Debate on the Address: Health and Social Care

Philip Loft; Tim Jarrett; Tom Powell

The Queen’s Speech of December 2019, included the following section on health and social care:

For the first time, the National Health Service’s multi-year funding settlement, agreed earlier this year, will be enshrined in law.

Steps will be taken to grow and support the National Health Service’s workforce and a new visa will ensure qualified doctors, nurses and health professionals have fast-track entry to the United Kingdom. Hospital car parking charges will be removed for those in greatest need.

My Ministers will seek cross-party consensus on proposals for long term reform of social care. They will ensure that the social care system provides everyone with the dignity and security they deserve and that no one who needs care has to sell their home to pay for it. My ministers will continue work to reform the Mental Health Act.

In addition to announcing non-legislative measures, detailed in the Government Briefing on the Queen’s Speech published in December 2019, legislation on health and social care was also announced:

NHS Funding Bill

Under the Funding Bill, the Government committed to increase investment in the NHS, enshrining in law the multi-year funding settlement agreed in 2019. The Government states that this will result in a £33.9 billion increase in cash terms by 2023/24 (source: UK Government, Queen’s Speech 2019, December 2019, p.30).

This Bill will extend to England only.

NHS Long Term Plan Bill

In September 2019, NHS England and NHS Improvement published Recommendations to Government and Parliament for an NHS Bill, intended to speed up the implementation of the 10-year NHS Long Term Plan, which was published in January 2019. The recommendations included

Introducing a new NHS ‘triple aim’ for better population health, better quality of patient care, and financially sustainable services. This ‘triple aim’ would apply to all NHS organisations, to help them focus on wider, shared, responsibilities.
Changing the exiting NHS competition framework to allow more discretion about when to carry out a formal procurement process for health services.
Merging NHS England and NHS Improvement to create a single leadership body, combining their respective responsibilities for performance, finance and care transformation.

The Government has said it is “considering the NHS’s recommendations thoroughly and will bring forward detailed proposals shortly”, leading to draft legislation (source: UK Government, Queen’s Speech 2019, December 2019, p.30).

A summary of the NHS Long Term Plan is available in a House of Lords Library Briefing and in the Ministerial Statement on the Long Term Plan made in January 2019.

This Bill will extend to England only.

Medicines and Medical Devices Bill

The Government states that the Bill aims to “ensure that our NHS and patients can have faster access to innovative medicines, while supporting the growth of our domestic sector”(source: UK Government, Queen’s Speech 2019, December 2019, p.10). The Bill will include provisions to:

reduce “unnecessary bureaucracy for the lowest risk clinical trials”
implement a scheme to “combat falsified medicines entering supply chains”, including a registration scheme for online sellers
increase the range of professions able to prescribe and supply certain medicines
enable regulators to develop new regulatory approaches “to respond quickly to developments such as artificial intelligence in treatments”
simplify and strengthen the system of enforcement where medical device regulators are breached

This Bill would extend and apply to the whole of the UK. Human and veterinary medicines are reserved in the case of Scotland and Wales, but are devolved to Northern Ireland.

Health Service Safety Investigations Bill

The Bill will establish the Health Service Safety Investigations Body to investigate patient safety concerns and share recommendations to prevent similar incidents recurring (source: UK Government, Queen’s Speech 2019, December 2019, p.35). The Government published a draft version of the bill in September 2017 and updated related briefings in October 2019. A Joint Committee of both Houses published a report on an earlier draft version of the Bill in 2018.

This Bill would extend in the main to England, with a provision on data protection extending to the whole of the UK.

Social Care Reform

In England, social care reform has been considered by two Government-appointed commissions in the past 20 years, but substantive reform as to how people fund it and their eligibility for financial support from local authorities has not been forthcoming.

The Government committed to “urgently seek[ing] a cross-party consensus in order to bring forward the necessary proposals and legislation for long-term social care reform in England”. The government is also committed to “ensure that nobody needing care will be forced to sell their home to pay for it” (source: UK Government, Queen’s Speech 2019, December 2019, p.37).

This followed Boris Johnson’s first speech on the steps of Downing Street, when he said “we will fix the crisis in social care once and for all with a clear plan we have prepared to give every older person the dignity and security they deserve” (source: Prime Minister’s Office, Boris Johnson’s first speech as Prime Minister: 24 July 2019). The already-prepared plan referred to by the Prime Minister has yet to be published.

In a January 2020 answer to a PQ on when the Government plans to publish the social care Green Paper, the Government stated that it “will seek to build cross-party consensus and will outline next steps shortly” (source: PQ, Social Services, 80, 9 January 2020).

Mental Health Reform

The Mental Health Act 1983 sets out the legal framework in England and Wales for the treatment and detention of people with mental ill health. The Government commissioned the Independent Review of the Mental Health Act to look at rising rates of detention under the Act. The review reported in December 2018. The Government states that it will respond to the review’s recommendations through a White Paper in early 2020, followed by legislation to amend the 1983 Act when parliamentary time allows (source: UK Government, Queen’s Speech 2019, December 2019, p.39).

Library Briefings

The House of Commons Library has produced relevant briefings:

Mental Health Policy in England, 2020

Health and Social Care Workforce Gap, 2020

Paying for Social Care: 20 Years of Inaction, 2019

NHS Pressures in England: Waiting Times, Demand, and Capacity, 2019

NHS Reform: Integrated Care Systems, 2019

Health and Social Care Integration, 2019

NHS Key Statistics: England, 2019

NHS Expenditure, 2019

Adult Social Care Funding (England), 2019

Adult Social Care: The Government’s Ongoing Policy Review and Anticipated Green Paper (England), 2019