It’s at this time that the Liberal Democrat grassroots pressure for changes must be heard the loudest, to prevent the government from making cosmetic or wrong-headed amendments to the NHS legislation and try to pass them off as significant improvements to the policy.
By Dr. Prateek Buch, a research scientist and an executive member of the Social Liberal Forum, and former MP Dr. Evan Harris, vice chair of Liberal Democrat Federal Policy Committee
At last month’s Liberal Democrat spring conference, the party’s views on Andrew Lansley’s health reforms could not have been made clearer; the Health and Social Care Bill is unacceptable to Liberal Democrats in its current form, and the membership is now insisting on significant amendments to bring the policy back in line with last year’s coalition agreement and with Lib Dem principles.
Following the overwhelming show of support for substantial changes to the bill, several leading Liberal Democrats have composed a number of specific provisions which need to be inserted into the bill or guaranteed. Lib Dem MPs will need to make clear to the Conservatives that these are the changes required. The amendments that we expect to see delivered would reaffirm the role of the secretary of state to provide or secure a comprehensive NHS; ensure proper democratic accountability and/or scrutiny of commissioning bodies; restrain the proposed deeper marketisation of services; and ensure that any changes are brought about at a pace that the NHS can handle.
Various reports indicate that the government has agreed to delay, take control of and significantly alter the bill to fend off increasingly damaging criticisms. In addition the house of commons select committee on health published its recommendations which, in many areas, echo the Liberal Democrats’ call for changes. Andrew Lansley has thus been forced to admit the need to make concessions; though Nick Clegg went even further this morning on BBC breakfast by saying that major changes would be made.
It’s at this time that the grassroots pressure for changes must be heard the loudest, to prevent the government from making cosmetic or wrong-headed amendments to the legislation and try to pass them off as significant improvements to the policy.
There was some scepticism amongst Labour bloggers about the value of internal party democracy as defined by the Lib Dems’ debate on health reforms; perhaps the changes about to be made to the bill will encourage Labour to reinvigorate their own internal democracy.
There are some things which were not Liberal Democrat policy that can not be prevented because they were included in the coalition agreement as part of the deal. These include a national commissioning board. There are other provisions which are made more difficult to stop because of the way they were introduced or even embedded under the Labour government.
For example, a greater role for GP commissioning (which Labour’s manifesto also called for), a continued role for the private sector in provision, foundation trusts having the greater freedom of the market place and all trusts being forced to move to foundation trust status.
It is no excuse for the coalition government to point out that some of the other unacceptable suggestions originated under Labour. They were wrong then too! For instance, the attempt to out-source to the private sector Oxfordshire Primary Care Trust’s commissioning function in 2008 by Patricia Hewitt. Or the proposal to allow price competition on tariff services found in the December 2009 NHS Operating Framework. Or the way that primary care trusts were forced to privatise a specific proportion of their provision and forced to transfer activity from the NHS to ISTCs who were then paid regardless of activity – wasting £22 million in London alone.
It is astonishing that the Conservative party has not understood that while the Labour party could get away with undermining the NHS if it wanted to, because of the trust earned gradually but not consistently over decades, the Tories simply can not. That is politics 101 and it is an irony of the situation that Labour and Lib Dems are combining to save the Tories from retoxifying their brand to the full extent that Andrew Lansley and the Tory right seem to wish to.
The essential amendments we have published are necessary if the NHS is to be retained as a comprehensive, egalitarian, world-class institution. There is ample evidence to suggest that Lansley’s proposals threaten the cohesion and cooperation at the heart of the NHS, and it’s only by retaining these core values at the heart of the system that any reform will be acceptable for Lib Dems and the country at large.
32 Responses to “Govt. must go beyond cosmetic changes to health bill warn Lib Dem activists”
Chris
RT @leftfootfwd: Govt. must go beyond cosmetic changes to health bill warn Lib Dem activists: http://bit.ly/eDq19I write @prateekbuch an …
Richard Blogger
Perhaps my scepticism is really naivety. I expected the white paper consultation (which highlighted many of the issues the Lib Dems were concerned about in their Spring conference) would lead to a change in the Bill. It didn’t, most of the criticisms expressed during the consultation process were summarily dismissed in the government’s response. Further, as concern was increasing before the end of last year (and just before the Bill was published) a Lib Dem, Danny Alexander, reviewed the Bill and signed it off. Alexander was satisfied with the Bill, surely we should take that to mean that he thought it agreed with the Coalition Agreement and key Lib Dem policy?
The debate for the second reading of the Bill had Lib Dem MP after Lib Dem MP speaking in support of the Bill (notably, Andrew George was against and John Leech expressed concerns, but still voted for the Bill). Were those Lib Dem MPs speaking for the bill aware of what was in it? Two months later the Lib Dem grassroots gave those MPs the message that they were clearly out of touch.
Then the Bill moved to the Committee stage, which, rather naively, I thought would scrutinise the Bill and make amendments. The Bill committee contained John Pugh and Mike Hancock, both Lib Dem MPs (the latter, a chair of the committee) as well as Paul Burstow (Lib Dem Minister of State). Yet the only amendments made to the Bill were by the government, and we were told that they were simply “tidying up” and “clarifications”. In the midst of the Committee’s work the Lib Dem Spring conference declared that they wanted important changes made to the Bill, yet the Minister of State (in a good position to make Coalition government changes that would alleviate Lib Dem fears) made no such changes.
Perhaps I do not understand how coalition government works, perhaps I do not understand how the parliamentary system works, but I have not seen any Lib Dem influence on this bill as it has gone through Parliament. Indeed, I have seen Lib Dem MPs in the second reading debate fully support the Bill.
Now we hear that Lib Dems are against the Bill in its current form. Why weren’t they against it in the second reading? Why weren’t they willing to make amendments in the Committee stage? This is why I am sceptical.
Mr. Sensible
The proposals in their current form are in a total state.
Jos Bell
For anyone who doubts the worth of the NHS being free at the point of need for all who need it, I advise you to read this telling report from an 89 year old retired doctor who vividly remembers the pre NHS days….. http://tinyurl.com/5sfppf Also note those who were excluded from ‘the panel …the most needy & the most vulnerable’. Sound familiar? Let us stop this vile Bill before history is repeated – not out of ignorance now, but out of deliberate cruelty.
Essentially if anyone believes that a mere tinkering with the Lansley Bill will suffice – just remember loose jawed Letwin letting slip that it has been specifically designed to demolish the NHS within 5 years. We need to preserve the NHS and build on our proven success, protecting it from profiteers and take overs – to do anything less will show that we have wasted our knowledge and brutally rejected the evidence. Please do not let ‘the pause’ be used up by nothing more than feigned listening – let us state our case loud and clear to make sure the ‘listeners’ actually hear us.
Liam Carr
Natural Break? A wobble, but not yet a U Turn. I teach Biology but I Have never taught prospective medical students about balance sheets. The changes are fundamentally flawed here’s why… http://bit.ly/fK92rs