THE HEALTH BILL.
The Bill has passed its Second Reading on 1 June and readied for the next stage of its journey into law, the detailed examination by MPs on a Public Bill Committee, a process starting on 16 June and ending at 5.00 pm on 16 July.
Our PEP representative John Wigley submitted the following to the committee on our behalf
From the Hertfordshire Patient Engagement Platform (PEP). Our submission
The PEP is a large group of experienced and informed patients and members of the public, who have worked with the NHS in a voluntary capacity for many years, and for most of the last three years as members of the Patient Engagement Forum (PEF) set up by the Hertfordshire and West Essex Integrated Care Board (ICB).
As a result of ICB restructuring the PEF lost its mandate, with no provision made for an equivalent successor organisation, so its former members have set up the PEP.
The PEP is disappointed to find that the Health Bill proposes to abolish Healthwatch, which was set up as an independent champion of patients and public, and makes no attempt to ensure that each ICB establishes a body to secure patient and public engagement and representation. Nor does it consider the role of patients within GP Practices, only some of which currently have Patient Participation Groups (PPGs). The Bill does propose to set up a Directorate of Patient Experience within the Department of Health and Social Security; however, this will not give it the independence necessary to secure public confidence.
We therefore make four recommendations.
1) Oblige each ICB or ICB cluster to establish a body to secure independent patient and public engagement.
2) Oblige each ICB to include true patient representation on their board.
3) Ensure that every GP surgery has a PPG and each region has a PPG network.
4) Set up the Directorate outside the DHSC.
Thanks very much.
John Wigley for and behalf of the Hertfordshire Patient Engagement Platform
PARTONE.
Your intrepid health correspondent has been guided by another of his mottoes. The intricacies of Parliamentary procedure have made it hard to act on "keep it simple", but given lots of scope to apply the words "the pen is mightier than the sword."
The Parliamentary authorities have acknowledged receiving our submission to the Committee on the Health Bill. It has been circulated to members of the Committee and published on the Public Bill Committee webpage.
We can now publish it on our PEP website.
PART TWO.
Response from the Parliamentary authorities.
Dear John,
Thank you for your submission. Your submission will be circulated to members of the Committee.
The Committee may make use of your evidence for the purpose of considering the bill, including—if it wishes—printing and publishing your evidence, or making it available for public inspection in the Parliamentary Archives. The Committee will not publish or otherwise disclose personal postal or e-mail addresses or telephone numbers. The Committee has decided that witnesses can themselves publish or otherwise make use of their own evidence, once it has been published on the Public Bill Committee webpage. If, on further consideration, there is information in your submission which you believe to be sensitive, you should contact us to explain what harm you believe would result from its disclosure. The Committee will take this into account when deciding whether to publish the evidence.
Further information on the progress of the bill is available on:
Health Bill publications - Parliamentary Bills - UK Parliament
PART THREE.
Our submission was alongside 146 other written submissions, many from "big hitters" such as the Alzheimers Society, the British Dental Association, Carers UK, the NHS Alliance, the Nuffield Trust, the King's Fund, and the Royal College of Emergency Medicine.
As a result of the submissions, and witnesses who gave evidence in person, such as Jeremy Hunt MP, a former Health Minister, the Committee proposed several amendments, for example one to review the effect of the abolition of Healthwatch, another to enhance patients' involvement in their treatment by giving them a choice of at least two providers of secondary care.
PART FOUR. WHAT HAPPENS NEXT?
When Parliament resumes in September, the Committee will report to the House of Commons (the Report Stage), usually involving brief debate and discussion followed by a vote (the Third Reading; the First and Second Readings were held before the Committee Stage) which the government will almost certainly win. The Bill will then go to the House of Lords.
So, as the First World War song goes. "It's a long, long way a-winding."
The Department of Health and Social Care Policy Paper. Health Bill. Summary. Fact Sheet. Published 19.05.26.
The Bill will abolish NHS England and return many of its powers to the Department of HSC.
Key aim for patient engagement etc.
To "Embed patients at the heart of national decision making by transferring the functions of Healthwatch England to the DHSC, and developing a new patient experience directorate to make the public voice more directly relevant to the formulation of policy."
Presumably, this is what Mr. Streeting meant when he said that patients needed no intermediaries between themselves and the NHS.
Healthwatch was independent. Will the DHSC directorate be an independent champion of patients' needs?
Flying a little further into the surrounding gloom, I found an analysis produced by Healthwatch Stockton-on-Tees** which suggested that some Healthwatch functions might be transferred to ICBs and local authorities.
I had hoped to learn more about the Bill by watching the debate on the BBC Parliament Channel (Channel 232) but discussion and debate concentrated on proposals for patient records, all previous proposals for which seem to have had little effect.
As soon as your reporter has discovered more about the Bill, he will share his findings with the PEP
The PEP History of THE NHS MODERNISATION BILL aka THE NHS REFORM BILL.
Episode 1
After bringing you the latest news from Stockton-on-Tees**, your intrepid correspondent flew south through ever-darkening gloom, touched down in St. Margaret's Street and, before the security men had time to un-shoulder their arms, dashed through the Norman Gate (believe me, it does exist) and into the Palace of Westminster, from which he emerged clutching a copy of what's actually headed HEALTH BILL!
Under the heading "Secretary of State's Functions" it states that the S of S "Must promote the involvement of patients and their carers and representatives (if any) in decisions which relate to (a) the prevention or diagnosis of illness on the patients, or (b) their care or treatment. In exercising functions in relation to the health service the S of S must consult with a view to enabling patients to make choices with respect to all aspects of health services provided to them."
Nothing much new there. Does the Bill contain anything about patient and public engagement or involvement or representation or similar? If it does, I've not yet found it, perhaps because I've not yet read each of its 200 pages. In case anyone else wants to search, here’s the link. Maybe an AI search will reveal something.
Episode 2
Regular readers will recall that your intrepid correspondent entered the Palace of Westminster through the Norman Gate, and will have inferred that he left with a copy of the Bill, link as above. To throw off his pursuers, he ducked back into the Palace and infiltrated the Public Bill Office. There he found that the Bill had passed its Second Reading on 1 June and was being readied for the next stage of its journey into law, detailed examination by MPs on a Public Bill Committee, a process starting on 16 June and expected to end at 5.00 pm on 16 July.
All members of the public with "relevant expertise and experience or a special interest" in the Bill are invited to send written evidence to the Committee between 16 June and 16 July, although it would make no sense to leave that till the last few days. It's the early bird that gets the worm.
There's even an address to which to send written evidence
There is even a whole lot of advice, available via Google at "UK Health Bill. Call for Evidence."
So, ladies and gentlemen, members and friends of the PEP, are we going to sit on our hands?
Or are we going to get together, scratch our heads, and draft a nice and simple, jargon-free and succinct bit of written evidence re the Health Bill?
I. your intrepid correspondent, hereby volunteer to collate views and produce a draft.
Time for that whist I'm in hiding from the security guards.
But don't lets dilly and dally and postpone and procrastinate, send your views to the Editor@thepatientengagementplatform.org.uk
Follow WSC: "Action this day."
JW.
THE NHS AND The Hertfordshire PATIENT VOICE.
Over the years, patients have often complained about aspects of the NHS, whether about access to treatment or about actual treatment.
In 2025, it was announced that Health Watch, widely regarded as an independent means for patients to seek redress, was to be abolished.
Just recently. the Local Government Association warned that the abolition of H-W would leave patients with little option but to go directly to the NHS or to local councils.
Some Patient Voice History
For fifty or so years, the NHS supported patient "engagement" or "involvement" or "representation" but did not clearly define what it thinks the terms meant.
Over those fifty years, the NHS had many organisations that were supposed to give patients and public a role within it, but they were often short-lived.
1) Community Health Councils, set up 1974, with specific powers: one third of members nominated by voluntary organisations.
2) 2003 abolished, replaced by Patient and Public Involvement Forums
with specific legal powers, e.g. enter and view, and require information.
members appointed after interview by NHS.
3) 2008 abolished and replaced by Local Involvement Networks, LINKS.
retained power of enter and view and right to request information
tasked with finding the "patient voice".
4) 2013 LINKS abolished and replaced by
Healthwatch, which retained enter and view, and could conduct research, etc, as independent patient voice.
each Clinical Commissioning Group, e.g. the Herts Valleys CCG, had a Patient + Public Committee
latterly, two members attended meetings of the HVCCG Board, able to speak (but not vote) and sit on committees
2023 the CCGs abolished and with them the HVCCG and its Patient + Public Committee.
5) CCGs replaced by ICBs and our Herts & West Essex ICB set up the Patient Engagement Forum (PEF).
2025 PEF told by Paul Burstow (HWE ICB Chair) that it is not a "supervisory" body.
6) 2025 announced that Health Watch is to be abolished.
7) Original ICBs shut down as part of NHS reorganisation and the new Central East Cluster ICB formation leads to demise of the PEF, without providing for a successor
8) Former members of the PEF set up the Patient Engagement Platform (PEP).
It can be seen that the recent trend has been to reduce "patient power".
The Government’s NHS Ten Year Plan floated several ideas.
Amongst many others, it suggested that
"Power will be given to the frontline clinicians and patients" (page 76),
"Strategic authority mayors" will be made "board members for their ICBs" (page 79)
Power will be pushed "out to patients and public" (pages 83 and 84)
- a Choice Charter will enhance the patient voice, patient choice and patient feedback.
- Patients will report back on their treatment to the NHS organisation that gave it
- Patient Power Payments: patients will decide if the full cost of their treatment should be paid.
However, the word "will" was a misnomer; the Ten Year Plan was a plan, not a "done deal".
It deserved to be interpreted in the context of Mr. Streeting's view that there should be no intermediate bodies between patients and the NHS, hence the
impending abolition of Health Watch and the silence of the ICB clusters on the future (if any) of "patient power" in their areas.
What of the future?
We need to check the details of the NHS Modernisation Bill, coming up for its second reading in the House of Commons on Monday 1st June.
Does it seem likely that it will provide for an increase in "patient power"?
We will bring you the news as it breaks. (see above)
JW June 2026