Clegg hits out at Cameron over NHS reforms

Deputy PM attacks Cameron for undermining the NHS while declaring that he loves it.

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.

George Eaton is political editor of the New Statesman.

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Like it or hate it, it doesn't matter: Brexit is happening, and we've got to make a success of it

It's time to stop complaining and start campaigning, says Stella Creasy.

A shortage of Marmite, arguments over exporting jam and angry Belgians. And that’s just this month.  As the Canadian trade deal stalls, and the government decides which cottage industry its will pick next as saviour for the nation, the British people are still no clearer getting an answer to what Brexit actually means. And they are also no clearer as to how they can have a say in how that question is answered.

To date there have been three stages to Brexit. The first was ideological: an ever-rising euroscepticism, rooted in a feeling that the costs the compromises working with others require were not comparable to the benefits. It oozed out, almost unnoticed, from its dormant home deep in the Labour left and the Tory right, stoked by Ukip to devastating effect.

The second stage was the campaign of that referendum itself: a focus on immigration over-riding a wider debate about free trade, and underpinned by the tempting and vague claim that, in an unstable, unfair world, control could be taken back. With any deal dependent on the agreement of twenty eight other countries, it has already proved a hollow victory.

For the last few months, these consequences of these two stages have dominated discussion, generating heat, but not light about what happens next. Neither has anything helped to bring back together those who feel their lives are increasingly at the mercy of a political and economic elite and those who fear Britain is retreating from being a world leader to a back water.

Little wonder the analogy most commonly and easily reached for by commentators has been that of a divorce. They speculate our coming separation from our EU partners is going to be messy, combative and rancorous. Trash talk from some - including those in charge of negotiating -  further feeds this perception. That’s why it is time for all sides to push onto Brexit part three: the practical stage. How and when is it actually going to happen?

A more constructive framework to use than marriage is one of a changing business, rather than a changing relationship. Whatever the solid economic benefits of EU membership, the British people decided the social and democratic costs had become too great. So now we must adapt.

Brexit should be as much about innovating in what we make and create as it is about seeking to renew our trading deals with the world. New products must be sought alongside new markets. This doesn’t have to mean cutting corners or cutting jobs, but it does mean being prepared to learn new skills and invest in helping those in industries that are struggling to make this leap to move on. The UK has an incredible and varied set of services and products to offer the world, but will need to focus on what we do well and uniquely here to thrive. This is easier said than done, but can also offer hope. Specialising and skilling up also means we can resist those who want us to jettison hard-won environmental and social protections as an alternative. 

Most accept such a transition will take time. But what is contested is that it will require openness. However, handing the public a done deal - however well mediated - will do little to address the division within our country. Ensuring the best deal in a way that can garner the public support it needs to work requires strong feedback channels. That is why transparency about the government's plans for Brexit is so important. Of course, a balance needs to be struck with the need to protect negotiating positions, but scrutiny by parliament- and by extension the public- will be vital. With so many differing factors at stake and choices to be made, MPs have to be able and willing to bring their constituents into the discussion not just about what Brexit actually entails, but also what kind of country Britain will be during and after the result - and their role in making it happen. 

Those who want to claim the engagement of parliament and the public undermines the referendum result are still in stages one and two of this debate, looking for someone to blame for past injustices, not building a better future for all. Our Marmite may be safe for the moment, but Brexit can’t remain a love it or hate it phenomenon. It’s time for everyone to get practical.