Health bill will be gutted, say Lib Dem left

Key Liberal Democrat activists Dr Prateek Buch and Dr Evan Harris report on Liberal Democrat opposition to Andrew Lansley's marketisation of the NHS.

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

In a move that clearly demonstrates his Party’s unease with the Health and Social Care Bill, deputy prime minister Nick Clegg has taken a firm stance on a vital aspect of Health secretary Andrew Lansley’s NHS reforms – Liberal Democrats will not support a bill that sees Monitor become a purely economic regulator that arbitrates on and promotes competition.

Labour’s shadow health secretary, John Healey, suggests that is somehow new-found opposition to the reforms – in fact Nick’s language strongly echoes what our Party Conference agreed in March – before the local elections.

And this was at a time when the Yes to AV campaign was ahead in the polls so was nothing to do with disappointing results in either.

Mr Healey further states that “Lib Dem MPs have voted for it [the bill] at every stage in Parliament”, but surely must know, as his less Blairite colleagues will have experienced, that in government Labour rebels on foundation hospitals and academy schools did the same thing; they voted for the the host bill at second reading, which allows a bill with some parts that can be supported to go forward for amendment, then for specific amendments at report stage.

What Liberal Democrats have done to date then, is no different;as we believe the bill is amendable to deliver what was in the coalition agreement – policies such as a stronger role for GPs in commissioning, which was also in Labour’s manifesto and presumably remains Mr Healey’s policy too. As with the Labour government, the committee stage is a place for debate and the sole Lib Dem MP on the committee was appointed on the basis that any votes against the government would be saved until report stage.

Indeed when Nick told Andrew Marr recently that no bill is better than a bad one, he made clear that Liberal Democrats would go further than rebels in previous Labour governments – they’ll vote against the bill at 3rd reading unless sufficient amendments are made.

It’s also been suggested that Lib Dems should have raised these issues before the bill was published – perhaps to protect Mr Lansley from the embarrassment of publishing an unacceptable bill, or as some sort of counsel of perfection. Such thinking didn’t prevent the worst elements of the Private Finance Initiative (pdf) and of the scandalous Independent Sector Treatment Centre programme being published and implemented under Labour, so it’s unclear why it would have worked here.

In any case we can assure Mr Healey and other friends of the NHS, that Lib Dems did raise concerns at the white paper stage, but faced two problems:

• Firstly, Conservatives in government were encouraged to believe that these reforms would attract significant support from new Labourites given the backing for the market aspects given by Alan Milburn and John Hutton;

• Secondly, Mr Lansley simply asserted, as he did to the health select committee, that the reforms would be harmless.

It was precisely because Lib Dems weren’t prepared to accept these assurances that our very next conference, in March – that Mr Healey attended – debated in public its rejection of much of the Lansley reforms. It must have been a revelation to a Labour frontbencher to see a party publicly and democratically tell its leadership what they were prepared to accept. And to be fair to Nick Clegg, he didn’t oppose the much-amended conference motion, nor has he at any stage sought to downplay it.

In the end when this bill is gutted, rather than carping about the timetable, people will be pleased that the Lib Dems said no to more marketisation of the NHS, and will be wondering what more things – not in the coalition agreement – the Lib Dems should be blocking from happening!

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19 Responses to “Health bill will be gutted, say Lib Dem left”

  1. Jonathan Todd

    RT @leftfootfwd Health bill will be gutted, say Lib Dem left: < Labour party of NHS

  2. Alan Marshall

    RT @leftfootfwd: Health bill will be gutted, say Lib Dem left: – @PrateekBuch and @DrEvanHarris report

  3. Alex Marsh

    RT @leftfootfwd: Health bill will be gutted, say Lib Dem left: – @PrateekBuch and @DrEvanHarris report

  4. Dr Evan Harris

    [email protected] My rebuttal of your assertion that LD position on health bill is "newfound conversion".

  5. Chris Bryden

    [email protected] My rebuttal of your assertion that LD position on health bill is "newfound conversion".

  6. Gareth C

    [email protected] My rebuttal of your assertion that LD position on health bill is "newfound conversion".

  7. Richard Blogger

    The problem I have with this article, and to be frank, against anything LibDems say in Parliament about the Health Bill is that they behave as if they are permanently in opposition. Let me give you a clue, you do not justify your position through your opposition to labour’s policies Labour are no longer the government. Your problem is not with Labour, they no longer make the laws, it is with your coalition partner. If you let a bad bill pass it will be your fault, you cannot blame Labour for that. Grow up and start behaving like a party in government.

    Having said that, can I remind you that the Committee stage is the usual time to make amendments and your Spring Conference was slap bang in the middle of the Committee stage. Your LibDem Minister, Paul Burstow, could easily have added all your conference demands to the Bill during the Committee stage. He didn’t. Why was that? Is he no longer a LibDem? Or maybe he didn’t like your conference motion? Whatever it is, he looks like he prefers to work for Lansley than for you, so perhaps you should start to look into how to remove the LibDem whip from him?

    And here’s news for you (clearly, you seem to be unaware of the situation). The Coalition Agreement says: We will develop Monitor into an economic regulator that will oversee aspects of access, competition and price-setting in the NHS.. How does that fit into the statement from Nick Clegg today the decision to establish Monitor as an ‘economic regulator’ was clearly a misjudgment? Either you demand that the Coalition Agreement is followed rigidly, or tear it up. You cannot pick and choose when it suits you.

  8. Ed's Talking Balls

    I agree with Richard.

    Stop this nonsense and behave like a party of government. No-one is going to buy this notion of the Lib Dems riding down on white horses, saving the country from the evil Conservatives. It’s laughable: Burstow was involved, heavily, right from the start, while Clegg signed the whole thing off.

    I do hope that the inevitable throwing of toys out of prams after the drubbing in the local elections and the AV fiasco will be short and not too undignified. It’s all well and good to assert your identity and make clear that the coalition is a marriage of convenience, not an intended merger. But while rants from Cable and Huhne might appease some sandalistas, it’s neither smart nor helpful in the long-run.

  9. John Cartmell

    [email protected] My rebuttal of your assertion that LD position on health bill is "newfound conversion".

  10. Anon E Mouse

    Richard Blogger – I also agree with you. The Lib Dem’s should go for it and be damned.

    They signed the coalition document quite willingly…

  11. Prateek Buch

    RT @leftfootfwd: Health bill will be gutted, say Lib Dem left: – @PrateekBuch and @DrEvanHarris report

  12. Prateek Buch

    @Richard Blogger: the agreement uses the word aspects advisedly – whereas the Bill would make it focus purely on econommic matters, promoting competition not an integrated health service. So we are demanding that the letter and spirit of the agreement.

    @Ed’s Talking Balls: how would you describe a party of government behaving? by ensuring that legislation is improved such that it’s acceptable to most people and in particular the professionals and stakeholders it relates to? cos that’s what we’re doing. Yes Mr. Burstow was involved from the beginning – that’s why the Bill attempts to do things like integrate social and mental health care with the NHS and brings public health functions closer to local authorities. You repeat the fallacy that we’re opposing the health Bill because we got trounced (and we did, it was a polling day disaster) on May 5th – this, with due respect, is a lie. Concerns about the NHS reforms have been raised from say one, and as the article clearly states our conference made our opposition to it clear well before May 5th. As for settting out our Party’s independence, I’d say that not only is is smart and helpful in the long run, I only wish we’d done it more clearly from about November and avoided the tuition fees debacle 🙂

    @Anon E Mouse – we did indeed sign the Coalition agreement, and as I said above this Bill violates aspects thereof so our aim is to bring it as close to said agreement as we can…

  13. mr. Sensible

    The simple fact is that this point about Monitor being an economic regulator was a fundomental part of the bill at second reading, and so it remains.

    The Liberal Democrats, and indeed the wider listening exercise will be judged on outcomes, not words.

  14. Anon E Mouse

    Prateek Buch – Then you should have kept a better grip on what is being proposed.

    The economy will turn round in the next four years – these things go in cycles. Labour are (comparatively) tanking in the polls and with Ed Miliband leading that is both understandable and unlikely to change. The Lib Dem’s just need to keep cool and stop trying to pander to the electorate with every bad opinion poll in a newspaper and things will work out OK in the end.

    The fact is at the last election the Lib Dem’s did very very badly and by rights should be extremely thankful to Cameron for his generous offer of government.

    Call an election tomorrow and the Tories would win outright, Labour couldn’t afford it and the Lib Dem’s would be finished.

    It’s time for the Lib Dem’s to just f*&king cool down…

  15. Prateek Buch

    @Anon E Mouse – to some extent I agree that reacting to every opinion poll and interview is a bad strategy, and that calm leadership is required – where I disagree is that Lib Dems did very, very badly at the last election:
    2010 number of Lib Dem votes: 6,836,824, share of vote 23%
    2005 number of Lib Dem votes: 5,985,454, share of vote 22%
    so, a nearly million more votes, putting us within 2 million (6%) of Labour who ended up with 201 more seats. it was FPTP that did very very badly, but that’s another story 🙂

  16. Richard Blogger

    “the agreement uses the word aspects advisedly”

    No it doesn’t. You are trying to weasel your way out of the fact that you were not paying attention when you signed the Coalition Agreement.

    “So we are demanding that the letter and spirit of the agreement.”

    Man up. Hold Lansley to account for abolishing PCTs when the CA says they would be directly elected. Hold lansley to account for the biggest re-organisation ever, when the CA says there would be no more. That is where the fight lies.

    “that’s why the Bill attempts to do things like integrate social and mental health care with the NHS”

    The Bill has nothing to do with Social Care. The House of Commons research document that accompanies the Bill (RP11-011) points this out: “Although the Bill deals primarily with health services, its title refers to social care because a number of measures would apply to bodies with joint functions and responsibilities; the Government intends to introduce legislation on social care reform later in the Parliament.” You are back peddling. The Bill is about setting up a healthcare market, that was always the intention of this Bill and it still is.

    I recognise, and support the Lib Dem manifesto pledge to integrate health and social care. But the ONLY way to do that is to merge the budgets. It is ludicrous to have LAs and hospitals fighting over who have the responsibility to pay for patients. This Bill will not solve the issue. A bill that takes social care out of local authority hands and integrates it as part of a totally integrated service, would.

    Can you explain why there was an emergency motion at the LibDem Sept Conference on the White Paper that was lost, yet a similar motion at the Spring conference was passed? Could it possibly be because LibDems had finally realised that the Lansley proposals were to destroy the NHS? Some LibDems realised that in September, but it appears tha the majority of LibDems are so slow thinking that it takes them 6 months to see the bleeding obvious. And I challenge you yet again, why didn’t Burstow address the Spring Conference concerns during the Committee stage? That is the time to change the Bill, yet he ignored the LibDem Spring conference entirely. Is he a Tory now?

    Kill the Bill, it is the only sensible thing to do.

  17. Anon E Mouse

    Prateek Buch – I’m a Lib Dem supporter but you’re comparing the wrong thing. Nick Clegg was doomed as leader if Cameron hadn’t ridden to the rescue.

    Also remember that the boundary changes will help but look at the unfairness of FPTP for the Tory’s – it takes a landslide to unseat Labour and finally your comparison is one where Labour had done particularly badly.

    Agree on the unfairness of the system – Nick Clegg should have demanded PR which would ironically have benefitted the Tory’s as well…

  18. Anon E Mouse

    Richard Blogger – I find myself in agreement with a lot of what you say which leads me to believe I may need to see a doctor…

  19. NHS reforms live blog | Birmingham Link

    […] view Dr Prateek Buch, a research scientist and an executive member of the Social Liberal Forum, writes on Left Foot Forward that it was Labour who let down the public over the […]

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