Speeches by Coleman.

“The problem is not the system approach, which is really effective and also happens in hospitals local to me, but the funding that local authorities know they can rely on and plan ahead for. The problem there is that the NHS has a different timetable for its funding. Its budget has different start and end points. As so …”

“That is brilliant.”

“And they are on board with this?”

“Absolutely. Prevention is obviously one of the three drivers, and it works much better. My experience of the Better Care Fund—I have only been a Member of Parliament since July 2024, so I appreciate that things may have moved on—is that the NHS dictates to local authorities what is going to happen. There is a sort of n…”

“The 10-year plan talks about strategic authority mayors, rather than local councils, sitting on ICBs. We do not have a strategic authority mayor in London who does that, and there are other parts of the country where it might not be appropriate. I think one of the weaknesses of what is otherwise a very impressive 10-ye…”

“A paper that the Committee discussed before Christmas, the name of which escapes me, says that only mayors will be on ICBs. At the moment, you have three councils sitting on the North West London ICB, which is unusual—we had to fight for it, and we got it—and in other places it is one or two. You are merging ICBs—obvio…”

“It is good to see you all today. Thank you for coming. May I ask a bit about ICBs? To pick up the point that you were talking about with the Chair, if you want local authorities to be more involved in developing palliative care services and other services, why is the Government planning to reduce the number of local au…”

“I am going to stop you. Forgive me.”

“No, I am just focusing on the problems that you—”

“Are there other problems that you have come across? I think you have left something significant out, but I do not want to lead you. I just want to get your view on what else has been a big problem. Samantha, I can see that you want to come in.”

“I am going to stop you right there, because I thought you would say that. I am not going to ask you about the model; I would like to go one step back. What were the problems that you found with PFI that the new model is trying to address? If you could start with the problems, and then we could talk about how the new mo…”

“I would like to move on to a different area, which is mostly going to involve questions for Sir Jim and Samantha, to give Wes a break. It will be about PFI and public-private partnerships. The plan is to build 250 neighbourhood health centres, with 120 operational by 2030, the vast majority via a new PPP model and cost…”

“Are the PPPs going to be negotiated and managed by ICBs? If so, will they be trained?”

“I congratulate the Minister as heartily as everyone else has on bringing the UK back into Erasmus and ensuring that people from all backgrounds, including university students, can once again enjoy the opportunities that the Tory Brexit took away. Part of my Chelsea and Fulham constituency ranks among the 12th most depr…”

“Simply within the public sector, if you had been able to make the money available to keep hospitals properly maintained over a number of years, that would be the comparator that you would need to use. I think it is a wholly unjustifiable statement to make. I have one last, very quick question. Are ICBs going to be nego…”

“Forgive me for coming back on that, but if you had spent the same amount of money as a PFI scheme costs to maintain—”

“I think there is great strength in somebody starting to negotiate and just saying, “No, we can’t negotiate. You’re asking too much,” and walking away from it. Is there a danger that civil servants would feel under so much time pressure that they might not be prepared to walk away or close down projects?”

“That requires quite a lot of time, and the pressure on building 120 and getting them operational by 2030—”

“That is a very important point, and I appreciate you making it—I felt that you might—but isn’t there a big difference between building something on time, which is meeting a political imperative, and seeing what happens over years to come: whether there are problems, how they are dealt with, whether civil servants have …”

“Are you saying that we are getting private sector people in to train up the civil servants in negotiating, or are we going to be doing what we did previously, which was effectively taking advice from the private sector all the time while we negotiated? Inevitably, they will be acting in different fora from the very peo…”