Speeches by Smyth.

“Q Dr Dickson, can you describe how you think the single patient record could be transformative for patient care, given where we are? Dr Dickson: Part of it has been touched on by the previous panel, regarding patient experience. Patients come in, they give the same story again and again to different healthcare professi…”

“Q What are the key things we need to get right to ensure that safety investigations in general and safe space in particular are made to happen in the new arrangements? Dr Benneyworth: The two key things have been touched on already. The first is the independence to choose what we investigate and make recommendations to…”

“Q Those things obviously are manageable in another system, but people need that safe space to come forward. You rightly outlined reality and perception, and perception is often important for confidence. You talked about the culture of fear, which I think we have recognised over time. We are all constituency MPs, so we …”

“Q You have leant into my next question, Sir Jeremy. You are a former Chancellor of the Exchequer, so you understand some of these tensions. My question is about the number of recommendations and outstanding actions. As you said, honestly recognising that it happened during your time as well, this has all arisen over ti…”

“Q To move on to the transfer of NHS England’s functions, in your time in office NHS England was a new independent body. What are your reflections on how we can use the transfer of those NHS England functions back into democratic oversight to improve impacts on patients, particularly patient safety? Sir Jeremy Hunt: I s…”

“Q To pick up on Sir Ciarán’s comments about experiences being extremely rare, the changes in the Bill sit alongside changes to the national centre and clarity for ICBs, with very little change to providers. What would make the biggest difference to providers and commissioners to improve things? Sir Ciarán Devane: The b…”

“Q Sir Ciarán, may I clarify a point with you? I think you are not objecting to the abolition of NHS England—yes or no? Sir Ciarán Devane: No, we are not.”

“Q Because you also said that the risk of not having financial control is high. I would say that, over the last few years, financial control has been a massive problem, and we have put in much better financial control. I think that your concern is with the future rather than the legislation. Sir Ciarán Devane: Yes, comp…”

“Q Mr Blythe, what does the single patient record mean for you in running a big hospital? James Blythe: I think the single patient record offers enormous opportunities to improve patient care. We know that we see patients every day whose quality of care and patient experience would be improved through having access to a…”

“Q As we have heard, despite 52 years of independent patient voice, 20,000 reports and many hundreds of recommendations, we have some of our worst ever patient satisfaction. We are also now more than 10 years on from the Francis report, but recommendations are not being followed through locally or nationally. It is pret…”

“Yes. Professor Croisdale-Appleby: Fine. The Government’s move to the integrated patient record is absolutely excellent. Most of us have wanted that for a very long time, but we also recognised the IT difficulties in doing it, as well as the question of security. However, as digital has advanced, we have nutcrackers tha…”

“Q Councillor Wright, the Bill will essentially abolish NHS England. Do you have any comments about how that works at the moment in terms of local government? How can we unlock some of the potential in the Bill, with the changes to NHS England, with regard to local government, particularly on health and wellbeing boards…”

“Q May I come to you, Sally, particularly on social care and the opportunities that might arise from it? Sally Burlington: Health and wellbeing boards will probably become even more important following the removal of local government representation from the ICB. It will be the only place we have NHS and local government…”

“Q Can you say a little more about what those opportunities might be, particularly for social care, with better focus on health and wellbeing boards? Sally Burlington: Neighbourhood health is a really important vision that we strongly support. In a way, it is obviously the right thing to do to move services closer to th…”

“Q I will follow on from Dr Johnson’s questions. You have all expressed support for the single patient record, which is great, but that is not universal. Obviously, the Bill has to be enacted for that measure to go forward. It would be helpful to hear about your current experiences in your different areas—older people, …”

“Q My questions around the benefits that you might see have been really well answered, so I will not go back to that issue. Dr Cocker and Dr Imam, in your work on maternity and frailty, what early lessons have you picked up on how this might work for you? Dr Cocker: Having seen the maternity-focused prototype that NHS E…”

“Q Dr Byrne, you talked about the issues around trust, which we absolutely recognise. We hear quite a lot about the work going on to try to get the legislation right technically, but, further to what you have suggested, how would you advise the Government to communicate clearly about the benefits, while understanding pe…”

“Q It is always good to have a doctor from the NHS supporting managers in the NHS, having been one. I declared my interest earlier that I am a member of Managers in Partnership. We had a lot of change with the Health and Social Care Act 2012, and the Bill seeks to reverse that in terms of the architecture of the NHS. We…”

“Q As you say, the Bill does not deal with social care, but it is great to have your expertise here. Do you think the Bill should or could have included social care at this stage? Sir Andrew Dilnot: The question of the fine details of how legislation should be passed is certainly outside my skillset, so I have to be agn…”

“It is very important for patients to have access to innovative medicines as quickly as possible, especially where there is unmet clinical need or no alternative treatment. We are working to streamline the decisions of the National Institute for Health and Care Excellence and the Medicines and Healthcare products Regula…”