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NHS 10-Year Plan

My Lords, I also start by sending my very best wishes to my noble friend Lady Merron. No one more than me is looking forward to her making a very speedy recovery. I am very pleased to hear from her that she is making good progress, so we look forward to her return. I think it is appropriate that I declare an interest: my son is a GP, which I think is perhaps slightly relevant to the debate before us today.

To recap before I go into more of the details, I emphasise that this plan is different in so many ways to the NHS plans that have come before it. As we have heard, it is a road map for radical reform that is built on three fundamental shifts. Those of us that have been around the health agenda for a while recognise the past aspiration for some of these measures, but there was never a bold, innovative, collaborative plan to take our ambitions forward.

From hospital to community care, bringing care closer to home and making access to GPs faster and simpler is absolutely fundamental, particularly in the current climate—and from analogue to digital, giving staff modern tools and patients the kind of convenience and control they expect elsewhere in their lives. All of us have heard heartbreaking stories of patients who go from one specialist to another, and there is not that join-up. This has to be changed. There is no reason why this cannot apply across all the experiences the public have, regardless of where they are seeking services.

Many of us have been talking about the need to move to prevention in so many areas of life. Where better than people’s health, looking at the root causes of poor health and making healthy choices? It is the easy choice, but at the moment it is not that easy.

The new NHS has patients at its heart, will deliver equity and quality, is devolved and decentralised so that we are more responsive to local community needs and the front line is freed up to harness innovations, and the rules and incentives in the system support clinicians and lead us locally to be able to make the right decisions. This means that there is no simple chapter or section within the plan for individual conditions or groups setting top-down actions. The impact on particular services and outcomes will be through successfully transforming how our health ecosystem works. As we will come on to with the more specific questions, this is very much a work in progress. I am delighted by the reach the consultation has had over the last year. That has informed the debate and the outcome that is seen in the plan, so there have been no surprises. Many people who have been involved recognise what is in the plan.

The plan is backed by £29 billion per annum of extra investment by the end of the review period and, crucially, by a drive to cut unnecessary bureaucracy and empower front-line staff, giving them the tools to do what they do best: caring for patients.

I thank the noble Lord, Lord Kamall, for his very constructive comments; they were exceptionally helpful. Across the House, we all look forward to taking this extremely seriously and moving forward.

Turning to the comments of the noble Lord, Lord Scriven, on social care, he and I share a very positive background in local government, and nothing could be closer to our hearts than working out how we are going to bring the two together. That is fundamental. Both noble Lords made the point very clearly, and we welcome that.

Over the next three years, we will focus on the neighbourhood health approach to those most let down by the current system. That includes older people with frailty and those in care homes. Social care professionals will work alongside NHS staff in local teams, supporting recovery, rehabilitation and independence. We have examples from around the country where this is already happening: services are joined up and the cultural differences between the NHS and local government have been successfully broken down. We need to make sure this is replicated and spread to every part of the country. We need to enable care professionals to take on many more health-related responsibilities, such as blood pressure checks and reducing avoidable hospital administrations. Of course, pay terms and conditions have to be improved through fair pay agreements.

In the longer term, the noble Baroness, Lady Casey, will produce an interim report next week, but it is very much a work in progress.