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Everyone knows the NHS needs change. People are waiting too long for appointments. Too many patients feel they are passed from pillar to post. The system often feels too big, too slow and too far away from the people it is meant to serve.
I am sitting on the Bill Committee for the new Health Bill, which will examine this legislation line by line. My job is to make sure this new law works for patients, staff and local communities.
The biggest change is the abolition of NHS England, the national body that helps manage the NHS in England. Most people do not know what NHS England is or who runs it, even though it has huge influence over how the NHS works.
The Bill will bring many of its powers back under the control of the Department of Health and Social Care. That means clearer responsibility. The NHS is paid for by the public, and the public deserve to know who is in charge. If things go wrong, those responsible must answer for it.
Local health bodies, called Integrated Care Boards, will have a clearer job. They will have more responsibility for planning local services, including more primary care services such as GP, dental, pharmacy and eye care services.
That means decisions are made closer to patients by people who understand local priorities.
The Bill also changes how patients are listened to.
The NHS has too many management bodies, too many layers and too much confusion. Patients often do not know who to speak to. Families tell their story again and again, reports are written, but many still feel nothing changes.
Under this Bill, the job of listening to patients will move closer to the people who actually make decisions.
For health services, local Integrated Care Boards would take on this role. For social care and public health, local councils would take it on. In plain English, this means fewer middlemen and clearer responsibility.
If patients cannot get a dentist, local NHS leaders should hear that directly, and if people are being bounced around the system, the organisations in charge should not be able to hide behind another body.
As a member of the Bill Committee, I will be scrutinising this closely.
My aim is clear. I want to see less management and more action, and an NHS where patients are not just consulted, but listened to, and their experiences result in real change for the better.
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Dereham can’t take any more housing without additional investment in infrastructure and especially health services for a growing population of young families & elderly.
The closure by NHS England of the Toftwood Surgery left South Dereham residents without a local surgery which is not acceptable - especially given the 50% increase in the Labour Government’s housebuilding targets for Breckland.
That’s why I worked with the local Cllr’s Phillip Duigan and Alison Webb at the time to try and stop the closure and why I’ve made clear that the temporary NHS relocation of Toftwood patients to Orchard and Theatre Royal Surgeries MUST be temporary. And that given the housing growth South Dereham must have one of new Government’s new Community Health Centres with Dentistry, Early years and Elderly care, diagnostics & primary treatment clinics to reduce avoidable travel to the N+N.
That’s why I’ve proposed a Dereham HealthCare Summit this summer and an All Party Dereham Community Healthcare Plan & Campaign so that we can speak with one voice as #TeamDereham to lobby for Government funding.
That’s why I’ve contacted the DHSC Minister to start the campaign.
Delighted that my letter to all Dereham Cllr’s and Health Care bodies has received such a positive response, and look forward to working with all the Cllrs elected across the Town to get the healthcare facilities we need
Correspondence with Ed Garratt OBE, Chief Executive NHS Norfolk and Suffolk ICB
It was a wonderful afternoon on Saturday as we celebrated the Licensing and installation of Reverend Jennifer Elizabeth Mayo as the new Priest-in-Charge at the Parish Church of St. Mark, Shelfield & High Heath.
I know just how long the local church and our wider community have been waiting for this moment, and the sheer joy and warmth in the room on Saturday showed exactly how much this means to everyone.
A massive, warm welcome to Reverend Jenny! We are absolutely thrilled to have you here, and I know our community is looking forward to supporting you and working alongside you in this exciting new chapter for St. Mark’s.
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An abridged version of this article ran in The Times on 3rd February 2025
In 2007, in the pages of this newspaper, I argued that Britain should seize the moment and move Heathrow to the Thames Estuary, freeing up the congested west London site for much-needed housing while creating a world-leading transport hub fit for the 21st century. It was an ambitious plan—perhaps too ambitious for a nation that has lost its appetite for grand infrastructure. Seventeen years later, what do we have? The same tired debates, the same dithering, and now, a third runway proposal that represents the absolute minimum of what could be done. It is not a vision; it is a concession to stagnation.
Throughout history, Britain built infrastructure that transformed cities and continents. The Victorians laid thousands of miles of railways across India and Africa. British engineers built the world’s first underground railway in London, the great docks of Hong Kong, and the vast shipping hubs that made global trade possible. Ours was once a nation that saw scale and complexity as challenges to be overcome, not reasons to prevaricate. Today, while China constructs floating airports in Hong Kong and Dalian, we are still arguing over a few extra miles of tarmac at an aging airport hemmed in by suburban sprawl.
The case for expanding Heathrow is undeniable. The airport operates at near capacity, with any disruption causing delays that ripple across the global aviation network. Additional capacity is needed. But the third runway is not a bold leap forward—it is an unimaginative compromise. The design is a relic of a bygone era when Britain was still willing to approve large infrastructure projects but had already begun its slow descent into cautious incrementalism. Surely for a solution we should be looking beyond the immediate horizon, daring to create something transformative.
Compare this to the grand infrastructure ambitions of Asia. Hong Kong’s Chek Lap Kok, which replaced the legendary but perilous Kai Tak airport in the 1990s, was built on reclaimed land. It was a marvel of engineering (mostly British), completed in just six years. Now, China is taking the concept even further: Dalian is constructing a floating airport, pushing the boundaries of what is possible. This is a country that doesn’t simply accept geographic limitations—it overcomes them. Britain, meanwhile, is paralysed by protest groups, endless consultations, and political hand-wringing.
A floating airport in the Thames Estuary—an idea proposed and swiftly dismissed—would have been a statement of ambition. London could have had its own Chek Lap Kok, a world-class hub unencumbered by the constraints of Heathrow’s location. Instead, we are left with a piecemeal expansion of an outdated site, in a project that will take decades and still leave Britain trailing behind.
The environmental argument against expansion is often cited as a reason for delay, but it is a red herring. Modern aviation is rapidly advancing towards lower emissions and greater efficiency. If the concern is air pollution and carbon footprints, the answer is not to stifle airport expansion but to embrace new technology, support cleaner aviation fuels, and invest in modern air traffic management. Britain should be leading these efforts, not using environmental concerns as an excuse for stagnation.
The economic cost of our hesitation is immense. Aviation is a key driver of trade, tourism, and investment. Heathrow’s constraints mean we lose out to European rivals, with airlines shifting long-haul routes to Paris, Amsterdam, and Frankfurt. The third runway, even if built, will do little to reclaim lost ground. By the time it is operational—assuming it even survives the judicial challenges that will inevitably come—other nations will have long since surpassed us.
What Britain needs is a fundamental shift in mindset. We must stop viewing major infrastructure projects as necessary evils to be endured and start treating them as national priorities. This requires reforming our planning laws, streamlining approval processes, and fostering a political culture that celebrates engineering excellence rather than recoiling from it.
The third runway at Heathrow is not the answer—it is a symptom of our decline. Instead of an afterthought tacked onto an aging airport, we should be considering radical alternatives: offshore airports, high-speed rail integration to regional hubs, and a renewed commitment to infrastructure that places Britain at the forefront of global connectivity. We were once a nation that built the world’s most advanced transport networks, that pioneered engineering breakthroughs others only dreamed of. We can be that nation again—but only if we stop settling for mediocrity and start daring to think bigger.
The world is not waiting for Britain to catch up. While we squabble over a single new runway, China is building entire new airports on water. The contrast is stark, and the lesson is clear: boldness breeds success, hesitation ensures decline. If Britain truly wishes to remain a global player, we must abandon the timid incrementalism of the third runway and embrace the kind of audacity that once made us great.
Kit Malthouse 1st February 2025
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