King’s Speech and new Health and Social Care Secretary

King’s Speech introduces new health bill

Delivering his speech on Wednesday 13 May, the King set out the Government’s legislative plans for the year ahead. Against significant political unrest and flux, the King set out 37 Bills that his Government plan to introduce and deliver in the coming months.

The NHS Modernisation Bill was confirmed in the speech, with the government committing to push forward significant reforms, including those set out in the 10-year plan. This includes the shift from hospital to community care, consolidation of arm’s-length bodies, and creating digital health records.  

Much of the speech was security focussed, with energy security, economic security, defence, and national security featuring highly. Cost of living messages including welfare reform and tax are increasingly being framed in a broader security narrative, arguing that long-term structural reform through energy independence, stronger trade relations, and investment in housing and infrastructure is the route to improving living standards.

Additions not widely trailed in advance include the Tackling State Threats Bill, a National Security Bill in direct response to the Southport attack, a Removal of Peerages Bill, and a commitment to respond to the Milburn Review into the NEET crisis, and the TimmsReview into Personal Independence Payments. The UK’s G20 presidency in 2027 also received a mention, signalling ambition on the world stage.

Next Steps

Following the Speech, the Commons debate it over several days, known as the ‘debate on the address.’ Each day focusses on a different policy theme, with senior ministers opening and closing each day’s debate. At the end of the debate, MPs will vote on a ‘humble address’, which is a motion formally thanking the King for the speech. As legislation is introduced, or timetabled, we will get a sense of priorities and how quickly Government wants to enact its policy proposals.

The King’s Speech 2026

NHS Modernisation Bill

“My Ministers will push forward with significant reforms to… the National Health Service”

• The NHS Modernisation Bill is integral to the Government’s plans to improve care for patients through investment and modernisation. It will enhance patient safety and experience through a new Single Patient Record, enabling joined up, proactive care and empowering patients. The Bill puts power and resources in the hands of frontline NHS organisations by abolishing NHS England and stripping back national bureaucracy.
• These are necessary steps to reduce inefficiency, drive innovation, and support early intervention to help people stay well for longer. This will help put the NHS back on its feet so it’s there for patients when they need it, a better place for staff to work and better value for taxpayers.

What does the Bill do?

• Lord Darzi’s 2024 Review of the NHS in England found the NHS in a critical condition. A system too rigid and complex, over-centralised and with unclear accountability, using fragmented and outdated information systems resulting in poor patient care and experience.
• The 10 Year Health Plan for England sets out the Government’s vision to deliver high-quality healthcare for the public. An NHS that harnesses digital technologies, unlocks the value of health data, empowers patients and clinicians, embeds patient voice in decision-making, and gives greater power to local leaders, supported by a streamlined and accountable national centre.

The Bill will:

• Build the Single Patient Record – by enabling the NHS to bring together patient’s health and social care records into one place to improve patient safety and experience. It will enable people to see their own health records securely on the NHS App, empowering them to make informed decisions about their own health. This will apply to those receiving maternity and frailty care by 2028, with learning from this applied to the wider rollout.
• Abolish NHS England – by transferring NHS England’s functions into the Department of Health and Social Care or the wider system, it will reduce bureaucracy, freeing up resources to be reinvested in the frontline – and in doing so will restore democratic ministerial accountability for national decision-making.
• Strengthen local democratic accountability in health systems – by placing new requirements for mayoral nominees to be on Integrated Care Boards (ICBs).
• Streamline the patient safety landscape and ensure better outcomes for patients and staff by transferring the Health Services Safety and Investigations Body functions to the Care Quality Commission. It will also help bring confidence that the Government has learnt from previous experiences by extending the time limit for the Care Quality Commission to bring legal action against a provider.
• Embed patient voice in national decision-making by transferring the functions of Healthwatch England to the Department of Health and Social Care, and developing a new Patient Experience Directorate in the department to make the public’s voice more directly involved in the formulation of policy.
• Support ICBs to become strategic commissioners by transferring responsibilities for all but the most specialised commissioning functions to ICBs, including primary care, dentistry, ophthalmology and pharmacy.
• Give ICBs the flexibility in how to manage their local systems by refining the membership of their boards. The Bill will also streamline the planning process to ensure there are ICB plans at neighbourhood and strategic level, eliminating the requirement on a local area to have an Integrated Care Partnership and allowing for greater flexibility.
• Empower providers through Foundation Trust reform, giving them more flexibility to design and deliver healthcare around local needs by removing the requirement for a Council of Governors. The power to deauthorise Foundation Trusts as a last resort option will also return to Ministers.
• Ensure the voices of patients, service users and local people feed directly into the services they receive, by transferring the functions of Local Healthwatch to where local decisions are made. The functions relating to healthcare will transfer into ICBs, while the functions relating to social care move to local authorities. Putting patients at the heart of care means devolving decisions to a local level, so those who truly understand the needs of their communities are trusted to shape and integrate services more effectively.

Territorial extent and application

• The majority of the Bill will extend to England and Wales, with some provisions extending to the whole of the UK. The majority of provisions will apply to England only.

Key facts

• Accountability has been lost in layers of bureaucracy. Since NHS England’s creation in 2013, the number of staff working in NHS England (including previously independent digital, workforce and trust regulator bodies) and the Department of Health and Social Care has risen by 50 per cent. Local leaders have complained of “two centres”, creating confusion and inertia, and diluting democratic accountability for the NHS. The public rightly expects to hold politicians to account directly for the quality of the services they are paying for.
• The reintegration of NHS England and the restructuring of ICBs is expected to save £1 billion a year by the end of this Parliament.
• The wider national health and care landscape includes 23 arm’s length bodies, some of which have overlapping responsibilities, creating confusion and slowing decision-making. This Bill will clarify the role of local health bodies, giving them real flexibility to design and deliver health services to best meet the needs of their local populations.
• The Hewitt Review of integrated care systems, published April 2023, highlighted challenges to the system from competing requests for information from both NHS England and the Department of Health and Social Care. For example: “… in December 2022, in one instance one integrated care system received 97 ad-hoc requests from DHSC and NHSE, in addition to the 6 key monthly, 11 weekly and 3 daily data returns.”
• There are more than 70 different channels or organisations that offer a place for patients or users to share feedback. The Dash Review of patient safety across the health and care landscape, published July 2025, concluded that even though there are multiple organisations representing the voice of the user (including local Healthwatch), patient experience has not been given the attention that it deserves.
• A cluttered patient safety landscape has resulted in an overwhelming number of recommendations, varying in quality and value with 74 recommendations overlapping or contradicting others. The Thirlwall Inquiry found that there have been over 1,400 recommendations from 30 inquiries that have taken place in England and Wales in the last 30 years, related to its Terms of Reference alone. The various inquiries and reviews into maternity care over the last five years resulted in over 450 recommendations.
• Information silos across hospitals, GPs and community care force patients to repeat their stories and clinicians to work with incomplete data. This is not just an inconvenience: it puts patient safety at risk. When clinicians do not have all the relevant facts available, they cannot make the best decisions, and patients lose out. A lack of joined up care records also means that the NHS misses opportunities to diagnose and treat people early.
• According to Healthwatch England’s May 2025 Report, nearly one in four adults have noticed inaccuracies or missing details in their medical records, such as incorrect personal details, inaccurate records of medication, diagnoses, treatments, and conditions. Over one in four of those who have noticed inaccuracies say they have had to repeat their patient history.
• Independent public deliberations showed support for the Single Patient Record was strong and wide. It was described as a “long overdue fix to fragmented care” and 76 per cent were in support of a single patient record.
• A survey of 1,888 English adults (aged 18-75), by the King’s Fund in February 2025, found that nearly two in three patients and carers have experienced at least one problem over the last year with their care, such as having to chase for test results, attending an appointment but the right information was not available, or inability to change or cancel appointments. The survey concluded that this is leading to patient frustration, with four in 10 who faced administration problems less likely to seek care in the future.
• In the year up to April 2018, there were over 11 million occasions of a patient presenting to a hospital using a different Electronic Patient Record system to their previous attendance (Warren et al, ‘Measuring the Scale of Hospital Health Record System Fragmentation in England’, August 2020).
• In the year up to April 2018, nearly 4 million patients accessed care at two or more NHS hospitals trusts, highlighting the demand for effective interhospital data sharing. 65 per cent of maternity complaints to the Parliamentary and Health Service Ombudsman between 2020 to 2022 related to communication failures.

Another Bill to note is:

Regulating for Growth Bill (p30-33)

Key facts

• The UK’s regulatory system is increasingly misaligned with the speed and nature of modern innovation. Businesses describe growing pressure from global competitors who are benefiting from faster, more coordinated and more digitally enabled regulatory systems, while UK processes remain slow, fragmented and administratively heavy.
• Only around one in five businesses say regulators support innovation or understand their business well enough to provide tailored advice – limiting the adoption of new products, technologies, and business models.
• In medicines regulation, existing innovation pathways for streamlining the development of new medical treatments (Innovative Licensing and Access Pathway and the Innovative Devices Access Pathway) operate within current legislation. This limits the Medicines and Healthcare products Regulatory Agency’s ability to support novel products and regulatory approaches, even when statutory flexibilities, including Emergency Use Authorisation, are maximised.
• In healthcare, nearly 750,000 patient imaging cases were not reported within four weeks over the past year, a 31 per cent increase year-on-year, driven by a mismatch between demand and workforce growth. Imaging demand is rising by approximately seven per cent annually, while the radiology workforce is projected to grow by only approximately 3.9 per cent per year over the next five years. Evidence shows that every four week delay in starting cancer treatment increases mortality risks by around ten per cent. Research indicates that AI could materially improve capacity and productivity, with AI performing better than 78-90 per cent of radiologists on certain prediction tasks.

Overview of Bills

Strengthening economic security:

• Steel Industry (Nationalisation) Bill
  • Will nationalise the steel industry and bring British Steel under public ownership. It will establish a public interest test that must be met for this transfer of ownership and introduce compensation powers to obtain independently assessed compensation.
• Northern Powerhouse Rail Bill
  • Will invest £45 billion to deliver Northern Powerhouse Rail. Will include upgrades to lines east of the Pennines for delivery in the 2030s; bring forward a new route between Liverpool and Manchester via Warrington and Manchester Airport; and deliver better cross-Pennine links in addition to the Transpennine Route Upgrade.
• European Partnership Bill
  • Will give powers to fulfil treaty obligations in UK EU agreements when it serves the UK national interest and the power to extend this into any future treaties.
• Small Business Protections (Late Payments) Bill
  • Will impose maximum payment terms of 60 days, enforce mandatory interest for late payments and introduce a time limit for raising invoice disputes. It will require boards or audit committees of persistently late-paying large companies to publish commentary on poor payment performance and give the Small Business Commissioner new powers to investigate, adjudicate and fine businesses that persistently fail to comply.
• Clean Water Bill
  • Introduce a new Water Ombudsman to ensure complaints are taken seriously and resolved quickly and effectively. It will combine powers from Ofwat, the Drinking Water Inspectorate, the Environment Agency and Natural England under a new integrated water regulator. The bill will also update outdated regulations and frameworks to tackle pollution at source.
• Competition Reform Bill
  • Delivers reforms to the Competition and Markets Authority to make competition investigations faster and more predictable reducing burdens on business and ensuring consumers benefit sooner.
• Regulating for Growth Bill
  • Will bring the UK’s regulatory system fit for the future by strengthening the Growth Duty and creating “Sandbox Power” which will allow businesses to test cutting-edge technologies safely, prove what works and scale up faster.
• Enhancing Financial Services Bill
  • Will modernise how the sector is regulated, enabling it to grow and lend more to businesses. It will make consumer protections fit for the digital age. It will ensure high standards of regulation and oversight.
• Highways (Financing) Bill
  • Will introduce a new funding model to unlock greater levels of private capital investment in road infrastructure. This will entail a licence regime, an independent regulator and backstop measures to protect publicly used assets.
• Overnight Visitor Levy Bill
  • Will provide a legislative framework to enable mayors and potentially other local leaders to introduce a levy.

Ending the opportunity crisis: a Britain built for all:

• Social Housing Renewal Bill
  • This bill will extend the eligibility criteria for ‘right to buy’ to ten years for existing properties and 35 years for new-build social housing. It will increase protections for tenants who are victims of domestic abuse.
• Commonhold and Leasehold Reform Bill
  • Will ban new leaseholds for flats and cap ground rents at £250 per year. It will implement a new process for converting to commonhold and create a new legal framework for commonhold, providing full freehold ownership for flats and a bespoke approach to communal living without control by third-party landlords. It will make it cheaper and easier for leaseholders to extend their lease or buy their freehold.
• Education for All Bill
  • Will provide early support to children with SEND by requiring settings to produce individual support plans for every child with SEND and introduce a new national template. It will create National Inclusion Standards to identify and implement best practice. It will provide over £200 million of investment in training for all staff. It will ensure schools are funded on a fair and consistent basis wherever they are in the country and require schools to pool a portion of their SEND funding. It will introduce a ‘triple lock’ of transitional provisions so no child loses their current support.
• Representation of the People Bill
  • Will give 16 and 17-year-olds the right to vote in all UK elections. It will broaden the range of ID that can be used at polling stations and move towards automated testing systems and strengthen the resilience and capacity of postal voting. The Bill will also introduce tougher rules on political donations and strengthen the power of the Electoral Commission to enforce these rules. It will bring in measures to tackle the intimidation and harassment of voters, electoral staff and campaigners online and in person
• Remediation Bill
  • Will fix the cladding crisis by making construction product manufacturers pay and equipping regulators with the powers to compel action. It will introduce a legal duty to remediate and a backstop that will allow a third party such as Homes England to carry out works themselves.
• Draft Conversion Practices Bill
  • A draft bill will be published for pre-legislative scrutiny that will be balanced and targeted to ensure that legitimate healthcare and broader support is provided for those seeking to explore their sexual orientation or gender.
• Draft Ticket Tout Bill
  • Will make it illegal to resell a ticket for a live event at more than its original cost and cap the service fees of resale sites. It will make it illegal for someone to resell more tickets than they originally entitled to buy and place strict obligations on resale platforms. The Competition and Markets Authority will be empowered to impose fines of up to 10% of global turnover on those found to be breaching new laws.
• Sporting Events Bill
  • Will ensure that major sporting events can be delivered as efficiently as possible by coordinating transport planning, deterring touts and prohibiting advertising and trading around events.

Strengthening public services and reforming the state:

• Police Reform Bill
  • Create a new National Police Service that will deliver a unified response to the most serious crimes, set national standards and ensure a more consistent service. It will establish Local Policing Areas led by a senior officer – these will form part of fewer, larger police forces. The bill will abolish Police and Crime Commissioners. It will establish clear national priorities led by a more active Home Office and set sand enforce standards for policing. It will also establish a legal framework to underpin law enforcement use of facial recognition and similar technologies.
• NHS Modernisation Bill
  • The bill will abolish NHS England, transferring its functions into the Department for Health and Social Care. It will also transfer the functions of Health Watch England into the department and the functions of the Health Services Safety and Investigations Body into the Care Quality Commission. It will create the Single Patient Record, enabling the NHS to bring together health and social care records in one place and enable people to access their own records.
• Railways and Passenger Benefits Bill
  • Establishes Great British Railways as a new publicly owned company. The bill also sets up a new Passenger Watchdog that will set consumer standards for railways and investigate poor service. The bill will simplify fares and tickets by consolidating the existing operator websites into a single online platform.
• Digital Access to Services Bill
  • Will introduce a non-mandatory free-to-access digital ID that will provide a secure proof of identity across a range of government services.
• Public Office (Accountability) Bill
  • Will deliver the ‘Hillsborough Law’ placing a duty of candour on public bodies and officials. It will create a new offence of misleading the public. It will provide bereaved families access to non-means-tested legal aid for all inquests where a public authority is an interested person and place a duty on public authorities to only use legal representation when necessary and proportionate.
• Removal of Peerages Bill
  • Will create a mechanism for removing peerages from disgraced peers without the need for bespoke legislation.
• Courts Modernisation Bill
  • Removes the right of defendants to elect for a Crown Court (i.e. trial by Jury) in cases that can be heard in either a Crown or Magistrate’s Court and extends Magistrate’s Court’s sentencing powers. Replaces the automatic right to appeal against a conviction in Magistrates Court with a permission stage. Introduces new modes of trial by judge alone for complex and lengthy fraud cases. It will bring forward measures to prevent victims of sexual offences being unfairly undermined in the courtroom and clarify the support available to them. It will repeal the presumption of parental involvement to ensure children’s best interests are at the heart of decision-making.
• Northern Ireland Troubles Bill
  • The bill will enable victims and bereaved families across the UK to seek information and accountability through a reformed Legacy Commission.
• Draft Taxi and Private Hire Vehicle Bill
  • The bill will give regulators stronger enforcement powers and improve transparency and information sharing nationwide. It will also deliver more accessible services for disabled passengers.
• Civil Aviation Bill
  • The bill will deliver consumer enforcement powers to the Civil Aviation Authority (CAA) to reduce harm, ensure compliance and allow for timely regulatory intervention.
• Sovereign Grant Bill
  • Will set the grant amount for the Sovereign and reduce the amount paid following the Buckingham Palace Reservicing Programme.

Strengthening our energy security:

• Energy Independence Bill
  • The bill will cut energy bills by placing Exchequer funding of 75% of the Renewables Obligation scheme for three years on a permanent basis. It will create the Warm Homes Agency and implement rules to ensure landlords invest in home upgrades.
• Nuclear Regulation Bill
  • The bill will overhaul and streamline existing regulation and frameworks to improve coordination and speed of decision-making.
• Electricity Generator Levy Bill
  • Will uncouple electricity prices from gas prices and offer new low-carbon generators a long-term contract that guarantees a stable fixed price for the energy they generate.

Strengthening our national security:

• Tackling State Threats Bill
  • The bill will give the government powers to ban state-backed organisations involved in espionage, sabotage and interference in the UK, such as Iran’s Revolutionary Guards Corps.
• Armed Forces Bill
  • The bill contains new powers to make it easier to mobilise former military personnel and enshrines the Armed Forces Covenant into law.
• National Security Bill
  • The bill will criminalise harmful online content that “glorifies, trivialises or normalises” serious violence in the wake of the Southport attack in 2024.
• Immigration and Asylum Bill
  • The bill will make it easier for the government to revoke refugee status, take further steps to clamp down on small boat crossings and restrict taxpayer support to asylum seekers.
• Cyber Security and Resilience Bill
  • The bill aims to strengthen online protections for businesses and services across the country, as well as bring data centres into the scope of Britain’s cyber security reporting scheme.

 Media coverage

• The Guardian | Starmer sets out changes to education, health and courts in king’s speech.
• The Sun | MORE MISERY Hated holiday tax, Brexit betrayal & NO plan to drive down UK’s benefits bill – everything unveiled in King’s Speech.
• The Independent | King’s Speech 2026: Key points from Charles’ address amid Starmer leadership crisis.

New Secretary of State

On 14 May James Murray MP replaced Wes Streeting MP as Health Secretary, following his resignation in protest at the performance of the Prime Minister. This means the post holder remains a London MP, with James Murray representing the Ealing North constituency.