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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Brexit could destroy our NHS – and it would be the government's own fault

Without EU citizens, the health service will be short of 20,000 nurses in a decade.

Aneurin Bevan once said: "Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune, the cost of which should be shared by the community."

And so, in 1948, the National Health Service was established. But today, the service itself seems to be on life support and stumbling towards a final and fatal collapse.

It is no secret that for years the NHS has been neglected and underfunded by the government. But Brexit is doing the NHS no favours either.

In addition to the promise of £350m to our NHS every week, Brexit campaigners shamefully portrayed immigrants, in many ways, as as a burden. This is quite simply not the case, as statistics have shown how Britain has benefited quite significantly from mass EU migration. The NHS, again, profited from large swathes of European recruitment.

We are already suffering an overwhelming downturn in staffing applications from EU/EAA countries due to the uncertainty that Brexit is already causing. If the migration of nurses from EEA countries stopped completely, the Department of Health predicts the UK would have a shortage of 20,000 nurses by 2025/26. Some hospitals have significantly larger numbers of EU workers than others, such as Royal Brompton in London, where one in five workers is from the EU/EAA. How will this be accounted for? 

Britain’s solid pharmaceutical industry – which plays an integral part in the NHS and our everyday lives – is also at risk from Brexit.

London is the current home of the highly prized EU regulatory body, the European Medicine Agency, which was won by John Major in 1994 after the ratification of the Maastricht Treaty.

The EMA is tasked with ensuring that all medicines available on the EU market are safe, effective and of high quality. The UK’s relationship with the EMA is unquestionably vital to the functioning of the NHS.

As well as delivering 900 highly skilled jobs of its own, the EMA is associated with 1,299 QPPV’s (qualified person for pharmacovigilance). Various subcontractors, research organisations and drug companies have settled in London to be close to the regulatory process.

The government may not be able to prevent the removal of the EMA, but it is entirely in its power to retain EU medical staff. 

Yet Theresa May has failed to reassure EU citizens, with her offer to them falling short of continuation of rights. Is it any wonder that 47 per cent of highly skilled workers from the EU are considering leaving the UK in the next five years?

During the election, May failed to declare how she plans to increase the number of future homegrown nurses or how she will protect our current brilliant crop of European nurses – amounting to around 30,000 roles.

A compromise in the form of an EFTA arrangement would lessen the damage Brexit is going to cause to every single facet of our NHS. Yet the government's rhetoric going into the election was "no deal is better than a bad deal". 

Whatever is negotiated with the EU over the coming years, the NHS faces an uncertain and perilous future. The government needs to act now, before the larger inevitable disruptions of Brexit kick in, if it is to restore stability and efficiency to the health service.

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