The Liberal Democrats have called on Health Secretary Andy Burnham to halt what they describe as a "bonfire of patient safety" contained within the government's NHS Modernisation Bill. The legislation would abolish Healthwatch England, the independent body representing patients' views on local health and social care services, alongside the Health Service Safety Investigation Bureau (HSSIB), which currently conducts patient safety investigations. Ministers maintain the changes will cut bureaucracy and strengthen, rather than weaken, patient safety outcomes.
Under the proposed reforms, Healthwatch's current responsibilities would pass to integrated care boards (ICBs) and local authorities. Critics argue this arrangement would leave these bodies answering complaints about their own services rather than facing scrutiny from an independent watchdog. Separately, HSSIB's investigative functions would be absorbed into the Care Quality Commission (CQC), a government-run regulator, raising questions from the Lib Dems about whether staff who report safety concerns would retain guaranteed anonymity.
What has the government said in response?
The Department of Health and Social Care insists that protections for whistleblowers will not be lost in the transition. A DHSC spokesperson said the bill "explicitly preserves safe space provisions and staff will continue to be protected," adding that the reforms would give patients "a stronger, clearer voice at the heart of health and social care." The government has also published formal impact assessments covering the abolition of Healthwatch England and the transfer of HSSIB's functions into the CQC, according to official government documents. Those assessments themselves acknowledge a risk of disruption during the restructuring and concede the changes may diminish the independent voice patients currently rely on, according to the published impact assessment document.
A separate government fact sheet states that HSSIB's "safe-space" protections will be retained even as its functions move into the CQC, according to the official fact sheet. The same fact sheet notes the bill would extend the CQC's window for bringing proceedings in certain safety cases from three years to five, and would introduce a single patient record while shifting some patient-safety duties from NHS England to the Secretary of State directly. Analysis from the Nuffield Trust adds that the legislation would grant the Secretary of State new powers to compel disclosure of data from across the health and social care system, including from GPs, in order to build that single record, according to the Nuffield Trust's analysis.
Why are the Liberal Democrats so alarmed?
The party has invoked the Stafford Hospital scandal, one of the most serious failures in NHS history, in which a Healthcare Commission report found at least 400 more deaths occurred than would have been expected between 2005 and 2008 amid years of neglect and abuse. Liberal Democrat health spokesperson Helen Morgan called the proposed changes "a catastrophic step backwards," describing them as
the greatest backward step in patient safety in a generation.
Morgan added:
Andy Burnham must urgently put an end to this, and fix the Health Bill so that modernising the NHS doesn't come at the expense of accountability, transparency or patient safety.
The party also argues the bill removes the NHS's current duty to cooperate with the CQC by supplying key safety data, and eliminates automatic "safe space" protections for whistleblowers — a claim the government's fact sheet disputes in relation to HSSIB specifically. The Lib Dems have tabled amendments intended to reverse these changes and say they are pressing what they call the "new Burnham administration" to adopt them, with plans to contest the measures vigorously in the House of Lords, where Labour lacks a majority.
What historical context shapes this debate?
HSSIB was originally modelled on the Air Accidents Investigation Branch, according to the Nuffield Trust, reflecting an approach that treats patient safety incidents with the same rigorous, independent scrutiny applied to aviation accidents. Under the new bill, its work would not disappear entirely but would instead continue as a discrete unit inside the CQC rather than as a standalone body, according to the government's own impact assessment documents. A legal analysis from Hill Dickinson notes that critics of the 2026 bill have also raised concerns that folding these functions into government-run structures could increase political interference and oversight over what were previously arm's-length safety functions, according to the Hill Dickinson analysis.
Burnham himself has a direct history with this issue: he was health secretary in 2009 when the Healthcare Commission's report on the Stafford Hospital scandal was released, and he went on to launch an independent inquiry into the affair in 2010. In May, the Local Government Association told a national broadcaster that disbanding Healthwatch would represent a "significant step back" in accountability, warning that
without an independent, locally rooted voice to challenge and represent communities, there is a risk of duplication and gaps in accountability.
There are currently more than 150 local Healthwatch organisations operating across England, each feeding into the national body that would be scrapped under the bill.
The debate over patient safety oversight comes as Burnham has separately been engaging with other parties on the future of adult social care. He has previously warned that the NHS could collapse without social care reform, and has since invited Conservative and Liberal Democrat leaders to talks on social care reform as he looks to accelerate the Casey Commission's work.
What happens next?
The NHS Modernisation Bill is currently at report stage in Parliament and is scheduled for its third reading on 7 September 2026, according to reporting on the bill's progress. The Liberal Democrats have signalled they intend to press their amendments through that stage and, if unsuccessful in the Commons, to continue their opposition when the bill reaches the House of Lords.
Key Facts
- Healthwatch England and the HSSIB would both be abolished under the NHS Modernisation Bill.
- Healthwatch's duties would transfer to integrated care boards and local authorities; HSSIB's functions would move into the CQC as a discrete unit.
- The government's own impact assessment acknowledges a risk of disruption and a possible reduction in patients' independent voice.
- The bill would extend the CQC's time limit for bringing certain safety proceedings from three to five years.
- The bill's third reading is scheduled for 7 September 2026.
