David Cameron has privately told MPs there will be ‘no retreat’ from the NHS plans, according to the Telegraph.
This is after the Liberal Democrat Spring conference voted for two motions which severely limit their possible support for the bill; and the BMA — at its first emergency meeting in 19 years — called on Lansley to withdraw the health bill, ‘warning that they would lead to the “fragmentation” and “privatisation” of the NHS’.
The Telegraph opines that the government will still have no difficulty passing the bill in the Commons, but could face difficulty in the Lords, where the opposition to the bill, led by Shirley Williams, is stronger.
The Guardian reported from the LD Conference that the Lib Dem position is as follows:
The Lib Dems as a party are now committed to limiting the role of the private sector in the NHS. That is the implication of the two amendments accepted today – and it runs counter to what Andrew Lansley is trying to achieve. In particular, the Lib Dems have voted for:
– GP consortia to be banned from taking decisions about the spending of NHS money in private.
– Any competition based on price to be completely ruled out.
– New private providers to be allowed “only where there is no risk of ‘cherry picking’ which would destabilise or undermine the existing NHS service relied upon for emergencies and complex cases, and where the needs of equity, research and training are met”.
– Private companies to be banned from taking over NHS commissioning.
– The proposed health and wellbeing boards to have “substantial representation” from councillors.
– Half of the seats on the boards of GP commissioning consortia to go to councillors.
The Chair of the BMA council wrote to Lansley expressing doctors’ BMA ‘grave concern about major elements of the Bill, especially, as drafted, the powers that will be given to Monitor to ensure the promotion of competition.’
‘Despite government reassurances, the vast majority of doctors believe the implementation of these powers will lead to a fragmentation of care and will undermine commissioning consortia’s ability to make decisions based on the best interests of their patients and local populations.’
Tory MP Dr Sarah Wollaston writes in the Telegraph that ‘the reforms manage to be both “top-down” and “bottom up”‘, and that ‘we could end up with the worst of both worlds.’
‘I cannot see that it makes sense to foot the bill for redundancies for the entire middle layer of NHS management only to be re-employing many of them within a couple of years. Commissioning consortia will be overwhelmed trying to adapt to their new roles … if Monitor, the new economic regulator, is filled with competition economists with a zeal for imposing competition at every opportunity, then the NHS could be changed beyond recognition.’
Commenting on the government PR offensive in the wake of the Lib Dem and BMA calls, Max Pemberton writes: ‘all the independent scientific evidence suggests that introducing the market into health care promotes inequality and division and drives down quality.’