with diabetes, to help prevent its occurrence and to provide the best possible care and treatment. But at the heart of the problem, as the noble Lord, Lord Hunt of Kings Heath, said, is a dilemma: as people try to treat medical conditions such as diabetes differently and say there should be a localist approach, there is a fundamental problem for the whole of the country in that, if we fail to deal with this, the cost is on all of us. The costs to taxpayers, the costs of people not working, the costs of not paying to HMRC and the costs of drawing down on the DWP are growing enormously. This is such a huge problem that, as we have said at many points today, we have to look across all government sections at how we work together on all these issues. On that note, I beg leave to withdraw my amendment.