NHS bill: Lords approve NHS reforms

Doctor in ward Critics of the bill say it would fragment the NHS but ministers say it will put patients first

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The government's planned changes to the NHS in England have cleared their final reading in the House of Lords.

Labour have forced a Commons debate on whether MPs can consider planned NHS changes for a final time before an assessment of the potential risks to the health service is published.

It will take place on Tuesday after being granted by Speaker John Bercow.

The government has agreed to a series of changes to the bill and wants it to become law as soon as possible.

MPs will consider amendments to the bill agreed by the Lords on Tuesday - the final stage in its passage - but only after the 90-minute emergency debate on the plans.

The bill has been the subject of a prolonged battle over the past year - with professional bodies representing doctors, nurses and other NHS workers resisting the changes.

The legislation would abolish Strategic Health Authorities and Primary Care Trusts and give much greater control over care budgets and commissioning decisions to GPs and other health professionals.

Opponents are trying to mobilise support behind a last-ditch attempt to try and delay the bill, saying the financial implications of the changes to the NHS must be properly considered.

Meanwhile, scores of people staged a candlelit vigil to protest on Monday night against what they called the "destruction" of the NHS.

Some 25 protests were held across the UK to draw attention to the proposed changes.

'Right to know'

The Freedom of Information Tribunal recently upheld a decision by the Information Commissioner that the NHS transitional risk register must be published. The government have said they will not do so until the tribunal has explained its ruling.

The register was drawn up to calculate the risks relating to the implementation of the bill.

Shadow health secretary Andy Burnham said it was "highly unsatisfactory" that MPs would not have an opportunity to consider the information in the register before finally approving the bill.

Start Quote

Parliament has a right to know, before it is asked to make a final judgment that will have huge implications for every person in this country”

End Quote Andy Burnham Shadow health secretary

"Parliament has a right to know, before it is asked to make a final judgment that will have huge implications for every person in this country," he told MPs.

In the Lords, crossbench peer Lord Owen called for a similar delay to the bill's third reading in the Upper House pending the publication of the document. But his motion was defeated by 328 votes to 213.

Ministers say some of the details in the register have already been published in impact assessments and that publishing the entire document would flout a fundamental principle that advice by officials given in confidence should be protected.

Speaking in the Lords, Health Minister Earl Howe said the bill had been subject to more scrutiny than any other in recent times, with parliamentary debates of "unparalleled duration and scope".

"I cannot accept for one moment that without sight of the transition risk register the House has somehow been denied a deep insight into what this bill means for the NHS," he said. "It is an absurd proposition."


Peers considered a series of amendments to the bill, including on the registration of health care support workers and the functions of the body due to replace the Health Protection Agency.

And they rejected a motion by Labour peer Baroness Thornton calling for the bill to be dropped by 269 to 174 votes.

Her motion - which argued that the bill did "not command the support" of patients, NHS workers or the public and would lead to the "fragmentation and marketisation" of the health service - was defeated by 95 votes.

Lord Greaves was the only Liberal Democrat rebel who voted with Labour on Monday in their bid to block the bill's passage.

Some 73 Lib Dem peers voted against the amendment, along with 170 Conservatives.

The government has made a series of concessions on the bill, to limit competition and clarify the powers and responsibilities of the secretary of state in relation to the health service, but say it should now proceed.

The legislation must be approved by the end of the parliamentary session but, pending its approval by the Commons on Tuesday, could receive its Royal Assent and become law later this week.


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  • rate this

    Comment number 448.

    I have just watched The Daily Politics show, and the interview about the NHS was a farce. You had a doctors view, but when it came to the studio discussion, you had basically two tories-where was an opposing view?? Also, the budget discussion, why did you not ask the Con-Dems about the relaxing of the anti-tax rules for multinationals (Controlled Foriegn Co) so they can dodge their tax bills?

  • rate this

    Comment number 447.

    434. steve

    What happens when there is nothing left to sell?

    What then?


    We will have to start paying back the money we borrowed to fund our luxurious Western life-styles.

    But don't worry, we will leave it to our unborn descendants to sort it out for us.

  • rate this

    Comment number 446.

    Is there anything more sickening than the report of the cabinet in unison banging the table to signify the passing of the Health Bill. This action is a public school demonstration of approval. What is more worrying is that they have actually boasted about their action. Nick Clegg has now shown his true colours.

  • rate this

    Comment number 445.

    Another reason to abolish the House of Lords. They talk the talk but they don't walk the walk.

  • rate this

    Comment number 444.

    438. Adam

    There is a distinct difference between a service and business.

    It has failed on all essential service privatisations. Gas, Electric, Water. The only one that worked was BT, but that is not essential.

    You still have a choice, if you can afford it, as with schooling. Both of which should be tax deductible.

    Get the NHS back to basics and equal access. Just make it work properly.

  • rate this

    Comment number 443.

    441 Don't kids yourself, the silent majority want the inefficient, union paralysed anachronistic monolith reformed.This bleeting about democracy is so hypocritical, a party is voted in they crack on with making laws. Didn't see many lefties complaining when the Union bribes were being handed out, or the borders were being thrown open, despite a huge majority anger. Not in manifesto.

  • rate this

    Comment number 442.

    I for one welcome our new insect overlords

  • rate this

    Comment number 441.

    This is a sad day for the NHS and a sad day for democracy. I can't believe that the coalition have managed to push through this catastrophic health bill despite not mentioning it pre election, misleading the public preelection regarding their plans for the health service, and despite the majority of the people and health workers in this country not wanting this disastrous health bill.

  • rate this

    Comment number 440.

    435. Nick

    We are all private individuals and how we supply our services, depends on the consumer of the service and provider of the service agreeing to a modus operandi.

    What I find objectionable, is that a 3rd party gets involved, supplying the doctor

    Service cost= Actual cost + profit.

    Instead of the actual cost. The NHS ends up paying pays the service cost.

  • rate this

    Comment number 439.


    Competition can work wonder for any public service, if done in the right way. It's about knowing that if you are not satisfied with the service you receive, you can go elsewhere next time.


    People don't want to go elsewhere, they just want to get the same decent standard of care wherever they live.

    Turning this into a postcode lottery is not in any sense of the word progressive.

  • rate this

    Comment number 438.


    How do you propose to improve the NHS without a profit motive?

    Competition can work wonder for any public service, if done in the right way. It's about knowing that if you are not satisfied with the service you receive, you can go elsewhere next time. People don't like monopolies in other sectors of the economy, so why shouldn't the same apply to health?

  • rate this

    Comment number 437.

    430. GT1973

    Every government has tried to reform it since the late 70s. All they have ever succeeded in doing is to add another layer of bureaucracy, reduced the service, enabled another avenue for profiteering and thrown more money at it.

    Do you really think this bunch will fare any better.

    Unless we put a stop to it, then it will be picked dry and will have nothing left to give of itself.

  • rate this

    Comment number 436.


    GP's are only human and therefore can't do everything. They're going to have to outsource a lot of work out to private companies. That's why some are calling this bill a goldmine for private management consultants.

    I can't see why so much emphasis is being placed upon GP's. What about all the other NHS staff? Why aren't they entitled to a say in how budgets are spent?

  • rate this

    Comment number 435.

    431. Gotterdammerung
    There is no room for a profit motive, within the NHS. That is benefiting from people's pain, sickness and misery.

    Good thing GPs are self employed contractors then.

  • rate this

    Comment number 434.

    What happens when there is nothing left to sell?

    What then?
    -------With this government it will be sell their own grandmothers as their souls were sold years ago!

  • rate this

    Comment number 433.

    Well, it's done,

    I am willing to bet cash that this will be disastrous for patients, the people who actually need/rely on this service.

    Anyone want to take that bet?

  • rate this

    Comment number 432.

    #422, Alpha -" If there was greater focus on prevention and tackling root causes of problems, especially within our modern society and culture, that would save some money"
    A good idea, unfortunately the Govt who are dismantling the NHS think it's ok for the food industry to advise them on nutrition and the brewers to advise them on alcohol intake! Any inmates want to run an Asylum?

  • rate this

    Comment number 431.

    No one other than a fool, would say that the NHS doesn't need reform. However, how about reversing some of the more obvious mistakes of the past first, rather than compounding them with more changes?

    There is no room for a profit motive, within the NHS. That is benefiting from people's pain, sickness and misery.

    The private sector should keep to vanity procedures.

    The NHS is being ConDemd

  • rate this

    Comment number 430.

    I just hope we can now get on with reforming the NHS. The NHS has needed reforming for years, and every government has bottled it when the Unions kick off. Good on the Coalition for standing firm.

  • rate this

    Comment number 429.

    271. Goodbye, no tears will be shed.


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