Liberal Democrat peers seek to amend the government's health bill, as the Royal College of Physicians considers balloting its members on the reforms.

Liberal Democrat peers seek to amend the government's health bill, as the Royal College of Physicians considers balloting its members on the reforms (Getty)

The health and social care bill is enduring a tortuous passage through parliament and has already been heavily amended.

Now Liberal Democrat peers want to make further changes, including scrapping plans to increase competition in the NHS. They are said to have the tacit backing of their party leadership, which is in coalition with the Conservatives.

Baroness Jolly, the Lib Dems' co-chair for health, said parts of the bill were "seriously flawed". She told BBC Radio 5 Live that although her party was in favour of "huge chunks" of the legislation, changes were needed.

"We are trying really hard to say no more competition and no more favours for the private sector and if they come out we will be delighted," she said.

Only political pride is preventing this prime minister from dropping his bill. Labour leader Ed Miliband

Emergency session

The government's plans are also under attack outside parliament, with the Royal College of Physicians (RCP), which represents hospital doctors, meeting in emergency session on Monday. It is considering a ballot of its 26,000 members.

If the RCP comes out against the legislation, it would join the other royal colleges, the British Medical Association and the Faculty of Public Health in calling for the bill to be withdrawn.

Labour leader Ed Miliband wrote in the Times on Monday: "Only political pride is preventing this prime minister from dropping his bill. If he ploughs on, he will not only destroy trust in himself, he will also prevent the real change that the NHS needs."

Several changes have been made to the government's health reforms since they were first published. Find out what they are.

Since the NHS white paper was published in July 2010, there have been numerous changes. There was a pause in the bill's jouney through parliament in 2011 to allow for further consultation.

Professor Steve Field, former head of the Royal College of GPs, was asked to liaise with NHS professionals and draw up proposals to improve the bill. His recommendations were approved by the government, but the bill is still being closely fought over in the House of Lords.

Competition

Originally, the government wanted the regulator Monitor to encourage competition in the health service. After Prof Field's intervention, it agreed that Monitor's primary duty would be the protection and promotion of patients' interests.

Competition will now be based on quality, not price. Initially, competition was going to be opened up to "any willing provider"; this has been changed to "any qualified provider".

According to the Observer newspaper, an online poll conducted by doctors opposed to the reforms found that 92.5 per cent of RCP members want the bill to be ditched.

A spokeswoman for the college said: "The RCP continues to have serious concerns about the reforms and has been lobbying vigorously for changes to the bill since its publication."

'Unnecessary, confused and confusing'

Former NHS chief executive Lord Crisp said the reforms were "a mess", as well as being "unnecessary, confused and confusing". But Prime Minister David Cameron has said it is vital the legislation is passed, warning of "chaos" if the reforms were abandoned.

Chancellor George Osborne said at the weekend that the bill would ensure the NHS was affordable and able to meet the needs of an
ageing population.

Lib Dem activists are threatening a revolt at the party's spring conference in March.