The Pigeon – September 2021

The Governments’ recently announced Health and Care Bill contains much of what was agreed with NHS leaders over the past few years and yet many, including myself, have pointed out the numerous flaws which remain. These include a last-minute power grab by the previous Secretary of State and the absence of anything about Social Care. It contains nothing serious towards integration with Local Authorities and a pathetic single clause to address chronic and dangerous workforce shortages.  

After an earlier career in NHS senior management, and some of the frustrations experienced as a local MP, my particular focus remains this Bill’s governance provisions.  Particularly how will people here in Bristol South have their say about local health and care services.  Who, locally, will be accountable for your care?

The NHS should be a public service; not a market and not a collection of semi-autonomous organisations having some mythical competition. As a public service it should be as open and transparent as possible and there should be an end to the pretence that somehow NHS bodies are independent commercial entities entitled to confidentiality. There should be an active desire to engage and consult with the public and staff, not exclude them.  And crucially we should know who is responsible for making the key decisions. 

This Bill represents a major political change for the NHS.  It is the end of the era of marketisation and a return to collaboration as the way to improve quality and deliver better value care. I welcome this but only if the logic of ending the obsession with the free market and moving to an NHS rooted in ‘place’ is really followed through.

I have tabled a number of amendments to the Bill to build on my professional experience within the NHS and the needs of people in Bristol South. 

I will be pushing for a Good Governance Commission, an independent body to oversee appointments for Chairs and non-executive directors. Moreover, I will submit a new clause that sets requirements for all NHS organisations to meet in public, publish the papers and only to go into closed session if there is a genuinely strong case for confidentiality that overcomes the public interest.

These are just two examples of many amendments I’m tabling.

The Government have shown thus far that they are turning their backs on a modern NHS and social care system. They left us unprepared for the pandemic. Let us be clear, failure to learn from the last decade will dramatically undermine outcomes for patients and lead to worse health inequality. Something I am determined to avoid.  

As always, if you have any comments to share, or have been affected by the issues I’ve discussed in my column, please do get in touch with my office on or 0117 953 3575 to share your experiences.