Committee publication · Report · 12 June 2026 · HC 219

1st Report – Health Bill 2026–27

Government response deadline: 12 August 2026

Summary

The Health and Social Care Committee's first report on the Health Bill 2026–27 proposes six targeted amendments to the legislation. The bill primarily abolishes NHS England and transfers functions to integrated care boards and the Department of Health and Social Care. The committee's amendments focus on retaining local authority representation on ICBs, requiring a statutory Mental Health Investment Standard, strengthening duties on health inequalities, expanding section 75 budget-pooling arrangements, ensuring service co-production, and extending SEND Tribunal powers to health and social care.

Key findings

The Health Bill removes local authority representation requirements from Integrated Care Boards, which witnesses argued risks disconnecting NHS planning from social care and public health at local level, undermining prevention and community-based treatment shifts
Section 75 budget-pooling arrangements between NHS and local authorities are underutilised despite evidence of effectiveness; the bill misses an opportunity to reform or promote their use
The Mental Health Investment Standard is being weakened—redefined to require only inflation-level funding growth rather than faster growth rates, with reduced compliance audits, despite mental health representing 20% of disease burden but receiving under 10% of NHS spending
The bill fails to extend SEND Tribunal powers to make binding recommendations on health and social care provision in Education, Health and Care Plans, leaving a level-playing-field gap versus education provision
Clause 4's health inequalities duty is too narrow, focusing only on healthcare access and outcomes rather than broader determinants (housing, air quality, transport); a 20-year gap in healthy life expectancy exists between richest and poorest regions

Recommendations

Retain the statutory requirement for Integrated Care Boards to include at least one member jointly nominated by local authorities
Amend the Health Bill to require the Secretary of State to review the effective use of Section 75 of the NHS Act 2006 and produce guidance to support NHS bodies and local authorities in pooling budgets and jointly commissioning health and social care services
Make meeting the Mental Health Investment Standard a statutory requirement on Integrated Care Boards, rather than merely reporting on it
Explicitly specify on the face of the bill that the Secretary of State's public involvement duty in commissioning includes co-production of service design and delivery
Extend the powers of the First-tier Tribunal (SEND Tribunal Service) to issue binding orders—not just recommendations—requiring Integrated Care Boards to comply with tribunal decisions on health and social care provision in Education, Health and Care Plans
Strengthen the Secretary of State's duties in clause 4 to include a broader health improvement and health inequalities duty encompassing general health determinants such as housing, transport, and environmental factors; place a duty on all ministers to consider how their policies contribute to or reduce health inequalities

Tone

Critical

Topics

nhs-governancehealth-inequalitiesmental-healthintegrated-carelocal-government

Key actors

Layla Moran, Sarah Woolnough, Dr Hugh Alderwick, Dr Wendy Taylor, Harry Dyson, Health Foundation, Kings Fund, Health Equals

Notable line

“The risk is that you will lose the connection with social care and public health at a local level.”

Key Quotes

“The risk is that you will lose the connection with social care and public health at a local level. That is critical for things like managing multimorbidity, and it might make things like pooling budgets more distant or difficult just because the planning together is not as effective.”
— Dr Hugh Alderwick, Director of Policy and Research at The Health Foundation · on the impact of proposed changes to ICB membership removing local authority representation

“… if neighbourhood health is going to work, local authorities have to be at the centre of making it work”
— Dr Wendy Taylor, Chair of the Local Government Association's Health and Wellbeing Committee · arguing against removal of local authority representation on ICBs

“[t]he real challenge that comes with doing meaningful co-production is that it is ultimately about sharing power, and it does cost money.”
— Harry Dyson, peer researcher at the McPin Foundation · on the barriers to effective service co-production

“The government need to focus on health and inequalities. A lot of that is about political will and investment. But if you wanted to use the legislation to force that issue, there are a couple of things that you could do.”
— Dr Hugh Alderwick, Health Foundation · on legislative mechanisms to strengthen health inequalities duties

“At present, the Health Bill brings together old duties on the health secretary and NHS England to reduce inequalities in access to health care and outcomes (Section 4). These duties are too narrow and do not reflect the wider determinants of health that the government has pledged to tackle.”
— Health Equals campaign group · advocating for broader health inequalities duty encompassing social determinants

“… a lot of time debating about who pays, rather than having a conversation about how, in the longer term, we can invest in people's outcomes to enable better health and wellbeing”
— Melanie Williams, President of the Association of Directors of Adult Social Services · on barriers to integrated health and social care funding

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Source · parliament.uk record ↗