Karin Smyth

I am going to move on, because there is a lot to get through. My hon. Friend the Member for Bexleyheath and Crayford (Daniel Francis) made a powerful speech, based on his own experience and the terrible experiences of his constituents. I will write to him about what we want to do with ICBs to make that situation better. I now turn to new clause 56, tabled by the hon. Member for Mid Sussex (Alison Bennett). I also thank my hon. Friend the Member for Blaydon and Consett (Liz Twist) for her ongoing work on, and interest in, carers throughout the passage of this Bill. I can assure the House that the Government fully recognise the importance of supporting carers’ health and wellbeing, including ensuring that they can take breaks from their caring responsibilities where needed. The Care Act 2014 already includes duties to assess and address carers’ current and future needs, and of course, we want to ensure that carers get the full benefit of the single patient record. To achieve this, we intend to use our regulation powers, which are already in the Bill. The topic of inequalities has been highlighted a lot today. We are committed to ensuring that local areas are empowered to make decisions, tackle the specific health challenges they face and make real progress on health inequalities. I want to reassure the House that reducing health inequalities remains a priority for this Government. I know that the Chair of the Health and Social Care Select Committee, and the Committee as a whole, takes a great interest in this issue, and we are committed to working with them. I thank my hon. Friends the Members for Stoke-on-Trent South (Dr Gardner) and for Uxbridge and South Ruislip for their championing of this important issue and for our meeting last week. I am not, however, convinced about new clause 91. Our focus is, and must remain, on delivering improvements in health outcomes, supporting prevention and tackling the causes of ill health, rather than creating additional statutory red tape. We already have a wide range of duties from the 2006 Act, and we have a new duty on combined authorities. There was a duty on ICBs in the Health and Care Act 2022, and there is a duty on foundation trusts. We have the public sector equality duty, as well as our commitment in the 10-year health plan. Again, the issue is making it work and empowering local leaders to do just that. I commend the work of my hon. Friend the Member for Lewisham East (Janet Daby) on the APPG on sickle cell and thalassaemia, and I will write to her specifically on the issues she raised. She talked about specialised commissioning, a topic that was also raised by my hon. Friend the Member for Middlesbrough and Thornaby East (Andy McDonald). We know that this is an ongoing concern across many areas, and I commit to keeping in touch with them and with other Members. Turning to women’s health—including mental health—and maternity services, again, I can assure the House that this is a priority for the Secretary of State. That is why we published the action-focused renewed women’s health strategy. It is why we are undertaking a single national action plan on maternal health, overseen by the national maternity and neonatal taskforce, to drive improvements where it matters to families, clinicians and other experts. I know that many Members of this House are committed to improving mental health, but I take this opportunity to thank my hon. Friend the Member for Sherwood Forest (Michelle Welsh) for all her work in this area as the national maternity adviser. Opposition Members mentioned the Hughes report, and I assure the House that the Government recognise the importance of providing a response. I do not have time to go into all the ongoing work at the moment, but I commit to doing so at the earliest opportunity. [Interruption.] The Conservatives had a long time. The hon. Member for Sleaford and North Hykeham (Dr Johnson) says that they were about to do it before the election, but that is not what we found when we came into power. The Conservatives left us a lot of work to do in this and many other areas, but we are committed to doing it. Fertility services and reducing inequalities in maternity services has been raised by my hon. Friend the Member for Stockport (Navendu Mishra) and the right hon. Member for Stone, Great Wyrley and Penkridge (Sir Gavin Williamson), who has been a tireless advocate in this area, as have many others. I have recently written to him. NICE guidelines inform how ICBs should commission in this area, but I know that things are not uniformly implemented. We will continue to work with ICBs to evaluate the next steps. There was a lot of discussion on primary care, and dental access across the country in particular. We are committed to rebuilding dentistry in England, but actions speak louder than words. We are making great strides in improving access, ensuring an urgent care safety net across the country, reforming the dental contract and developing a 10-year workforce plan. More broadly, we think it is right that under this Bill, primary medical services become the responsibility of ICBs. They have the right knowledge of their areas to make commissioning decisions, and that includes on eye care. They have responsibility for all primary medical services, but rightly they will be accountable to the Secretary of State for their performance. The right hon. Member for Godalming and Ash (Sir Jeremy Hunt) is right that we will say that he could have dealt with the issues he raises while he was in power, but we do not always say that, and he is absolutely right about continuity of care. I have also visited the practice he talks about in Horfield in Bristol, and not just because I was on the primary care trust board when the 2004 changes happened. Broadly, Bristol does have different standards on some of these issues, and that highlights our point. We do not need to put some of these provisions in legislation. Exactly this sort of good practice can be shared in local systems through neighbourhood care plans, neighbourhood work and the work in primary care networks. The single patient record is fundamental to the Government’s mission to create a modern, joined-up NHS that puts patients at the centre of their care. On amendments 26, 42 and 43, I assure Members that the overarching purpose of making regulations to create and operate the single patient record is limited to the direct care of patients, and clause 51 is already explicit about that. Crucially, the clause does not create any new data sharing gateways for secondary purposes such as planning and commissioning, so these amendments are not necessary. On data safeguards, the security and privacy of people’s health and social care data are paramount. As Members would expect, we will build the strongest safeguards into the record. On new clause 32, I can assure Members that the SPR will be designed to protect personal data by default, with the highest standards of cyber-security and information governance ensuring that only the right people can access the right information at the right time and only for the right reasons. Finally, I have heard how important it is that the single patient record is accessible and inclusive. I thank my hon. Friend the Member for Battersea (Marsha De Cordova) for amendment 87 and the important work she is doing to publicise this hugely important area. I assure her and Members that we are confident that the Bill is drafted to enable information related to support needs and reasonable accommodations to be included in the SPR. The Department will have regard to the accessible information standard as the SPR is developed. We are also committed to tackling digital exclusion. We have considered that as part of the single patient record equality impact assessment, and work is already under way to help address barriers around connectivity, skills and confidence. I heard what my hon. Friend the Member for Middlesbrough and Thornaby East said about the need to engage him and others about the single patient record as we go forward. On the federated data platform, decisions about public contracts must be made through fair, open and non-discriminatory processes. That is governed by UK procurement law, which recognises certain international treaty obligations. NHS England is reviewing the federated data platform contract to determine whether it should continue with standard contract management processes. It will look at evidence of delivery and the impact of the platform, and that should be the basis on which a contract continuation is decided.