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.

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

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There are two sides to the Muslim segregation story

White families must also be prepared to have Muslim neighbours. 

Dame Louise Casey finally published her review on social integration in Britain. Although it mentions all communities, there is a clear focus on Muslim communities. However, the issues she raises - religious conservatism, segregation in some areas and Muslim women experiencing inequalities -  are not new. In this case, they have been placed in one report and discussed in the context of hindering integration. If we are truly committed to addressing these issues, though, we have a duty of care to discuss the findings with nuance, not take them out of context, as some tabloids have already done.

The review, for example, highlights that in some areas Muslims make up 85 per cent of the local population. This should not be interpreted to mean that Muslims are choosing to isolate themselves and not integrate. For a start, the review makes it clear that there are also certain areas in Britain that are predominantly Sikh, Hindu or Jewish.

Secondly, when migrants arrive in the UK, it is not unreasonable for them to gravitate towards people from similar cultural and faith backgrounds.  Later, they may choose to remain in these same areas due to convenience, such as being able to buy their own food, accessing their place of worship or being near elderly relatives.

However, very little, if any, attention is given to the role played by white families in creating segregated communities. These families moved out of such areas after the arrival of ethnic minorities. This isn't necessarily due to racism, but because such families are able to afford to move up the housing ladder. And when they do move, perhaps they feel more comfortable living with people of a similar background to themselves. Again, this is understandable, but it highlights that segregation is a two-way street. Such a phenomenon cannot be prevented or reversed unless white families are also willing to have Muslim neighbours. Is the government also prepared to have these difficult conversations?

Casey also mentions inequalities that are holding some Muslim women back, inequalities driven by misogyny, cultural abuses, not being able to speak English and the high numbers of Muslim women who are economically inactive. It’s true that the English language is a strong enabler of integration. It can help women engage better with their children, have access to services and the jobs market, and be better informed about their rights.

Nevertheless, we should remember that first-generation Pakistani and Bangladeshi women, who could not speak English, have proved perfectly able to bring up children now employed in a vast range of professions including politics, medicine, and the law. The cultural abuses mentioned in the review such as forced marriage, honour-based violence and female genital mutilation, are already being tackled by government. It would be more valuable to see the government challenge the hate crimes and discrimination regularly faced by Muslim women when trying to access public services and the jobs market. 

The review recommends an "Oath of Integration with British Values and Society" for immigrants on arrival. This raises the perennial question of what "British Values" are. The Casey review uses the list from the government’s counter-extremism strategy. In reality, the vast majority of individuals, regardless of faith or ethnic background, would agree to sign up to them.  The key challenge for any integration strategy is to persuade all groups to practice these values every day, rather than just getting immigrants to read them out once. 

Shaista Gohir is the chair of Muslim Women's Network UK, and Sophie Garner is the general secretary and a barrister.