Speeches by Johnson.

“Q Thank you. Sally, what would be the impact of the removal of the pooling of better care funding among local authorities and ICBs? Sally Burlington: The better care fund is a really important source of funding for statutory core services. It funds about 80% of social care—in terms of the use of the better care fund by…”

“So you are losing a protection with the Bill. Sally Burlington: Exactly.”

“Q My first question goes to all of you. In principle, the single patient record offers opportunity, but people have expressed reservations, as have each of your charities. What are your thoughts on the single patient record? Paul Farmer: From the perspective of older people and people with long-term conditions, the sin…”

“Q I have a question for Emily about digital exclusion and the app. What can be done to help people not to be digitally excluded? How do you see this working in areas of the country with poorer broadband connections, for example? Also, what about the record? Sharing your medical records is not an all-or-nothing thing, i…”

“Q As a Lincolnshire MP, I am delighted to know that that is operating, if not necessarily in my constituency, then certainly in the county. I have a question for Kath: how does the single patient record apply to maternity in terms of safeguarding and access to that sort of information? As an aside, this Bill allows the…”

“Q I should say that I also work as an NHS consultant paediatrician. The single patient record offers a great opportunity for doctors, clinicians and patients to all be much more joined up, but I have a quote from the Secretary of State on Second Reading: “rather than data being transferred from where it exists at the m…”

“That would be moving it on to a new system. Dr Imam: That is in a separate shared care records system. Dr Byrne: As I understand it, the architecture is not yet decided, so how we solve those technical challenges will be determined by the choice of architecture. Dr Cocker: Similarly, I believe that the technical soluti…”

“Q Of course, it would need to be viewable across the whole country for people who travel around. What about the security of this data? Lots of people have expressed concerns about the security of the data, both from people who are a bit nosey and who want to have a look, and from people who would wish to do the country…”

“Q Does it surprise you that the Bill is being brought forward before it has been properly and completely designed? We have tabled some amendments to clause 47; I appreciate that you will not have had a chance to look at those yet, but we would be interested in your thoughts if you could provide them to the Committee af…”

“Q Do you have any thoughts on the separation of elements of the record such as safeguarding records and sexual health records? We have heard about carers being able to see parts of the record. Surely there are circumstances where we may want people to see parts of the record but not others, or people may wish to share …”

“Thank you. You are nodding, Dr Cocker. Dr Cocker: I was just going to say that we did do some exploratory work in relation to safeguarding, because that is quite a key part of safe maternity care, but because of the issues with confidentiality for other involved parties—say, a mother’s partner or someone else in the fa…”

“Q Presumably, the obstetrician may need to be aware of previous pregnancies, but the patient may not want their current partner to know about them. Dr Cocker: Yes, and those are concerns with the existing systems. There are multiple sources of information we record on a clinician-facing basis that might be deemed sensi…”

“Q Good afternoon, Mr Restell. When the NHS has been reorganised in the past, it has become more centralised or less centralised. Which do you think this Bill does? Jon Restell: There are lots of different ways to answer that. Obviously, some functions of NHS England moving into the Department, with powers going to the …”

“Q What effect is that having on managers and their ability to do the day job and deliver care? Presumably, a lot of time, effort and energy, and perhaps a lot of worry, are going into the process of reorganisation. What effect does that have on the delivery of services and the development of new ones? Jon Restell: This…”

“Q That does not sound very good. The Government said that they were going to regulate NHS managers. What impact do you think that would have? Jon Restell: Our members have been on a bit of a journey on this one. I think that they would broadly support the regulatory proposals that the Government will bring forward afte…”

“Q We have heard a lot today about things not being quite finalised yet; we are not quite sure where the destination is. Is it difficult for managers to be asked to transform from a current service to a new service if there is no well explained vision and understanding of what “new” looks like? Jon Restell: That is prob…”

“Q We do not have a plan of where we are going, but you have been asked to go somewhere. Jon Restell: Obviously, we have the 10-year health plan, which most people broadly see as a good vision for the service, but there are too many key design questions around the new department, the role of the department’s regions, wh…”

“Q Good afternoon. Social care is one area that is absent from this Bill. To what extent is it possible to make the health service more efficient without tackling problems in adult social care? Sir Andrew Dilnot: It is largely absent from the Bill—indeed, when I was asked to come and give evidence to this Committee, I w…”

“Q We have heard evidence today that the Bill weakens links between local authority working and the ICB. Does that help social care, or could that actually make it worse? Sir Andrew Dilnot: I would not claim to be expert here, but I have read the Bill and the briefings. The role of local authorities in social care is a …”

“Q You have talked a lot about adult social care in terms of the very elderly and frail and people with dementia, but it also affects younger people. For example, Swallow Lodge, which is a facility for working-age adults in my constituency, is under threat of closure. I and others have made the arguments about how it is…”