Why the Lib Dems won't be choosing their coalition partner anytime soon

If the election results in another hung parliament, the party will side with whichever partner gives it the most liberal government.

So Nick Clegg suggests George Osborne is on the verge of making a monumental mistake, next thing you know Ed Balls is describing Nick as a man of integrity, suddenly there’s a Twitter love-in going on, and everyone acts like we may as well not bother with the 2015 general election, as a Lib-Lab coalition is a done deal. Coaliscious

Or is it?

Well, as Labour figures get increasingly nervous about whether it will be able to achieve a majority in 2015, you can see why they are suddenly making rather kinder noises about Nick than ever before. They’ve been positioning themselves as more Lib Dem friendly for a while now, with their adoption of policies like the Mansion Tax and low carbon energy targets, partly to secure the 2010 Lib Dem voters that have moved to them already, but also just in case the next election result leads to coalition negotiations with the Lib Dems. As it seems increasingly likely that Nick will be leading the party into that election, a softening of attitudes towards him was also inevitable.

But is the feeling really mutual?

I suspect the true feelings of the Westminster Lib Dems are better expressed when you look at the press release put out on Tuesday by the red-hot favourite to be next deputy leader of the party, Lorely Burt, where she said:

“I would also stand up for the Liberal Democrat Party’s core values of fairness and economic responsibility, which the Conservatives and Labour are incapable of delivering on their own.

“As we draw the battle lines for the next General Election against both the other major parties, I want to see the Liberal Democrats continuing to deliver more jobs, lower taxes for ordinary workers, and a fairer start in life through free school meals and help with childcare.”

In other words, a plague on both your houses.

The Lib Dems have consistently refused to say which side they would jump to if a repeat of the 2010 result happened. Rather, we’ll be talking to the largest party first – but not necessarily uniquely. And let’s not even get into the scenario where the Tories have the most votes but Labour have more seats.

Sure it's lovely when Ed Balls starts making cow eyes in your direction. But if the votes fall for a coalition, we’ll be looking for whichever partner gives us the most liberal government. We’re a way off deciding whose Prom invite we’ll be accepting just yet.

David Cameron, Nick Clegg and Ed Miliband attend a ceremony at Buckingham Palace to mark the Duke of Edinburgh's 90th birthday on June 30, 2011. Photograph: Getty Images.

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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All doctors kill people – and the threat of prosecution is bad for everyone

We must recognise the reality of medical practice: just because a doctor makes a mistake, that doesn’t mean they’ve all broken the law. 

On 15 November the Court of Appeal quashed the 2013 conviction for gross negligence manslaughter (GNM) of a senior consultant surgeon in London, David Sellu. Sellu, who had completed his prison term by the time the appeal was heard, will never get back the 15 months of his life that he spent in jail. Nor will the personal and family trauma, or the damage to his reputation and livelihood, ever properly heal. After decades of exemplary practice – in the course of the investigation numerous colleagues testified to his unflappable expertise – Sellu has said that he has lost the heart ever to operate again.

All doctors kill people. Say we make 40 important decisions about patients in a working day: that’s roughly 10,000 per annum. No one is perfect, and medical dilemmas are frequently complex, but even if we are proved right 99 per cent of the time, that still leaves 100 choices every year where, with the benefit of hindsight, we were wrong.

Suppose 99 per cent of those have no negative consequences. That’s still one disaster every 12 months. And even if most of those don’t result in a fatal outcome, over the course of a career a few patients are – very regrettably – going to die as a result of our practice. Almost invariably, these fatalities occur under the care of highly skilled and experienced professionals, working in good faith to the very best of their abilities.

If one of these cases should come before a crown court, the jury needs meticulous direction from the trial judge on the legal threshold for a criminal act: in essence, if a doctor was clearly aware of, and recklessly indifferent to, the risk of death. Sellu’s conviction was quashed because the appeal court found that the judge in his trial had singularly failed to give the jury these directions. The judiciary make mistakes, too.

Prosecutions of health-care professionals for alleged GNM are increasing markedly. The Royal College of Surgeons of England identified ten cases in 2015 alone. This must reflect social trends – the so-called “blame culture”, in which we have come to believe that when a tragedy occurs, someone must be held responsible. In every one of these cases, of course, an individual’s life has been lost and a family left distraught; but there is a deepening sense in which society at large, and the police and Crown Prosecution Service (CPS), in particular, appear to be disconnected from the realities of medical practice.

Malpractice investigation and prosecution are horrendous ordeals for any individual. The cumulative impact on the wider health-care environment is equally serious. In a recent survey of doctors, 85 per cent of respondents admitted that they were less likely to be candid about mistakes, given the increasing involvement of the criminal law.

This is worrying, because the best way to avoid errors in future is by open discussion with the aim of learning from what has gone wrong. And all too often, severely adverse events point less to deficiencies on the part of individuals, and more to problems with systems. At Sellu’s hospital, emergency anaesthetic cover had to be arranged ad hoc, and this contributed to delays in potentially life-saving surgery. The tragic death of his patient highlighted this; management reacted by putting a formal rota system in place.

Doctors have long accepted the burden of civil litigation, and so insure themselves to cover claims for compensation. We are regulated by the General Medical Council, which has powers to protect patients from substandard practice, including striking off poorly performing doctors. The criminal law should remain an exceptional recourse.

We urgently need a thorough review of the legal grounds for a charge of GNM, with unambiguous directions to the police, CPS and judges, before the spectre of imprisonment becomes entrenched for those whose only concern is to provide good care for their patients. As Ken Woodburn, a consultant vascular surgeon in Cornwall who was accused and acquitted of GNM in 2001, has said: “You’re only ever one error away from a manslaughter prosecution.”

This article first appeared in the 01 December 2016 issue of the New Statesman, Age of outrage