The Staggers

The New Statesman’s rolling politics blog

The coalition is now split over national health policy

NHS reform becomes first public division as Lib Dem conference votes in favour of radical rewrite of

By Samira Shackle Published 12 March 2011 14:02

Controversial proposals to reform the National Health Service in England has become the first public split on policy between the two coalition parties, after the Liberal Democrat spring conference voted overwhelmingly in favour of an extensive rewrite of the bill.

While there have been numerous backbench revolts on certain issues, such as tuition fees, and areas in which the parties have codified their disagreement, such as voting reform, this is the first public division on policy.

Nick Clegg, who said yesterday he was "very relaxed and very positive" about the NHS debate, narrowly averted defeat by accepting two "rebel" amendments when it became obvious that they were going to pass.

The two amendments centre on limiting the role of the private sector in the NHS. The party votes for banning GP consortiums from taking decisions in private about spending NHS money, totally ruling out any competition based on price, banning private companies from taking over commissioning, allowing private health providers in only when it will not damage existing NHS services, and ensuring the role of local government in the consortiums.

This vote is a major development: it means that Clegg's party is formally committed to changing the Health Bill. Evan Harris, the former Oxford MP campaigning on the motion, said that the party expected Clegg and the health minister Paul Burstow to be bound by the vote. In a clear challenge to the leadership, Evans said: "We expect Liberal Democrats in government to follow what we overwhelmingly vote for."

This will pose problems for Clegg with his Conservative cabinet colleagues, as the proposed changes will not beaccepted happily by the Health Secretary, Andrew Lansley (who has also attracted the anger of doctors). Indeed, the whole bill – which proposes giving control of 80 per cent of the NHS budget to GP consortiums – is underpinned by a market-based philosophy.

This opens up an easy fault line for Labour, which can exploit the motion passed today by proposing amendments to the bill and challenging Lib Dem MPs to stay consistent with the decisions passed today and vote against the government.

More from Samira Shackle

View the discussion thread.

25 comments

Sat, 2011-03-12 22:15 — H Vincent (not verified)

AV will help only the fringe parties including the LIBDEMS.....YUK.....

Mon, 2011-03-14 01:41 — yuccaplant (not verified)

@Robin L honestly i think all 5 you mention are tory material makes you wonder though where would they go assuming they wouldn't fight they're current seats that is?

Mon, 2011-03-14 03:18 — Tommy (not verified)

The Liberals will do what they always do, make no fuss and give the Tories exactly what they want.

Fri, 2011-06-10 17:01 — redd (not verified)

However, Lansley will say that removing AWP will "remove patient choice" and he is against that. AWP is NOT patient choice, it is commissioners' choice, but Lansley is using a successful Blairite rhetoric.

http://health-med-news.com

Tue, 2011-11-22 09:41 — lavanda (not verified)

Hello! Read here!http://www.doctorsnewscom.com/

Sat, 2011-03-12 14:17 — tingedfringe (not verified)

It'll be interesting to see how Clegg chooses to go on this.
Will he go with his party or spin the line about 'cabinet responsibility' and go with the markets?

Difficult decision. He risks his party turning on him if he backs the coalition but risks the coalition if he backs his party.

Sat, 2011-03-12 14:27 — Tussyisme (not verified)

Please sign/Tweet/circulate - don't forget older neighbours etc not online - this excellent politically/organisationally unaffiliated petition: #saveournhs at http://saveournhs.org. Results go direct to MPs.

Sat, 2011-03-12 14:48 — PANDIK (not verified)

@tingedfringe

Yes it will be very interesting. Clegg & Co like to go on about how they are a democratic party and this was not copvered by the collusion agreement.

If Clegg ignores the party and cariies on he will be seen to have 'gone native' and abandoned any pretence that he has some sort of mandate for what he is doing.

But Lansley and Cameron aren't going to roll over and abandon this. I predict tears.

Sat, 2011-03-12 15:04 — madasbalooons (not verified)

For sure, the snake in the grass Clegg will try and spin his way out of this.

Sat, 2011-03-12 15:27 — yuccaplant (not verified)

This could well be the end of the Clegg era if he doesn't try to at least get changes to this nonsensical bill.

Finally the grass roots libdem members are reclaiming their party good on them

Sat, 2011-03-12 15:33 — hindle-a

given the history of the coalition so far -they will probably state a compromise has been made-safeguards,periodic reviews etc with the Tories largely getting their way and the lickspittle LibDems arguing they have diluted the proposals,made a significant impact for the better-ignoring the fact yet again -they are enabling the Tories to carry out policies which nobody voted for.

Sat, 2011-03-12 15:43 — Gracie

Clegg will go with the government, his seat in Sheffield Hallam is in danger so he'll be after a safe TORY seat come the next election. Let's be brutally honest here, Clegg is a blue Tory and he will cross the floor of the house at some point.

Sat, 2011-03-12 15:44 — Gracie

@ hindle-a

A very astute assessment and you are more than probably correct.

Sat, 2011-03-12 16:29 — Richard Blogger (not verified)

Prof Chris Ham in the BMJ puts it bluntly:

"Although many organisations have focused their attention on plans to give general practices a major role in commissioning health services and to require all NHS providers to become foundation trusts, these changes are of secondary importance compared with the radical extension of competition in healthcare."

The main policy of the Health Bill is Any Willing Provider and the imposition of competition law. Lansley wants to create a healthcare market; Letwin has said he wants "hospitals to compete for patients".

This new LibDem policy kills AWP and the idea of a healthcare market. It kills the entire bill. Lansley will not accept this. As hindle-a says, the response will be a bit more accountability (perhaps councillors on GP boards, a daft idea if ever there was one, why not mandate that the board has a majority of doctors, nurses, midwives etc? Councillors generally don't have a clue about healthcare provision). However, Lansley will say that removing AWP will "remove patient choice" and he is against that. AWP is NOT patient choice, it is commissioners' choice, but Lansley is using a successful Blairite rhetoric.

This Bill will be passed by a rump of LibDem ministers supporting their Tory masters.

Sat, 2011-03-12 16:30 — Richard Blogger (not verified)

The URL to the Ham article:

http://www.bmj.com/content/342/bmj.d1035.full

Sat, 2011-03-12 17:00 — willmill82 (not verified)

@Gracie

Is that conjecture, or do you know something everyone else doesn't?

Sat, 2011-03-12 17:08 — Martyn (not verified)

I don't particularly care what Clegg does now, unless he jumps ship and joins the Tories the position he's in now could well finish him.

Sat, 2011-03-12 17:41 — ang (not verified)

The headline is misleading.
The 'Coalition' sits on the benches in parliament, wheras the Conference would have been full of grass-roots Lib Dems. Theses are 2 completely different groups, with completely different agendas.

Sun, 2011-03-13 20:33 — jie4v7i14

From the words of Nye Bevan - play at it at your peril. Or words to that affect.

Sat, 2011-03-12 18:34 — S Moore (not verified)

I am NEVER going to vote tactically for the wibberals ever again!

Sat, 2011-03-12 18:56 — Mike S (not verified)

Quite right hindle-a..they are already claiming that many of the concerns have been addressed and amendments drawn up to resolve the difficulties. The fact is the leadership of the LibDems no longer care - for them there is no going back and the sooner the party recognises that it is all about the well being and survival of the Orange book mafia the sooner they will be able to save their party from extinction.

It won't matter to Clegg and Laws - they'll join the Tories anyway..

Sat, 2011-03-12 19:45 — hindle-a

Mike S-yes it seems to ba a tactic-the LibDems are congratulating themselves re the motion regarding the removal of the DLA mobility component for residents-"distinct difference between us and the Tories"-given the impression of not being mere lap-dogs of them-conveniently forgetting that the Tories already have said that they have delayed its possible introduction -this was due to campaigns by disability groups and charities-nothing to do with the LibDems-and the motion which they passed is so vague in its phraseology is a mere rewording of the Tories position and open to varying intepretations-they are deluding themselves.

Sun, 2011-03-13 22:50 — Mr Anton Jury (not verified)

There is also another online petition running to try and protect/save The National Health Service. If you are interested take a look and spread the word far and wide.

http://www.38degrees.org.uk