The Lib Dems launched a full-scale attack on the Health Bill this week, describing plans to abolish Healthwatch and the Health Services Safety Investigations Body (HSSIB) as a ‘patient safety bonfire'.

Under the Health Bill, the functions of Healthwatch will transfer over to ICBs and local authorities, while HSSIB's role will be taken on by the CQC.

Patient safety risks

Morgan said there were different types of risk associated with abolition of each organisation.

Set up in the aftermath of the Mid Staffordshire scandal, Morgan described Healthwatch as a ‘safe space' where patients can talk about their health service experiences.

‘We know from polling back in 2024 there are people who feel their care has been poor, but they don't want to report that back into the NHS because they are dependent on that care, and they think it might impact on the care that they're receiving, and that's the value of Healthwatch because it's so independent of the NHS,' Morgan argued.

‘If you put that into the Department for Health and into local ICBs, that perception of independence is lost, and that's what we're concerned about.'

Morgan described the HSSIB as similar to the Air Accidents Investigation Board where professionals who work within the service can talk about where things might have gone wrong without fear of reprisal.

‘As a constituency MP, I've spoken to health professionals who've said they've been frightened to raise concerns about their organisation because they felt that it might impact on their own career,' Morgan said.

‘We've heard it across the country as well, and having a safe space where an investigator can look without a blame culture at what's gone wrong in the system seems to me an important step forward.

‘Moving the HSSIB into the CQC means that it's no longer entirely independent, or at least the perception of its independence is lost, and the perception is as important as the operational organisation. So we really think that that keeping those two bodies completely independent of the NHS will build trust in their ability to identify where things might go wrong and investigate what has gone wrong and come up with appropriate solutions for them.'

Morgan also highlighted the Bill's removal of the duty for the DHSC to provide information, including patient safety incident data, to the CQC, which is currently required of NHSE.

She also expressed concerns over the loss of whistleblower anonymity guarantees that are currently provided by the HSSIB.

Further protection for whistleblowers is also being lost through the transfer of the National Guardians Office into the DHSC as well, Morgan argued.

Sweeping powers

In addition to patient safety risks, Morgan also highlighted the ‘sweeping powers' given to the health secretary by the Bill, including appointing chairs and non-executive directors of trusts, which she argued raised the risk of political interference in the day-to-day running of the service.

The health spokesperson also claimed the Bill disaggregated health and social care by getting rid of some of the processes that ICBs go through with the local authority, weakening of local authority representation on ICBs and splitting Healthwatch's health and social care functions between local authorities and ICBs.

‘There's a general separation of responsibility for social care and the NHS that is just moving in completely the wrong direction,' she argued. 

Morgan said the Lib Dems were broadly supportive of the Health Bill's move away from duplication, however, and were ‘very keen' on the single patient record, although more detail was needed.

She added there remained ‘significant concern', however, about building data privacy into the single patient record and ensuring it was used appropriately.

The Lib Dems put forward a number of amendments at the committee stage of the Bill which has just completed and Morgan promised there would be more to come when MPs return to Parliament from summer recess.

DHSC response

A Department of Health and Social Care spokesperson said: ‘The NHS Modernisation Bill explicitly preserves safe space provisions and staff will continue to be protected.

‘The reforms we are introducing will give patients a stronger, clearer voice at the heart of health and social care.

‘By bringing the voice of patients closer to the people making decisions, we will ensure a more direct impact on services.'

The DHSC said abolition local Healthwatch organisations would simplify the patient safety landscape and make it more not less effective.

It added whistleblowing protections in the NHS had been enhanced in April in in addition to the Freedom to Speak Up programme and protected disclosures under the Public Interest Disclosure Act.

The DHSC said it was also putting in place service improvements to ensure strong collaboration between national bodies on patient safety under the leadership of the national quality board.