Lord Kamall (Con)

My Lords, before I begin, it is the first opportunity for me from these Benches to wish the noble Baroness, Lady Merron, a speedy but restful recovery over the summer. I look forward to seeing her back after recess. I thank the Minister for repeating the Statement. As she will appreciate, for many questions that have been asked on health in this House in the last few months, the answer has often been, “You have to wait for the 10-year plan”. As the 10-year plan is here, now is the time to have some constructive debate. We will ask questions but also perhaps suggest some improvements. It gives us a chance to scrutinise and, I hope, to work constructively to make sure that the Government can deliver on the plan. Let me be clear that the Government welcome aspects of this plan—sorry, the Opposition; it has been a year now and I am still getting used to it. I am sure that the Government welcome it too, but we have many questions. First, I know there is the Casey review, but surely, we have to understand that we must get social care right if we are to unblock many of our beds. Some 13% of NHS beds have patients waiting for discharge. It is not about the financing of social care; it is about making sure people can go into the community. Secondly, we completely agree on the use of technology. I was the Minister for Technology in the Department of Health and Social Care, and we will support pushing through technological change as quickly as possible, but we also want to make sure we can save both time and cost and improve the patient experience. Far too many functions are duplicated, but, at the same time, if you fall off your bike in an area where you do not live, surely it ought to be easy for the clinicians and paramedics there to pull up and view your record. We still have not quite got there. How will the single patient record link with the NHS summary care record and the National Care Records Service? Will there be duplication, or will the Government be merging the SCR and the NCRS into a single patient record? The plan rightly places a lot of emphasis on the NHS app. I am proud that a Conservative Government introduced that app and welcome the fact that the Government are going to build on it. Page 121 talks about wearable medical technology being integrated into the app, which is very welcome. We know that many people already have these wearables and that they integrate them with apps other than the NHS app, but what about the concerns of some patients who worry about where else their personal data will be shared when they share it with the app? How will the Government reassure those people that the data from their wearables will not be shared elsewhere? Will patients be able to see who has accessed their records and when, so that they can have greater confidence in the idea of data sharing? Turning to the shift from the hospital to the community, which is something that we also agree with. On page 36 it says: “Our aim is to establish a Neighbourhood Health Centre … in every community”, and on page 32 it says that a neighbourhood will consist of 50,000 people. However, in his answers on the Statement, the Secretary of State said: “We aim to go for 250 to 300 new neighbourhood health centres by the end of this plan and 40 to 50 over the course of this Parliament”.—[Official Report, Commons, 3/7/25; col. 449.] If the Government create 300 neighbourhood health centres that each serve 50,000 people, the total served by these neighbourhood health centres will be 15 million people. England has a much larger population of about 57 million people, so, far from there being one in every community, simple maths suggests that there will be 42 million people without one. To help noble Lords understand, can the Minister explain some of the maths behind this assertion about neighbourhood health centres and what this really means? There needs to be some clarification. If they do not serve the whole population and we are not going to have neighbourhood health centres everywhere, on what basis will they be set up? Who decides where they will be? How do we make sure that they are located on the basis of need or deprivation rather than the politics of a local area? Will they complement existing GP practices and surgical hubs, and how do we make sure that there is no duplication? On prevention, we all know that we must tackle the obesity crisis and the ill-health crisis. The problem is that quite often we are tempted to go for top-down solutions. We like to say, “Let’s ban this and let’s ban that”, but when I speak to local community civil society organisations, which work with people in local communities to encourage them to eat healthily, they are very sceptical of a lot of these top-down measures. I think of a project like BRITE Box, near where I live in south London, which goes into family homes and delivers healthy ingredients and an easy-to-read menu that children can enjoy and teaches families to cook healthily together. Surely we need to get healthy eating, healthy cooking and the sharing of meals into family homes, particularly those in deprived communities, rather than adopt a top-down solution from Whitehall or Westminster. I would have liked to see more about how we engage the power of the community and civil society at local-community level to tackle many of these issues. Finally, there is one omission in this plan: fracture liaison services. There is only one mention of it, on page 165. That is rather disappointing, because I remember in June last year, before the last election, the current Secretary of State for Health said that he would take “immediate action” on fracture liaison services. Of course, we had to give the Government time to bed in, but it has now been a year, and we have got the 10-year plan, and there is nothing concrete on fracture liaison services. This is an easy win for the Government, because the savings to be gained from the rollout of fracture liaison services will be realised in two or three years—easily within the political cycle and easily before the next general election. If the Minister does not have the answer to all these questions, she can write to us and deposit a letter in the Library. We look forward to her replies.