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Evidence and consultations

Health and Care Bill: Public Bill Committee submission

The Health and Care Bill introduces new measures to promote and enable collaboration in health and care, building on earlier recommendations made by NHS England and NHS Improvement in 2019.

The Bill also contains new powers for the Secretary of State over the health and care system, and targeted changes to public health, social care, and the oversight of quality and safety.

This evidence submission focuses on Parts 1, 2, and 3 of the Bill, which deal with the NHS and its relationships to other parts of the system, including the Secretary of State, plus proposed changes to information sharing across the health and care system.


  • This legislation will remove clunky competition rules and make it simpler for health and care organisations to work together to deliver more joined-up care to the increasing number of people who rely on support from multiple different services.

  • These reforms are complex and to help those who will implement them, the Committee should call on the government to set out a clear narrative as to how they will make a positive difference to patients and service users.

  • We welcome that the legislation is designed to be permissive and flexible to local circumstance, avoiding the pitfalls of previous attempts at reorganisations that attempted to impose a one-size-fits-all solution. We recommend that the Committee resist specifying in legislation granular detail about how improved collaboration should be achieved, as this would risk undermining the local flexibility that is critical for integrated working.

  • To avoid the unhelpful politicisation of local service change decisions and avert the risk of a decision-making log jam, we urge the Committee to remove from the Bill those clauses that would give the Secretary of State greater powers to intervene in local service reconfigurations.

  • The Committee should seek further clarification regarding the scope of the new powers of the Secretary of State to direct NHS England, including how they might be used and what scrutiny of their use will be put in place.

  • We urge the Committee to support an amendment to mandate the publication of regular, independently verified projections of future demand and supply of the health and social care workforce in England.

  • We recommend that the Committee should amend the Bill to make addressing health inequalities a core aspect of each element of the new ‘triple aim’ duty that will frame the priorities for NHS organisations.

  • The Committee should consider whether adequate measures will be in place for Parliament and others to scrutinise use of the new powers conferred on the Secretary of State by this Bill.