It is less than 60 days since the last Queen’s Speech. Although the needs of the country have not changed much in that time, the political landscape has. This is reflected in the Government’s legislative agenda. Back in October, no one believed that the Government could carry Parliament on any legislation, contentious or otherwise. The Prime Minister could barely win a vote, let alone change the law. Now there are no such excuses.
With such a large majority, the Government can do pretty much what it wants. Number 10 will be keen to demonstrate that it is making good and rapid use of this new-found freedom. For health, this means legislation on funding and the regulation of medicines and medical devices.
On funding, this is essentially a reaffirmation of commitments made before the campaign. In truth, it is nothing new: if the Government was going to announce new money for the NHS, it would have done so before the election, not after it. The legislation will be a money bill, which means it will only need to pass through the Commons. The Government will be pleased that it is not subject to scrutiny by peers, some of whom might be moved to question whether there is a legislative purpose to the Bill, beyond ramming home a political point.
On medicines and medical devices, although this is legislation largely designed to do a simple thing – to make our medicines and medical devices laws operable in a post-Brexit world – it would, in a hung Parliament, have spiralled out of control as various interests took the chance to seek amendments to it. It remains an opportunity for these interests to make their voices heard, but – with a large majority in the Commons – the Government now has the ability to pick and choose what pressure it will yield to.
The Queen’s Speech is probably as revealing for what has not been identified as a Government priority. Social care gets a mention, but only in the context of cross-party talks. This is as about as far from legislation as it is possible to get. Proclamations about decisive action made on the steps of Downing Street have given way to talks about more talks.
NHS leaders may also be disappointed that a large parliamentary majority has not accelerated the pathway for the NHS’ own proposed reforms, which look to be buried in a pre-legislative scrutiny process. This isn’t quite the political equivalent of a deep freeze, but nor is it a day in the sun. In truth, expectations were probably unfairly raised by ill-informed speculation in recent days that passing the NHS’s own legislation would be a priority for the new administration. It isn’t.
Combined with Matt Hancock’s assertion that a new plan is required for the whole of health and care, leaders may now wonder whether the NHS’s Long Term Plan remains the reference point.
Since leaving the Government, Jeremy Hunt has redoubled his interest in patient safely. The former Secretary of State will be pleased that the Health Service Safety Investigations Bill is again included in the Queen’s Speech. After October’s false start, it should finally become law.
There will of course be other legislation that does much to shape the environment for health and care. The bill introducing a points-based immigration system will influence the nature of the workforce. The EU Withdrawal Bill will be dominate the Parliamentary agenda in the coming weeks.
Only once EU withdrawal is done will we see a flurry of legislation on the Government’s new domestic agenda. Despite protestations to the contrary, the Government may well at least be partially distracted by the next stage of Brexit and negotiating the UK’s future trading relationship with the European Union. We can expect the implications of trade talks to bleed into the debate on health. There will be continuity as well as a good deal of change.