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NHS Funding Bill: Briefing for Lords Stages

The NHS Funding Bill is a two-clause government bill intended to place a legal duty on the Government to guarantee a minimum level of revenue spending for the NHS in England in each year from 2020/21 to 2023/24 inclusive. The amounts specified rise from £127.0 billion in 2020/21 to £148.5 billion in 2023/24. These figures compare with £120.1 billion in 2019/20.

The bill would place into law a funding settlement for NHS England first announced by the then Prime Minister, Theresa May, in June 2018. This formed the basis of the NHS’s Long Term Plan, published in January 2019. Legislation to enshrine the settlement in law was a commitment in both the Conservative Party 2019 general election manifesto and the Queen’s Speech in December 2019.

The bill passed through its House of Commons stages unamended. Issues debated included:

• The funding amounts in the bill being set out in cash terms, not real terms (ie adjusted for inflation) meaning that if inflation exceeds expectations, the purchasing power of the settlement might be less than anticipated.
• That the bill only relates to revenue spending. Some speakers argued that other areas should also be covered, such as: capital spending; education and training; the local authority public health grant; and social care.
• The relationship between the bill and the aim of achieving “parity of esteem” for mental health services.
• The effect of the funding settlement on the NHS’s ability to meet its performance targets.

The bill is a ‘money bill’. This means it can receive royal assent without being passed by the House of Lords, and also that the House of Commons is not obliged to consider any amendments made by the Lords. It is normal practice for such bills not to be committed to a committee stage in the Lords, instead going directly from second to third readings.

The bill is an example of the Government committing in primary legislation to an action which is already within its power.