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”
Prateek Buch
RT @leftfootfwd: Health bill will be gutted, say Lib Dem left: http://bit.ly/l4AVyK – @PrateekBuch and @DrEvanHarris report
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…
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.
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…
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 🙂