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Health and Social Care Bill: second reading

12 October 2011

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The second reading of the Health and Social Care Bill was completed in the House of Lords on Wednesday 12 October. The House defeated Lord Rea's amendment seeking to halt further progress on the Bill, and Lord Owen's amendment for extra scrutiny of the Bill by a select committee.

The Bill now goes to a committee of the whole House for line by line examination. A date for committee stage is yet to be scheduled.

Lord Rea (Labour), former lecturer at St Thomas’ Hospital Medical School and GP, and member of the National Heart Forum, tabled a motion that, if passed, would have meant the Bill would go no further in the House of Lords and could not pass into law in this session of Parliament.

The House of Lords defeated the amendment by 354 votes to 220 –  a majority for the Government of 134 votes. 

Lord Owen (Crossbench), physician and Parliamentary Under-Secretary for Health (1974-76) and Lord Hennessy of Nympsfield (Crossbench), contemporary British historian, tabled a motion, which was debated because Lord Rea’s motion was not agreed to, that would have had the effect of setting up a select committee to examine the Bill with particular reference to the Lords Constitution Committee's 18th Report. 

The amendment was defeated by 330 votes to 262  –  a majority for the Government of 68 votes.  

The House sat until 12.23am after 87 of the 100 Members of the Lords scheduled to take part in the two-day debate had spoken. To accommodate the number of speakers, the House of Lords agreed a motion to enable the debate on the Bill to take place before oral questions and the House to sit at 11am on 11 and 12 October.

Contributors to today's debate

Members of the Lords took part in the debate included (use links to watch/listen to their speeches):

  • Lord Fowler (Conservative) chair of House of Lords Select Committee on HIV and AIDS in the UK, which published the report No vaccine, no cure: HIV and AIDS in the United Kingdom in September 2011
  • Baroness Finlay of Llandaff (Crossbench), physician, Professor of Palliative Medicine at Cardiff University; chair, Palliative Care Strategy Implementation Board for Wales; member of the End of Life Care Strategy Board, Department of Health (2007-09)
  • Lord Hunt of Kings Heath (Labour), Under-Secretary of State and Government Spokesperson for the Department of Health 1999-2003
  • Lord Winston (Labour) fertility expert, Professor of Science and Society and Emeritus Professor of Fertility Studies at Imperial College
  • Lord Patel (Crossbench), obstetrics physician, president of Royal College of Obstetricians (1995-98); chair of the Academy of Medical Royal Colleges 1996-98
  • Lord Alderdice (Liberal Democrat) former consultant psychiatrist
  • Baroness Pitkeathley (Labour) chair of the Council for Healthcare Excellence, vice-president of Carers UK and chief executive (1986-98); co-founder charity, National Voices a charity that aims to propel the views of patients, carers and service users directly into the heart of NHS and social services.

Lord Newton of Braintree (Conservative), Under-Secretary of State 1982-83, Minister of State 1983-86 and Minister for Health 1986-88 at the Department of Health and Social Security, who was scheduled to take part in the debate on Tuesday, spoke 'in the gap' on the Bill, as did the Archbishop of York and Baroness Scotland of Asthal (Labour), Attorney General for England and Wales (2007-10). Members of the Lords can rise to speak briefly 'in the gap' between the last backbench speaker and the front benches.

Day one

Contributions to the debate

(Use the links to watch/listen to the contributions.)

After the minister, Earl Howe, moved that the Bill be read a second time, the House debated  an amendment tabled by Lord Rea that could halt further progress of the Bill in this Parliament.

Members of the Lords who contributed to the first day's debate included:

  • Baroness Jay of Paddington (Labour), chair of the Lords Constitution Committee, which published a report on the Health and Social Care Bill on 14 September
  • Baroness Williams of Crosby (Liberal Democrat), Professor Emeritus of Elective Politics at the John F Kennedy School of Government, Harvard University
  • Lord Warner (Labour) member of the Commission on Funding of Care and Support – the Dilnot Commission, which published its report in July 2011; Minister of State at the Department of Health (2003-06), Director of Social Services, Kent County Council (1985-91)
  • Lord Darzi of Denham (Labour) Hamlyn Chair of Surgery at Imperial College London, Department of Health: Parliamentary Under-Secretary of State 2007-09
  • Lord Low of Dalston (Crossbench), currently leading the independent review of Personal Mobility in State Funded Residential Care – The Low Review – which is due to publish its recommendation in November 2011
  • Lord Crisp (Crossbench) Permanent Secretary of the UK Department of Health and chief executive of the NHS (2000-06)
  • Lord Hutton of Furness (Labour), Parliamentary Under-Secretary of State, Department of Health 1998-99, Minister of State for Health 1999-2005
  • Baroness Bottomley of Nettlestone (Conservative) Secretary of State for Health (1992-95).

Other Members of the Lords who made speeches in the debate included:

  • Lord Kakkar (Crossbench), surgeon and Fellow of the Royal College of Surgeons
  • Baroness Kingsmill (Labour), chair of the Southwark and Lewisham NHS Trust, and former deputy chair of the Competition Commission
  • Baroness Meacher (Crossbench) chair of East London and City Mental Health Trust and the East London NHS Foundation Trust
  • Baroness Murphy (Crossbench), former chair of City and Hackney Community Services NHS Trust, East London and City and North East London Strategic Health Authorities and St George’s Hospital Medical School
  • Lord Mawhinney (Conservative), Minister of State, Department of Health (1992-94); lecturer at the Royal Free Hospital School of Medicine (1970–84)  
  • Lord Patel of Bradford (Labour), former Mental Health Act Commission 1995-2008; Commissioner of the Healthcare Commission 2003-05.

Also speaking were:

  • Lord Adebowale (Crossbench), chief executive of the social care enterprise Turning Point, a health and social care organisation; member of the NHS Future Forum 
  • Baroness Bakewell (Labour) former Government Voice for Older People (2008-10)
  • Baroness Cumberlege (Conservative), vice president of the Royal Society for Public Health and vice president of the Royal Colleges of Nursing and Midwives
  • Baroness Emerton (Crossbench) Regional Director of Nursing South East Thames Regional Health Authority (1985-91)
  • Baroness Gould of Potternewton (Labour), pharamacist, president of the Family Planning Association Chair of the Independent Advisory Group on Sexual Health 
  • Baroness Hollins (Crossbench), Professor of Psychiatry of Disability, St George’s University of London
  • Baroness Wall of New Barnet (Labour), chair of Barnet & Chase Farm NHS Trust 
  • Lord Walton of Detchant (Crossbench), President of the British Medical Association (1980-82); President of the General Medical Council (1982-89) and President of the Royal Society of Medicine (1984-86)
  • Baroness Wilkins (Labour) President of the College of Occupational Therapists (2003-08); member of the Prince of Wales Advisory Group on Disability (1982-90).

Also taking part:

Lord Colwyn (Conservative), dental surgeon; Baroness Kennedy of The Shaws  (Labour) chair of the Human Genetics Commission (1998-2007), chair of the Royal Colleges of Pathologists and of Pediatrics’ Inquiry into Sudden Infant Death (2004); Lord Mawson (Crossbench), social entrepreneur and co-founder and president of Community Action Network;  Baroness O'Neill of Bengarve (Crossbench), chair of Nuffield Council on Bioethics (1996-98), a member and then acting chair of the Human Genetics Advisory Commission (1996-99); Lord Ribeiro (Conservative), President of the Royal College of Surgeons (2005-08); Lord Rix (Crossbench) President of the Royal Mencap Society; Baroness Tonge (Liberal Democrat), vice president of the Family Planning Association and a former general practitioner; Baroness Tyler of Enfield (Liberal Democrat), chief executive of the couples and family relationships charity Relate; and Lord Whitty (Labour), chair of Consumer Focus (2007-10).

Further information

The Health and Social Care Bill aims to: change how NHS care is commissioned through the greater involvement of clinicians and a new NHS Commissioning Board; improve accountability and patient voice; give NHS providers new freedoms to improve quality of care; and establish a provider regulator to promote efficiency. In addition, the Bill will underpin the creation of Public Health England, and take forward measures to reform health public bodies.

A Lords Constitution Committee report, published 14 September, said the Bill – which divides the Secretary of State for Health's statutory duties for the NHS in England between the Secretary of State, a new NHS Commissioning Board and new clinical commissioning groups – risks 'diluting the Government's constitutional responsibilities with regard to the NHS'. The the committee said that it may be necessary to amend the Bill to put the matter 'beyond legal doubt'.

Second reading is the first opportunity for Members of the Lords to debate the main principles and purpose of the Bill, and to flag up concerns and areas where they think changes (amendments) are needed.

Members of the public can attend House of Lords debates and follow proceedings from the public gallery.

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