Today I will be voting against the Government’s Health and Care Bill. 

We owe our NHS and social care staff an enormous debt of gratitude for all that they have done during these past 16 months of the Covid-19 pandemic.  They have worked at the frontline of this terrible disease, often putting their own health at risk to provide treatment and care to those in need.  The burden of the Government’s failure to prepare for a pandemic fell on them, as has the impact of more than a decade of austerity.

Our NHS and care staff need more than clapping, they need this government to step up and deliver the resources and investment to fund properly a reformed NHS and care sector, starting with a decent pay rise ensuring that every staff member is paid at least the real living wage.

They need buildings fit for the future of care, not crumbling and leaking relics of yesterday, they need investment in equipment, and they need a credible workforce strategy that helps to deliver the next generations of highly skilled well paid staff to fill the huge gaps in recruitment and problems with retention they have to deal with each week.

Staff need these things so that they can focus on the top priority of bringing waiting times down and delivering the best possible treatment, care and support to everyone who needs it.

But what they categorically don’t need - and no doctor, nurse or carer has ever asked me for - is this Bill. They do not need a Bill which will deliver a top down reorganisation of the NHS, and which bypasses the reform and sustainable funding of social care completely.

I have three major concerns about this Bill.  The first is that it seeks to integrate health and social care, but without reforming social care.  This will be a disaster.  Social care has been neglected for more than a decade by this government.  It is fragmented and underfunded.  More than 2 million people who are eligible for care are not receiving any help at all currently and more than £3 billion of additional funding is required for social care just to meet current needs.

Social care is an extremely diverse sector, encompassing care for older people and care for working aged adults provided in care homes, supported housing and in individuals’ private homes. But too many social care workers are desperately under paid. Social care work is complex, highly skilled and emotionally demanding, yet it is often possible to earn more at the local supermarket than by caring for our most vulnerable loved ones.  This is simply wrong on every level.

Social care reform is urgently needed.  This Bill will absorb our current, broken social care model into the NHS and it is clear that social care cannot possibly survive, let alone thrive, on this basis. 

While there are many similarities between health and social care, the two sectors are different.  The Government’s priority as we emerge from the pandemic must be to deliver a sustainable funding model for social care, increase the pay and job security of social care workers, and reform access to social care.

My second concern is that this Bill will reduce the accountability of the NHS.  The proposed governance framework introduces Integrated Care Systems.  These will cover very wide geographical areas – the ICS which covers my constituency, covers the six boroughs of Lambeth, Southwark, Bromley, Bexley, Lewisham and Greenwich. 

Yet the ICS board will be allowed just one local authority representative and accountability overall will be direct to the Secretary of State for Health.  It is hard to see how ICSs will be democratically accountable for their distribution of resources and commissioning of local services when their geography bears no relationship to any democratic structures.

Finally, I am concerned that this Bill opens the door to more NHS services being run by private, profit-making companies, by giving license for contracts to be awarded without competition, and for private providers to sit on ICS boards. 

We are already seeing the unacceptable encroachment of large US healthcare firms, for example in the purchase of GP practices in London by US company Centene.  We must be clear that our NHS, established to give everyone peace of mind that we will not be charged for healthcare at the point of need, is not there to provide a cash cow for the private sector, yet that is what this Bill enables.

So I call on the Government to withdraw this Bill and bring back legislation to reform social care, support our NHS to recover from the pandemic and deliver a decent pay rise for NHS and care staff now.