BMA: Lansley’s Health Bill may need to be dropped

As the government’s listening exercise winds down, a consensus on competition in the NHS is no close

The government's health plans for the NHS in England require such substantial changes that the entire bill may have to be dropped, according to the British Medical Association.

The doctors' union called for a series of changes in its submission to the government's six-week listening exercise, which was called in response to mounting criticism of the Health and Social Care Bill. In particular, doctors demand that the regulator's new duty to promote competition be dropped. They also want to see timetables relaxed and the net of responsibilities that the bill places on GP consortiums spread to involve other clinical staff.

The Deputy Prime Minister, Nick Clegg, is due to deliver a speech on health reform that will be closely watched, given his tough rhetoric on NHS reform in recent weeks.

Although he will call for substantial changes, he is expected to echo David Cameron's speech last week on the need for reform. The Liberal Democrats share their main concern about the bill with the BMA: that competition clause. The BMA wants a greater emphasis on collaboration; the Liberal Democrats endorsed this at their spring conference. To this end, Clegg will say:

People want choice – over their GP, where to give birth, which hospital to use. But providing that choice isn't the same as allowing private companies to cherry-pick NHS services.

As the listening exercise – essentially a second consultation period – draws to a close, it seems a consensus is no closer.

The government has repeatedly promised substantial change and rethinking of the bill (while reiterating the need for reform), but the question is how far it is willing to go with watering down the competition clause. Given that a free-market philosophy permeates Andrew Lansley's entire bill, and it has the support of many Conservatives, this will prove problematic.

Among the groups that have backed the government's plans for greater competition are Reform, a pro-market think tank, and the NHS Confederation, which represents managers. Doctors on one side and managers on the other: whose advice would you rather take?

Samira Shackle is a freelance journalist, who tweets @samirashackle. She was formerly a staff writer for the New Statesman.

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Voters are turning against Brexit but the Lib Dems aren't benefiting

Labour's pro-Brexit stance is not preventing it from winning the support of Remainers. Will that change?

More than a year after the UK voted for Brexit, there has been little sign of buyer's remorse. The public, including around a third of Remainers, are largely of the view that the government should "get on with it".

But as real wages are squeezed (owing to the Brexit-linked inflationary spike) there are tentative signs that the mood is changing. In the event of a second referendum, an Opinium/Observer poll found, 47 per cent would vote Remain, compared to 44 per cent for Leave. Support for a repeat vote is also increasing. Forty one per cent of the public now favour a second referendum (with 48 per cent opposed), compared to 33 per cent last December. 

The Liberal Democrats have made halting Brexit their raison d'être. But as public opinion turns, there is no sign they are benefiting. Since the election, Vince Cable's party has yet to exceed single figures in the polls, scoring a lowly 6 per cent in the Opinium survey (down from 7.4 per cent at the election). 

What accounts for this disparity? After their near-extinction in 2015, the Lib Dems remain either toxic or irrelevant to many voters. Labour, by contrast, despite its pro-Brexit stance, has hoovered up Remainers (55 per cent back Jeremy Corbyn's party). 

In some cases, this reflects voters' other priorities. Remainers are prepared to support Labour on account of the party's stances on austerity, housing and education. Corbyn, meanwhile, is a eurosceptic whose internationalism and pro-migration reputation endear him to EU supporters. Other Remainers rewarded Labour MPs who voted against Article 50, rebelling against the leadership's stance. 

But the trend also partly reflects ignorance. By saying little on the subject of Brexit, Corbyn and Labour allowed Remainers to assume the best. Though there is little evidence that voters will abandon Corbyn over his EU stance, the potential exists.

For this reason, the proposal of a new party will continue to recur. By challenging Labour over Brexit, without the toxicity of Lib Dems, it would sharpen the choice before voters. Though it would not win an election, a new party could force Corbyn to soften his stance on Brexit or to offer a second referendum (mirroring Ukip's effect on the Conservatives).

The greatest problem for the project is that it lacks support where it counts: among MPs. For reasons of tribalism and strategy, there is no emergent "Gang of Four" ready to helm a new party. In the absence of a new convulsion, the UK may turn against Brexit without the anti-Brexiteers benefiting. 

George Eaton is political editor of the New Statesman.