He may once have boasted that the government's NHS reforms were in the Liberal Democrat manifesto, but Nick Clegg is now chipping away at Andrew Lansley's masterplan. The BBC has obtained a copy of a Lib Dem policy document signed by Clegg which demands that Monitor, the health regulator, should have a duty to promote NHS colloboration rather than competition.
The document states: "We cannot treat the NHS as if it were a utility, and the decision to establish Monitor as an "economic regulator" was clearly a misjudgement, failing to recognise all the unique characteristics of a public health service, and opening us up to accusations that we are trying to subject the NHS to the full rigours of UK and EU competition law."
It's a demand that has been echoed by the British Medical Association and by the independent-minded Conservative MP Sarah Wollaston, and one distinctly at odds with Lansley's original vision of a market-based NHS. In his address to Lib Dem MPs and peers last night, Clegg said:
There must be no change in the way competition law operates in our NHS. No to establishing Monitor as an economic regulator as if health care was just like electricity or the telephone, and no to giving anyone in the NHS a duty to promote competition above all else.
But it's Clegg's coded criticism of David Cameron that is most striking. He is reported to have said:
People get confused when one day they hear politicians declare how much they love the NHS and the next they hear people describing themselves as government advisers saying that reform is a huge opportunity for big profits for health-care corporations.
The Deputy PM doesn't mention Cameron by name but it's clear who he has in mind. After all, it was the Prime Minister who declared in a speech on Monday: "[I]t's because I love the NHS so much that I want to change it." And it was his adviser Mark Britnell (recently appointed to a panel of senior health policy experts by Cameron), who told a conference for health-care corporations:
The NHS will be shown no mercy and the best time to take advantage of this will be in the next couple of years.
One legacy of the AV referendum campaign is that Clegg now feels liberated to speak out. Cameron's failure to block the vociferous attacks on his deputy by the No to AV campaign means that Clegg is a lot less willing only to air his grievances in private.