Health and Care Bill in the House of Lords

Posted on 31/01/2022 by Ed Hammond.

Peers considering the Health and Care Bill in the House of Lords reached amendments relating to overview and scrutiny on Wednesday 26 January. These amendments sought to impose on the Secretary of State the obligation to consult with local health OSCs before using the new power of Ministerial intervention in the Bill. You can read more about the new intervention power, and our concerns relating to it, here. You can read the amendment itself in the list of marshalled amendments here (it is listed as Amendment 180). 

Their Lordships brought some fairly sustained challenge to the Government’s planned approach, which largely reflected the nature of debate in the sector and the concerns expressed across both local government and the NHS about the risks that the changes mean for effective, strong local accountability. The Minister, Lord Kamall, responded to the debate by saying, 

The public expect Ministers to be accountable for the health service, which includes service change. We see the new intervention powers enabling the Secretary of State to act as a scrutineer and decision-maker for reconfigurations, to intervene when, for example, they can see a critical benefit or cost to taking one or other course of action, or to take action where there is a significant cause for public concern. Having said that, we accept that public concern could well be a political one, so we understand the concerns expressed by noble Lords.

We expect this power to be used infrequently and, when it is used, it will be done proportionately and transparently. All decisions made using the new reconfiguration call-in power in the Bill must be published, which will ensure transparency and proper scrutiny. The new call-in power for reconfigurations will allow the Secretary of State better to support effective change and respond to stakeholder concerns, including from the public health oversight and scrutiny committees and parliamentarians in a more timely way.


It is vital that all local views, including that of the health overview and scrutiny committees, are represented in the reconfiguration. The new power in the Bill will not replace the important local scrutiny and engagement that plays such an important role in service change decisions, and a duty for those locally responsible for service change proposals to consult local authorities will remain. It is right that for commissioners and providers who are responsible for planning, assuring and delivering reconfigurations the duty to consult HOSCs and other local stakeholders continues.” 

You can read the debate here (the Minister’s comments can be found at Col 384, with the debate immediately preceding this). 

The Minister also committed to “consult further” on the Bill in respect of these issues, which reflects what others have advised; that Government is likely to bring amendments to these proposals quite shortly. We are going to seek clarity on this from DHSC in the coming days. 

About the Author: Ed Hammond

Ed leads CfGS's work on devolution, transformation and on support to councils and other public bodies on governance and accountability.