Twenty five days of debate in the chamber of the House of Lords have now concluded on the Health and Social Care Bill. Our health team in the Lords has been involved in numerous meetings, events and correspondence discussing the Bill over the last eighteen months. We made it plain throughout the process that we could not have voted for the Bill without significant series changes that Liberal Democrats and professional organisations demanded. We believe that great care is now needed over how it is implemented in order to avoid the dangers of which many have warned and in order to restore the confidence of professionals in the NHS.
Our role, working with Liberal Democrats in both Houses and throughout the party, has been significant in making major changes that have yet to be communicated fully to either the professionals or the public, but we can say that our role has guaranteed that:
- The Secretary of State must retain responsibility for a comprehensive health service, has power to intervene if things go wrong and is accountability to parliament
- Competition has to be in the best interests of patients and based on quality, not just price
- Commissioning has to be done in a way which is transparent, accountable and free from conflicts of interest
- Any profits gained from private treatment have to be accounted for and invested in the NHS
- The NHS now has a duty to reduce health inequalities and report on progress
- All providers have a duty to provide NHS education and training
- The NHS will be at the forefront of research
We felt that there was more danger to the NHS from failing to pass it and starting again from scratch for several reasons. Delaying the Bill would have left the NHS at risk from the full force of competition law. More services would have been commercialised on the basis of price rather than quality and this would have been against patients’ interests. Important changes in the Bill , such as moving responsibility for public health to local authorities and establishing the Health and Wellbeing Boards would have been be delayed and this would have put back the important work of turning the NHS into a service focused on health promotion and improvement.
There is much more to get across to the party, the professionals and the public about these issues and we will continue to do our best to explain them. We have made this Bill better, now we need to work with everyone who wants to make the NHS better. In the meantime, we have placed on the party’s website a series of statements about health issues and policies.
* Baroness Judith Jolly is Co-Chair of the Liberal Democrat Parliamentary Party Committee on Health and Social Care.