Health Bill

Ben Coleman Excerpts

Report stage
Monday 7th September 2026 Commons Chamber

[Danny Beales]

There is much to support in the Bill, and I support its ambition to enable many of the provisions of the welcome 10-year plan for the NHS. The plan is the right one; the three shifts are correct, and we have to fundamentally reform the health system if we are to meet the modern health and care challenges that we all see in our constituencies. To some extent those challenges are not new, and neither are these ambitions—we have seen similar initiatives before—but the systems, the structures, the bureaucracy and the siloed budgets push against change in the health sector. They have been a hinderance, reinforcing silos and making the same investment choices. They have prevented digitalisation, kept care in acute settings and stopped joined-up working. This Bill could and should be a key lever in overcoming those challenges, which we need to do if we are to achieve those ambitions.

I very much support the digital single patient record, which is a key ambition in the shift from analogue to digital health. We have all heard from patients who have to tell their story over and over again at every single health appointment—between care and health, between community and secondary care—so a genuine single patient record has the potential to be transformational. We have, however, heard from pharmacies and community mental health services that if this is to work, they have to have a seat at the table. While this Bill enables the architecture, I hope that the delivery will ensure that the whole of the health and care system is part of the decision-making process when the single patient record is designed. That is crucial.

Turning to the abolition of NHS England, the idea of streamlining bureaucracy at the centre is a good one, and delivering power—including decision-making power—budgets and resources locally is also admirable. Success, however, will mean the right decisions being taken at the right scale.

[Ben Coleman (Chelsea and Fulham) (Lab)]

One of my concerns about the abolition of NHS England is that highly specialised services for treating the rarest and most complex conditions—of which there are only 79 in the country—currently sit directly with NHS England. It is not clear whether those services will continue to be commissioned centrally. Does my hon. Friend think it would be helpful if the Minister could clarify that?

[Danny Beales]

I thank my hon. Friend for that contribution. Having worked in neonatal care services and areas of specialised services in the NHS for 10 years, I understand that one of the benefits of NHS England was that it brought together highly specialised services, ensured consistent service specifications and uplifted the quality and availability of care across the country. I hope that when we make decisions about which specialised services will be devolved to ICBs, consideration will be given to that point. Equally, we have heard from national population health programmes such as the Diabetes Prevention Programme, which has been a huge success. As we make the final decisions about the level at which decisions are made, we cannot lose the benefits of public health initiatives at scale, such as vaccinations and prevention programmes. I would welcome the Minister’s thoughts and reflections on that.

Integrated working is also important—as I say, we have to blend budgets and bring together decision makers across current silo divides. In that spirit, I very much welcome the change made by Government amendment 60 to give local authorities a seat back at the table. We need a bigger voice for public health and social care in health decision making, not less, so I thank the Minister and the Government for listening to the Health and Social Care Committee and moving on that. In the view of the NHS Alliance, this is not enough; it would like to see a reciprocal duty to collaborate, which is an interesting suggestion. However, the Government’s amendment is an important start.

--- Later in debate ---

[Jen Craft]

I agree that there needs to be better accountability in the health service. It currently does not work, and the mechanisms by which we can hold healthcare bodies to account are few and far between. I believe that it is most acutely felt in paediatric care and in the special educational needs and disabilities system, where a mechanism for holding public bodies to account already exists: EHCPs. The idea that the responsibility should fall entirely on local authorities is misguided, because roughly 50% of what a child with an EHCP needs in order to access education is healthcare, which should be provided by a healthcare service. There must be better accountability and transparency for parents, and for their children, when that does not happen. I know that parents often have to go out of their way and spend, on average, £8,500 a year on their child’s healthcare so that they can access education.

[Ben Coleman]

Will my hon. Friend give way?

[Jen Craft]

I will not, because I am going to run out of time.

Roughly 40% of people have paid privately for therapies, and many are forced to fundraise for the vital medical equipment to which their child is legally entitled. It is worth noting that beyond the direct costs, many parents are forced to miss work because the right support is not available for their child to attend school. Around 40% report cutting back their hours, and 35% have left the job market completely. Before I became a Member of Parliament, I stopped work to become a full-time carer for my daughter. I do not regret that choice for a second, but it was a difficult and sometimes lonely period. Like many parents, I had not anticipated just how hard it would be to secure basic support for my child. Even to this day, I struggle to secure the basic healthcare support that she needs to support her education and her place at school. I am wearing a dragon for her today, and she will know why that is. I will not share it with the House, but if she watches this debate, she will see the dragon and it will make her smile.

New clause 85 is intended to fix the inequality. It would place a statutory duty on ICBs to deliver the health part of EHCPs, matching the existing duty on local authorities. The fundamental concept that there must be a meaningful legal requirement on health services to deliver the support set out in EHCPs is critical. If we do not act and do not rightly demand that health services pull their weight, the status quo of young people missing out on education will continue, and I am afraid the planned SEND reforms will be doomed to failure. Disabled children are no less worthy of a decent education than their peers and are no less capable of thriving in school, but we are denying them access to the tools they need to succeed.

I am grateful to the Health and Social Care Committee and the Education Committee for their support for new clause 85, and to the nearly 100 Members from across the House who put their name to it. I want to express my thanks to the charities involved for their continued campaigning efforts, and to the many parents who have contacted me. I sincerely hope that the Government will give the new clause the attention it deserves. If they cannot accept it in whole, I hope that they will give a commitment to deliver proper accountability.

--- Later in debate ---

[Ben Coleman]

I am also a member of the APPG, and I was also at that meeting. On the Health Committee, we raised the point about these short-term pilots, and we managed to get an extra year’s funding. I have to say—I will say this as the person I am—that I feel that if this was a problem that predominantly affected white people instead of black people, it would be taken a lot more seriously. I think that the Government need to reflect on that when they are deciding whether to accept this amendment and whether they wish to give sickle cell sufferers the full support that they need, which they are not getting.

[Janet Daby]

I thank my hon. Friend. He could not have said that more clearly. This is absolutely about inequalities in the health service. He has explained and expressed that extremely well. I know that he, like me, will continue to advocate for people from ethnic minority and diverse backgrounds.

New clause 162 would require the Secretary of State to do two things: first, to lay an annual report before Parliament on the performance of specialised services against national standards; secondly, to ensure the regular publication of data on quality and outcomes of the kind currently captured in the specialised services quality dashboards, which NHS England has maintained on a non-statutory basis. Without legislation, those dashboards could quietly disappear when NHS England does, and that must not happen. The new clause would make their continuation, or the continuation of something equivalent, a legal requirement.

I want to be clear about the modesty of this ask. We are not asking the Government to build new services, ringfence budgets or second-guess local commissioning decisions. We are asking them to measure, publish and report, in order to ensure basic accountability for patients with rare conditions, and for geographically dispersed people, predominantly from black and minority ethnic backgrounds, so that they have services that work.

The patients who rely on specialised services are often marginalised twice over: once by their condition, and again by a system that does not always see them clearly. New clause 162 would require the Secretary of State to identify them, and to report back to this House on what they find. I urge the Government to take this new clause seriously and to respond appropriately.