Josh Fenton-Glynn

This Bill has to be set in the proper context of the mess that we are clearing up from the previous Government. The Darzi report laid bare the crisis in the NHS. We must learn from that Government’s disastrous reorganisation, because we cannot afford to make those mistakes. I approach the Bill as a critical supporter of the changes that we have made and that we seek to make. I have not always given my right hon. Friend the Member for Ilford North (Wes Streeting) the easiest time, but I pay tribute to his leadership, both on this Bill and in the NHS more generally. Waiting lists are down, treatment is up and we are seeing a real shift to the priorities that we need—from sickness to prevention, from analogue to digital, and from hospital to community. We have seen an overall reduction in NHS waiting lists of more than half a million since July 2024. I welcome the new Secretary of State to his place. He has a famed eye for detail, which this job demands, and I hope that his background in local government means that he will take seriously the need to get to grips with social care. Clearly, there is a real problem that needs fixing. Over the past decade, the centre of health policy has increased: staffing across DHSC, NHS England and local commissioning bodies has doubled since 2013, from 20,000 to 40,000. The Lansley reforms were one of the most high-handed acts of sabotage that a Government have ever committed on the health service. They were meant to reduce bureaucracy, improve efficiency and save money, and they achieved none of those things. Some concerns about the Bill came up in a recent sitting of the Health and Social Care Committee. I am curious as to how, in practice, the merger will be able to concurrently reduce headcount from NHSE, DHSC and ICBs by 50% without causing unintended consequences. I am concerned about that and want to see more detail on it, particularly given the scale of the changes that we are trying to make in the NHS. A report published in 2012 by the Institute for Government entitled “Never Again?”, which looked at the Lansley reforms, warned against making redundancies that are quickly undone as organisations recognise that essential roles have been lost and end up rehiring the same staff. The cost of redundancies under the Bill is estimated at about £1 billion. The cost of the Lansley redundancies was about half that, but one in five of those staff ended up being re-employed by the same organisation. The Select Committee heard before the recess that some areas of the NHS are under-managed, and I do not want clinicians to take on those roles. Overall, I support the Bill, but we should be clear that a reorganisation of the centre at this scale is not simple. It has to be properly planned, co-ordinated and communicated. I welcome the new Secretary of State, but I hope that the Bill can make the changes we need.