9 May 2011

NHS reforms row hits the Commons

Health and Social Care Editor

As Labour calls for the Health Service Bill to be shelved, a Lib Dem MP tells Channel 4 News he wants to “rip the guts out of the Bill”, writes Victoria Macdonald.

A day after the Deputy Prime Minister Nick Clegg undermined the reforms by claiming for the first time that the Health and Social Care Bill was deeply flawed, Labour said there now needed to be radical changes to the proposed reforms.

Opening a Commons debate, John Healey, the Shadow Health Secretary, quoted the Liberal Democrats’ description of the NHS reforms from their Spring Conference, saying the reforms were based on a “damaging and unjustified market-based approach”.

Mr Healey said that he agreed with Mr Clegg that “no bill is better than a bad one”. But Mr Healey said this was a bad bill and that a pause was no longer enough.

Of course, when you want a stronger NHS for the future, it will require change. Health Secretary Andrew Lansley

The Health Secretary, Andrew Lansley, rejected the calls, claiming once again that the plans for the NHS were an “evolution of the better policies of the past 20 years”. He said that fears over privatisation were misplaced. Mr Lansley said that it “was not his intention and had never been his intention to see the NHS fragmented and privatised”.

NHS reforms: Lansley and Cameron under pressure? (Reuters)

He said: “What the staff of the NHS want is the ability to be able to deliver care for patients without being told what to do by the top-down bureaucracy and targets under a Labour Government.

“Of course, when you want a stronger NHS for the future it will require change – change so that the NHS no longer spends £5bn a year on bureaucracy.”

Read more in the Channel 4 News Special Report: NHS uncovered

Pressure

Mr Lansley has been under increasing pressure over the reforms of which he is the principal architect. Just one week after he rejected the idea of a pause in the passage of the Bill, the Coalition Government announced its “listening exercise”. He was the subject of an historic vote of no confidence at the Royal College of Nursing Congress last month, and now the Royal College of GPs has warned of the unravelling of the NHS forever if the Government fails to rethink key elements of its plans.

The RCGP said that while it welcomed proposals to give more power to family doctors to purchase care for patients, it challenged the need for greater market involvement.

“The kind of changes I think are necessary would effectively rip the guts out of the Bill.” Lib Dem MP Andrew George

Mr Clegg has added to the pressure after he told The Andrew Marr Show: “I’m not going to ask Liberal Democrat MPs and Liberal Democrat peers to proceed with legislation on something as precious and cherished, particularly for Liberal Democrats, as the NHS unless I personally am satisfied that what these changes do is an evolutionary change in the NHS, not a disruptive revolution.”

Interviewed on Channel 4 News, the Liberal Democrat MP Andrew George, spelled out how far he was prepared to go to change the Bill.

“The kind of changes I think are necessary would effectively rip the guts out of the Bill, so it would be the equivalent of starting again,” he said. “What we are interested in is not a concession to the Liberal Democrats, it is a concession to the NHS.

“We are trying to save the NHS from what would otherwise be a catastrophe.”

What do doctors think of the NHS reforms? Find out here

Chaos

Health experts, however, said today that to halt the Bill risked causing chaos because so many changes had already been made. A number of Primary Care Trusts have already been abolished and staff made redundant.

The British Medical Association also today reiterated its concerns over the Bill. In a briefing it said: “The BMA believes that some potentially positive elements of the reforms – giving clinicians greater responsibility for commissioning and shaping local health services, increasing public and patient involvement, and putting a greater focus on improving public health – are seriously threatened by other aspects, particularly those that seek to increase competition.”

The think tank, The King’s Fund, said that it was now too simplistic to simply say that the Bill must be kicked out, that there would be a risk that the NHS would feel directionless and legislation would still be needed because of all the structural changes that had already taken place.

The NHS Confederation also said that to stop the reforms now would risk losing control of NHS finances because you would have to pay GPs more to carry out the administrative functions previously carried out by the Primary Care Trusts and Strategic Health Authorities.