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Coalition tension over NHS reform escalates

Tory backbenchers set out “red lines” on reform and accuse Clegg of using Health Bill as a “politica

The row over NHS reform has intensified, with Conservative backbenchers expressing anger that their coalition partners are being given too much ground.

This follows weeks of anger at the pause in the legislation for the so-called listening exercise, and at increased Liberal Democrat vociferousness on the subject of NHS reform. Tim Montgomerie tweeted last week that Tories were referring to the Lib Dems as "yellow bastards".

So, perhaps it is not surprising that Nick de Bois, MP for Enfield North, sent out an email yesterday criticising comments made by Nick Clegg and calling for the Tories to set out "red lines" on reform.

The offending comments by Clegg came during a Q&A session after a speech. He said that he thought it would be wrong to rush the Health and Social Care Bill through parliament after the "listening exercise" ends next month.

"I think we will need to send the bill back to committee," he said – a process that could lead to a delay of six months. The speech had been approved by Downing Street – but there had been no discussion of sending the bill back to the committee stage.

De Bois's email accused Clegg of using the reform as a "political tool":

These are premature and inappropriate comments. We are still in the listening exercise. Our coalition partners have had the loudest voices in this debate and I am keen that the Conservative backbenchers have their voice heard so we can highlight our red lines that come from our manifesto.

But it was a smart move by Clegg. "It is best to take our time to get it right rather than move too fast and risk getting the details wrong," he said. If the government does offer the substantive changes it has promised, it will be difficult to argue with this sentiment.

Playing for time is all very well. However, as I pointed out yesterday, what this boils down to is a central disagreement over the principle of competition. The Liberal Democrats want to see it curtailed, while Tory right-wingers believe it is vital to the reform. This is a serious division, and one from which both sides will find difficult to back down.

Indeed, while many in the press have speculated that Lansley's career may be over, he is reportedly being hailed as a "hero" among the Tory right. He was even cheered at a meeting of the influential 1922 Committee last month. Expect the battle over NHS reform to get worse, not better.