Health and Care Act 2022: Final stages in Parliament

The Health and Care Act 2022 received Royal Assent on 28 April 2022. Changes were made to the Bill as it progressed through Parliament, including significant amendments introduced in the House of Lords between December 2021 and March 2022. Amendments were also made during the process known as ‘ping-pong’ between the Lords and Commons.

What happened in the Bill’s final stages?

The most substantive debates in the final stage of the Bill related to:

• Social care reform
• Workforce planning
• Early medical termination of pregnancy
• The Secretary of State’s powers to intervene in decisions about local changes to health services

Several Lords amendments relating to a new ‘cap’ on social care costs and on workforce planning were introduced despite Government opposition. These changes were removed on the Bill’s final day of consideration.

There were attempts to remove the Secretary of State’s new powers over the process to make local changes to NHS services (known as reconfigurations). The Lords agreed an amendment to this effect which was later overturned by the Government in the Commons. The Government made some concessions to further define when and how these powers could be used.  

A ‘free vote’ was held on provisions relating to early medical termination of pregnancy.  Parliament decided to extend provisions for home use introduced during the coronavirus pandemic.

NHS structure and services

The Act introduces significant reforms to the way the NHS in England is organised. It provides for Integrated Care Boards (ICBs) to take on statutory responsibilities for NHS services from 1 July 2022. Several Government amendments related to the duties of NHS England, ICBs and other NHS organisations. These included changes to strengthen their duties in relation to the reduction of health inequalities.

Other changes made in the Lords

Other new areas were introduced or updated during the Lord stages, including new powers to ban hymenoplasty (also known as hymen reconstruction), after amendments to prohibit virginity testing were introduced during the Commons stages.

Amendments to other parts of the legislation included changes to the rules on the procurement of NHS services, on advertising less healthy food and drinks, and on the protection of evidence gathered by the Health Services Safety Investigations Body (HSSIB).

Entirely new sections were also added to the Bill in the Lords, reflecting concerns about a range of issues, including the regulation of cosmetic treatments, overseas organ transplantation, and the need for mandatory training for health and social care professionals on learning disability and autism.