Below is the text of the speech made by Sarah Mullally, the Bishop of London, in the House of Lords on 9 January 2020.

My Lords, I am grateful for the opportunity to speak during this debate on Her Majesty’s gracious Speech. I note my interests, which I have declared, and I will limit my comments purely to health and social care.

I welcome Her Majesty’s Government’s focus on the NHS: health, social care and the workforce. I also welcome the additional funding. However, we must not be misled into thinking that this is a funding bonanza; it will serve only to stabilise NHS services. Between April and September, for all nine NHS cancer targets the lowest percentage of patients was treated on time since the standards were introduced. All 118 A&E units fell below the 95% threshold in November as the NHS posted its worst performance since targets were introduced more than a decade ago. We have a long way to go simply to stabilise the status quo. Are Her Majesty’s Government confident that the action outlined will make up the ground that is required?

The NHS is only as good as its workforce, and I am glad to see the focus on recruitment, training and immigration. However, issues related to immigration must be acted on as soon as possible. The new NHS visa is welcome, but it is a limited response to the need to recruit international staff to meet pressing workforce shortages. Health workers coming to the UK still need to pay the immigration surcharge, which is set to increase to £625 per person every year, on top of £464 for a visa. I wonder whether more needs to be done.

The Her Majesty’s Government’s commitment to bring forward draft legislation to support the implementation of the NHS long-term plan is to be commended. As already mentioned, this should be based on the targeted proposals NHS England has developed. This will make it easier for NHS organisations to collaborate with not only each other but their partners in local communities to improve services for the people they serve. However, as any nurse working in a hospital today knows, too often patients, many of them vulnerable, cannot be discharged, despite being medically fit, because they have nowhere safe to go. A strategy for social care and its workforce is also needed.

The additional £1 billion is welcome, but in a sense it may give only a short-term boost to social care services for adults and children. I wonder whether it is enough to meet the rising demand for care while maintaining quality and accessibility of services. I am reassured to see that there is a cross-party approach to seeking consensus on social care reform, but it will take tremendous commitment, tenacity and creativity if the Prime Minister is going to honour his promise to fix the social care system once and for all and to bring forward meaningful proposals for reform. I look forward to lending my support to this work.

Would Her Majesty’s Government consider bringing forward proposals for health and social care integration? As the British Medical Association states:

“Challenges for Britain’s health do not end in GP surgeries or hospitals and the Government needs a credible long-term plan on how to care for people at home and in communities.”

Given the scale of the task of merely maintaining the current situation and the combined demands on healthcare ​needs, such a plan is increasingly important. Plans should be there to see health in its wider community context.

The diocese of London is collaborating on a pioneering project with Health Education England to place mental health students in faith communities in the Grenfell area to enable mutual learning. We need more such initiatives. They free up capacity, relieve pressure on various parts of the NHS and also contribute to the health of the community. I wonder whether more progress could be made to commission, partner and champion with local charities and churches to provide services to support the vulnerable and at-risk groups and to look at health and well-being in broader terms.

Finally, I hope that the implications of the European Union withdrawal Bill on policy and legislative business do not distract from improving the NHS, health and social care. Improving health and social care is good not just for the individual but for the nation.