The profile of all select committees has risen over the last few years. The Health Select Committee in particular has been on newspapers’ front pages due to its inquiries, its former Chair’s position on the Health and Social Care Act, and the public’s general obsession with the NHS. Now, with focus on the NHS greater than ever, and with a fragile governing majority, its influence is going to be felt even more.
Rupert Murdoch’s appearance in front of the Culture, Media and Sport Committee back in 2011 was one of the most significant political moments of the last Parliament. His appearance not only set the agenda for the weeks and months that followed, it highlighted the potential of select committees as national watchdogs and the (unofficial) opposition.
On that occasion, the Committee’s profile was given a helping hand because the hacking scandal was dominating the news. But, in a world where health is likely to be similarly dominant over the next five years, we can expect the Health Select Committee to grow in profile and importance. Not because of any large-scale reform, but because of the momentous challenges facing the NHS: £22 billion of efficiency savings, rising patient demand, and falling performance standards.
It will be for the new Health Select Committee (formally appointed this week) and its Chair, Dr Sarah Wollaston, to keep a watchful eye on how ministers, officials and the NHS respond to these challenges.
Dynamics now
The effectiveness of a select committee is more often than not determined by its membership and particularly its chair. Margaret Hodge’s formidable chairmanship of the Public Accounts Committee not only generated headlines, but successfully changed corporate and government policy.
Sarah Wollaston’s independent-mindedness during the last Parliament and background as a GP garnered respect amongst the sector and her colleagues. Her public criticisms of the Government’s health reforms and its abandonment of minimum alcohol pricing made her a thorn in the side of ministers, and we can expect this to continue.
Labour’s internal leadership struggles have left the party’s functions as the official opposition limited until a new leader (and indeed shadow health secretary) are appointed. Until a new leader and shadow health secretary are settled in, the Health Select Committee may well be the most obvious source of “opposition” to government policy which exists - and its Labour membership knows it.
Newly-elected members Liz McInnes, Paula Sheriff, Emily Thornberry and Rachel Maskell have the opportunity to strengthen Labour’s ‘ownership’ of NHS issues over the Conservatives; ownership which existed at the time of General Election, but which ultimately proved insufficiently strong. Expect Emily Thornberry, as an experienced parliamentarian and former shadow care minister, to have a prominent position in the Committee.
The SNP’s member in the Committee, its health spokesperson, Philippa Whitford (also a doctor), could de facto hold the balance of power on the Committee. With Wollaston only having voting powers in the case of a tie, Whitford may represent the only opportunity for Labour to block the Conservatives’ ascendancy in the Committee. How Labour members look to work with Whitford and what stance she takes will add a new dynamic to the Committee.
What are the priorities likely to be for the new Committee?
Dr Wollaston’s election has given an element of continuity to the Committee’s work and it is likely to influence its priorities in the following years.
Balancing the NHS’ books without hitting services is set to be a herculean task and the Committee will be looking hard at how the £22 billion efficiency savings will ever be realised. The Committee’s public expenditure report, blocked before May’s General Election, might see a return as one of the Committee’s early inquiries, along with - potentially - investigations into specialised commissioning and the effectiveness of the Better Care Fund.
Winter pressures are also likely to be a top priority. Last year’s winter was the toughest the health service had faced in a generation, leading to falling performance standards and headlines warning of a ‘third world NHS’. How the NHS copes this winter is going to be an early challenge for the new administration, particularly with the new Labour leader (when elected) looking for opportunities to score some early wins. The Government’s winter planning may again be called out by the Committee as being ‘not good enough’ - just as it was two years ago.
The devolution of health spending to Manchester was positively received when announced but progress since then has been slow. With the Government already looking at devolving further powers to regions (eg DevoCornwall, now), DevoManc will inevitably be seen as a template to follow. A positive evaluation of DevoManc’s outcomes by the Committee might encourage other areas of the country to follow suit; a negative one might derail the policy agenda entirely.
The profile of all select committees has risen over the last few years. The Health Select Committee in particular has been on newspapers’ front pages due to its inquiries, its former Chair’s position on the Health and Social Care Act, and the public’s general obsession with the NHS. Now, with focus on the NHS greater than ever, and with a fragile governing majority, its influence is going to be felt even more.
This article was first published on the Incisive Health blog.