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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What type of Brexit did we vote for? 150,000 Conservative members will decide

As Michael Gove launches his leadership bid, what Leave looks like will be decided by Conservative activists.

Why did 17 million people vote to the leave the European Union, and what did they want? That’s the question that will shape the direction of British politics and economics for the next half-century, perhaps longer.

Vote Leave triumphed in part because they fought a campaign that combined ruthless precision about what the European Union would do – the illusory £350m a week that could be clawed back with a Brexit vote, the imagined 75 million Turks who would rock up to Britain in the days after a Remain vote – with calculated ambiguity about what exit would look like.

Now that ambiguity will be clarified – by just 150,000 people.

 That’s part of why the initial Brexit losses on the stock market have been clawed back – there is still some expectation that we may end up with a more diluted version of a Leave vote than the version offered by Vote Leave. Within the Treasury, the expectation is that the initial “Brexit shock” has been pushed back until the last quarter of the year, when the election of a new Conservative leader will give markets an idea of what to expect.  

Michael Gove, who kicked off his surprise bid today, is running as the “full-fat” version offered by Vote Leave: exit from not just the European Union but from the single market, a cash bounty for Britain’s public services, more investment in science and education. Make Britain great again!

Although my reading of the Conservative parliamentary party is that Gove’s chances of getting to the top two are receding, with Andrea Leadsom the likely beneficiary. She, too, will offer something close to the unadulterated version of exit that Gove is running on. That is the version that is making officials in Whitehall and the Bank of England most nervous, as they expect it means exit on World Trade Organisation terms, followed by lengthy and severe recession.

Elsewhere, both Stephen Crabb and Theresa May, who supported a Remain vote, have kicked off their campaigns with a promise that “Brexit means Brexit” in the words of May, while Crabb has conceded that, in his view, the Leave vote means that Britain will have to take more control of its borders as part of any exit deal. May has made retaining Britain’s single market access a priority, Crabb has not.

On the Labour side, John McDonnell has set out his red lines in a Brexit negotiation, and again remaining in the single market is a red line, alongside access to the European Investment Bank, and the maintenance of “social Europe”. But he, too, has stated that Brexit means the “end of free movement”.

My reading – and indeed the reading within McDonnell’s circle – is that it is the loyalists who are likely to emerge victorious in Labour’s power struggle, although it could yet be under a different leader. (Serious figures in that camp are thinking about whether Clive Lewis might be the solution to the party’s woes.) Even if they don’t, the rebels’ alternate is likely either to be drawn from the party’s Brownite tendency or to have that faction acting as its guarantors, making an end to free movement a near-certainty on the Labour side.

Why does that matter? Well, the emerging consensus on Whitehall is that, provided you were willing to sacrifice the bulk of Britain’s financial services to Frankfurt and Paris, there is a deal to be struck in which Britain remains subject to only three of the four freedoms – free movement of goods, services, capital and people – but retains access to the single market. 

That means that what Brexit actually looks like remains a matter of conjecture, a subject of considerable consternation for British officials. For staff at the Bank of England,  who have to make a judgement call in their August inflation report as to what the impact of an out vote will be. The Office of Budget Responsibility expects that it will be heavily led by the Bank. Britain's short-term economic future will be driven not by elected politicians but by polls of the Conservative membership. A tense few months await. 

Stephen Bush is special correspondent at the New Statesman. He usually writes about politics.