Health Bill

Lord Scriven Excerpts

Committee stage
Tuesday 3rd November 2026 Lords Chamber

[Baroness Merron (Lab)]

I would be very happy to do that.

[Lord Scriven (LD)]

I have been listening very carefully and, in answer to my noble friend, the Minister has just said that secondary legislation will be for all NHS services by choice. What stops that being put on the face of the Bill?

[Baroness Merron (Lab)]

This is the point I have just raised: we feel that secondary legislation is the better place to put it for flexibility and future-proofing; it is not appropriate, in a static way, for primary legislation.

[Lord Scriven (LD)]

As I am sure the Minister agrees, that would make sense if you were putting the operational services down. If you were making a commitment in Clause 5 that all NHS services in secondary, primary and community services will be accessible for choice, it would then give discretion within that boundary. I do not understand what stops the Government putting those principles on the face of the Bill, rather than making the operational amendments, which the Minister said were too restrictive.

[Baroness Merron (Lab)]

I think we just have a difference of approach to and opinion about the roles of primary and secondary legislation. I respect what the noble Lord is saying and I will of course review the points that have been made, as I always do; however, the position is exactly as I have described.

--- Later in debate ---

[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.

--- Later in debate ---

[Lord Kakkar (CB)]

My Lords, I support the amendment in the name of the noble Baroness, Lady Shawcross-Wolfson. It is an important amendment raising two fundamental questions, which I hope the Minister will be able to answer. The first is this: ultimately, in preparing a workforce plan that will enjoy broad confidence, there must be external scrutiny of that plan. It would be most helpful if the Minister could confirm how His Majesty’s Government’s healthcare workforce plan will be independently scrutinised. Also, how will His Majesty’s Government be able to reconcile potential differences generated as part of that independent scrutiny with what they consider to be deliverable at this particular moment in time?

The second issue is how a mechanism will be secured—now that the functions independently exercised in NHS England will become the responsibility of the Secretary of State for Health—in respect of long-term workforce needs and short-term financial pressures. As we have heard, investment in the workforce is a long-term investment, and Ministers will always be faced with short-term financial problems and crises. Historically in the NHS, the education and training budget has been periodically sacrificed when there have been other service, access and delivery demands on NHS institutions.

In providing an opportunity now with this Bill, how will the Government address that fundamental tension and secure a mechanism both for independent scrutiny and to ensure—with all the powers now lying in the hands of the Secretary of State for Health—that the education and training budget that secures the long-term development of the workforce cannot be sacrificed for short-term exigencies?

[Lord Scriven (LD)]

My Lords, I will speak mainly to Amendment 252 in the name of the noble Baroness, Lady Hollins. I apologise for not putting my name to it; I wish I had.

But I wish to speak first on two other amendments. The amendment from the noble Baroness, Lady Shawcross-Wolfson, is useful, and I thank her for the way that she presented it. An independently verified assessment and a 10-year plan is exactly what is needed. But I do have a word of caution. Publication within one month of Royal Assent could be a real challenge, even considering the amount of time that we have been waiting. Also, a plan that is produced that quickly risks being inaccurate, and an inaccurate workforce plan is worse than none at all, because people will make training and funding decisions on it. The amendment from my noble friend Lady Pidgeon offers a better timescale of 12 months from Royal Assent as well as an assessment of the staff needed, a funded plan to close the gap and an annual report to Parliament.

Amendment 252 matters because it names people who are easily forgotten in workforce planning: that is, the staff who care for people with a learning disability. Let me start with why that matters. The latest—in fact the last ever—national LeDeR report found that the median age at death for adults with a learning disability was 62.8 years, compared with 81.8 years for the general population. That is a gap of 19 years. Many noble Lords will know that my own wonderful nephew, Myles, who was 31 years old, is part of that terrible, tragic statistic. Some 39% of deaths of these adults were judged to be avoidable, against 21% for the general population. No workforce plan can fix that alone, but no plan that ignores it is worth having.