The question Lib Dem MPs must ask themselves

Will passing the health bill improve patient outcomes in the NHS?

There appears to be some confusion as to what the Lib Dem members were saying about The Health and Social Care Bill at Spring Conference over the weekend. Let me attempt to clarify things.

In short we are asking our MPs and Peers to decide if the cost of passing the Health and Social Care Bill is a price worth paying.

We don't like this bill. We trust our Conservative coalition partners on the NHS about as far as we can throw them. Our peers have done a tremendous job at amending the bill but it still has a very bad smell hanging around it. Even Nick made clear in his speech to conference that "this isn't a Liberal Democrat bill".

Nonetheless, there are some good things in the bill. No one pretends the NHS is perfect. Even Andy Burnham - who wrote an open letter to all Lib Dem members last week - says there is work to do to "enable the NHS to make some of the difficult service changes it needs to make to have a care model ready for the challenges of this century".

But everyone in the party does agree on one thing. Somehow - oh, how has this been allowed to happen - we have been manoeuvred into a position whereby if the bill passes, in the eyes of the electorate the responsibility for it will lie with us. And even if in the long term it turns out that supporters of the bill are right and the NHS improves through the passing of this bill, we wont get any of the credit, and we will get still get hammered by the voters for passing it. The cost of allowing this legislation comes with a heavy price tag for the Lib Dems.

So here is the question our Parliamentarians need to consider. It is perhaps a fairly obvious question - but in the midst of negotiations both around the bill and within the party, it is one that hasn't been asked enough.

Are you absolutely convinced that passing this bill will improve all patient outcomes in the NHS?

If you are - and I'm duty bound to point out this means you believe you know better than just about every professional healthcare body in the country - then you must pass this bill, no matter what the electoral cost to the party. It may mean another 80 years of electoral oblivion but if that's what you believe, you should put the NHS before the party.

But if you're not sure (and until the Risk Register is published, how can you be?), then is the cost of passing, as Nick calls it, the Conservatives' Health and Social Care Bill a price worth paying?

The members have done their bit and been clear that they don't think that it is.

But it's up to you now.

Richard Morris blogs at A View From Ham Common, which was named Best New Blog at the 2011 Lib Dem Conference.

Richard Morris blogs at A View From Ham Common, which was named Best New Blog at the 2011 Lib Dem Conference

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Donald Trump's healthcare failure could be to his advantage

The appearance of weakness is less electorally damaging than actually removing healthcare from millions of people.

Good morning. Is it all over for Donald Trump? His approval ratings have cratered to below 40%. Now his attempt to dismantle Barack Obama's healthcare reforms have hit serious resistance from within the Republican Party, adding to the failures and retreats of his early days in office.

The problem for the GOP is that their opposition to Obamacare had more to do with the word "Obama" than the word "care". The previous President opted for a right-wing solution to the problem of the uninsured in a doomed attempt to secure bipartisan support for his healthcare reform. The politician with the biggest impact on the structures of the Affordable Care Act is Mitt Romney.

But now that the Republicans control all three branches of government they are left in a situation where they have no alternative to Obamacare that wouldn't either a) shred conservative orthodoxies on healthcare or b) create numerous and angry losers in their constituencies. The difficulties for Trump's proposal is that it does a bit of both.

Now the man who ran on his ability to cut a deal has been forced to make a take it or leave plea to Republicans in the House of Representatives: vote for this plan or say goodbye to any chance of repealing Obamacare.

But that's probably good news for Trump. The appearance of weakness and failure is less electorally damaging than actually succeeding in removing healthcare from millions of people, including people who voted for Trump.

Trump won his first term because his own negatives as a candidate weren't quite enough to drag him down on a night when he underperformed Republican candidates across the country. The historical trends all make it hard for a first-term incumbent to lose. So far, Trump's administration is largely being frustrated by the Republican establishment though he is succeeding in leveraging the Presidency for the benefit of his business empire.

But it may be that in the failure to get anything done he succeeds in once again riding Republican coattails to victory in 2020.

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.