The Queen’s speech – what is it and what does it mean for health policy?

The Queen’s Speech is an address given by Her Majesty as part of the key ceremonial event of the Westminster calendar – the State Opening of Parliament, marking the start of the parliamentary year. It is a 500-year-old symbolic occasion with MPs being ‘invited’ to enter the House of Lords – the only part of Parliament the Queen is allowed to enter – to listen to the address. Despite its title, the speech is written by the Government in private and merely delivered verbatim by the Queen. It is designed to set out the Government’s agenda for the forthcoming year and is largely a rehash of manifesto commitments but always contains some new surprise proposals. Ministers and MPs look on and listen intently, hoping that their department or personal interest will get a mention, while industries such as pharmacy wait to hear whether any of the proposals will affect them, for the better or worse.

This year the event will take place on Wednesday 18 May. There was initially speculation that the Queen’s Speech would be delayed until after the EU referendum on 23 June, given that the Government’s priorities and legislative programme will need to be torn up and re-written in the event of an ‘Out’ vote. Indeed it may need to be radically altered if the result is anything less than a clear majority for the ‘In’ campaign that has been backed wholeheartedly by UK Prime Minister David Cameron.

It is worth bearing in mind that there is considerable talk of a cabinet reshuffle post-referendum and speculation that Health Secretary Jeremy Hunt could be one of its casualties. This could make it more likely for healthcare announcements to be made now, allowing an incoming Secretary of State for Health to pick up and run with a renewed agenda.

However there is one health policy that we know will be in the Queen’s Speech — Simon Stevens, Chief Executive of NHS England, confirmed in a Health Committee session on Monday 9 May that there would be new measures to help the UK reclaim more money from non-UK citizens using the NHS. The idea of tackling “health tourism” was first floated in the UK Independence Party (UKIP) manifesto in the 2015 General Election, claiming that up to £2bn of NHS resources was being used by those ineligible for free care. It seems now, with the referendum just weeks away, the Government has decided to tackle this issue (whether real or not) in order to boost support for remain.

Ministers are believed to have restricted this only to hospital related care and rejected charges for GPs and nursing care, because this may dissuade migrants with communicable diseases from seeking care should they fall ill. The Royal Pharmaceutical Society raised concerns during the government consultation on this topic that introducing prescription charges for some migrant groups and overseas visitors would increase pharmacy bureaucracy and be impossible to administer without giving the profession access to the patient care record.

Aside from this, it is likely that the Government will add more flesh to the bones of its Northern Powerhouse concept, potentially including further details of healthcare devolution to the likes of Greater Manchester. There are also reports of it seeking to bring forward new legislation to end the ‘blame culture’ in the health service by supporting NHS whistleblowing and facilitating medical professionals to come forward about mistakes in care.

Despite the previously resolute Government looking slightly more hesitant in recent weeks after considerable opposition to their academies and junior doctors’ policies, we can be certain that the Queen’s Speech will focus on a positive programme rather than any indication of a climb-down or u-turn. The speech will inevitably include some unpredicted policy nuggets and we will, of course, provide subsequent briefings on any relevant proposals.