NHS bill: Lib Dem peers signal end to rebellion

Baroness Williams Baroness Williams wants greater clarity as to the health secretary's role under the NHS reforms

Lib Dem peers are to end their rebellion over the NHS bill for England after the government signalled it would meet one of their key demands.

In a letter to the Guardian 32 Lib Dem peers said: "The time for declaratory statements is past."

The government signalled it would accept a Tory peer's amendment stating the health secretary "retains ultimate responsibility" for NHS services.

Its plans to restructure the NHS in England have proved controversial.

Government sources said they would "look favourably" on the amendment, from Conservative former lord chancellor Lord Mackay, but the Lords adjourned on Monday night before the government had a chance to accept it. The debate is expected to resume next Wednesday.

Ambiguities

The peer said his amendment "makes it absolutely plain in language we can all understand that the ultimate responsibility to Parliament will rest with the Secretary of State".

Concerns had been raised by Lib Dem peers that there were ambiguities about the secretary of state's role in the Health and Social Care Bill.

Health and Social Care Bill

  • Jan 2011: Commons First and Second readings. Approved with no rebellions
  • Feb - Mar: Commons committee stage, various amendments accepted on competition
  • 4 April: Bill "paused" following widespread criticism
  • April - June: "Listening exercise" conducted by NHS Future Forum
  • June - July: Bill sent back to Commons committee stage. MPs approve further amendments prompted by listening exercise
  • 6 - 7 Sep: Commons report stage and Third Reading - approved with four Lib Dem rebels
  • Sep: Bill arrives in the Lords
  • Oct 12: Lords reject bids to block the bill altogether and to send parts of it to a special select committee
  • Christmas? Ministers would like the bill to get royal assent by then but even without further delays, there are still several stages to go through
  • April 2013? Further delays notwithstanding, NHS commissioning groups due to take charge of budgets then

Baroness Williams had argued that it would mean the health secretary was no longer legally and constitutionally responsible for providing a comprehensive health service in England.

On Monday she said it was crucial that accountability for £120bn of taxpayers' money spent on the NHS and other health services was retained directly through Parliament.

But in a letter to the Guardian on Tuesday, Baroness Williams and 31 other Lib Dem peers wrote: "The time for declaratory statements is past. Patients who care passionately about the NHS and staff who want to give it the best possible service, need certainty about the future of the health service. Any politician who plays party political games with the NHS would be open to justified public criticism."

The government's plans for the NHS in England involve giving GPs and other clinicians much more responsibility for spending the budget, while greater competition with the private sector will be encouraged and have proved to be .

Ministers say their plans are needed to help the NHS cope with the demands of an ageing population, the costs of new drugs and treatments and the impact of lifestyle factors, such as obesity.

They say the bill, which has already been substantially altered following criticism from NHS staff, opposition and some Liberal Democrat MPs, now has wide support.

But some leading medical professionals have warned that the proposals are still unpopular.

Speaking in the House of Lords on Monday, shadow health minister Baroness Thornton said the bill still failed to reassure people and NHS staff, and a defining set of principles was required.

"Only clarity around the principles will get them to take NHS staff with them," she said.

Former SDP leader Lord Owen called it a "disastrous" bill, which would "unutterably change the principles of of the NHS".

"I have lost any hope of convincing the government or the Liberal Democrat benches about the substance of the bill. This is going to go through - it's unfortunate but that's the reality," he added.

Concessions

Later, cross-bench peer Lord Walton of Detchant, a former president of the British Medical Association, said the bill should make clear that the NHS should "provide education and training for its workers".

Several peers, including the health minister Lord Howe, have put down amendments on the issue.

Lord Howe's amendment, which is expected to be accepted, specifies that the health secretary should ensure there is an "effective system for the planning and delivery of education and training".

Earlier this month, the House of Lords rejected a proposed amendment that would have referred parts of the bill to a special select committee.

The reforms have been one of the most controversial areas of government policy over the past year and had to be put on hold in the spring amid mounting criticisms from the medical profession, academics and MPs.

It led to ministers making a number of concessions, including giving health professionals other than GPs more power over how NHS funds are spent as well as watering down the role of competition.

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