Paul Burstow writes: I will be listening to members on NHS at #ldconf

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This is the first spring conference since we entered Government. In all the years I’ve been a Liberal Democrat I’ve never known of such a potentially explosive spring conference. Or at least that’s what the media would have you believe. Debating policy is part of our DNA. And it shouldn’t change now that we’re in Government. This spring conference we’ll be debating the coalition’s proposals to update the NHS. And unlike in the media, it won’t be a case of who shouts loudest wins.

I understand why people are so concerned. Every time I meet party members I’m reminded of how important the NHS is to our party. It’s why I tabled a motion. Not just to speak, but to listen to the concerns, to criticisms and recommendations of colleagues.

It’s in part because of Lib Dem concerns that the Government last week amended the Health and Social Care Bill to close a loophole introduced by the previous Labour Government, which allowed private providers to be paid more than those from the public sector. For the past seven years Labour were able to rig the market in favour of the private sector by paying them on average 11% more than the NHS for the same service. Liberal Democrats have long criticised this practice, and now in Government it will be outlawed. Instead patients will be able to choose on the basis of quality who provides their treatment, but without guarantees for providers.

Many in the media will seize upon this conference as an opportunity to ferment discord and division in our party. But what they won’t realise is that most of us have been through this debate before. And not just the once. In 2002, conference debated Chris Huhne’s report into Public Services Quality, Innovation, Choice, which amongst other things recommended making the NHS more responsive to patients needs and choice by ensuring that decisions are made locally in response to local needs and preferences. Largely unnoticed the Health and Social Care Bill delivers on these recommendations by radically altering the relationship between the NHS and local government by ensuring that in the future Councils will be responsible for taking a lead in shaping local health services through Health and Wellbeing Boards.

In 2008, Norman Lamb proposed a ‘patient contract’, which would replace top down targets with a guarantee of access to high quality treatments in core areas. Crucially, it advocated using “the private sector to improve delivery by giving everyone the right to receive private treatment, paid for by the NHS.” And at the last general election the Liberal Democrats stood on a manifesto commitment to “commission services for local people from a range of providers on the basis of a level playing field”.

In Government we are putting those ideas into practice, instead of offering you just one option you’ll be given the support and information to make a choice from a range of NHS quality assured health providers. Most of the time it will probably be from the NHS, but if a charity or even a private provider can offer you better care then under our changes you’ll be free to go there. Each provider will be paid the same price, so your choice will be based on quality not price.

At conference in 2008, Dr Charles West put forward a series of amendments to Norman Lamb’s health policy paper to ensure that private sector procurement would not destabilise local NHS provision. Dr West proposed that new services should meet all NHS standards for quality, information and communication; that they can demonstrate that they provide value for money and do not undermine the local health economy; and that no NHS patient shall receive a diminished service as a result of the introduction of a new provider. Each of these policies can be found in the coalition’s proposals. Under our plans no provider, public, voluntary or private will be able to offer a service unless in meets NHS quality standards and works at NHS prices. And for the first time ever local health scrutiny will follow the NHS pound by allowing local authorities to scrutinise private providers.

These changes won’t open the NHS up to exploitation from American private providers, as some may have you believe. The coalition has put in place tough measures to remove any potential loopholes and ensure that unlike under Labour, private providers won’t be allowed to ‘cherry pick’ easy cases.

The proposals that will be debated at conference on Saturday have progressed significantly since the White Paper was first published last summer. The Health and Social Care Bill now gives local communities a vital role shaping commissioning decisions, increased scrutiny powers for local authorities, and measures to end to Labour’s bias towards the private sector. All of these proposals, in one form or another have been debated and discussed at party conference over the years. This Saturday conference will once again provide members with an opportunity to have their voices heard. I for one will be listening to what they have to say.

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12 Comments

  • Dominic Curran 10th Mar '11 - 2:21pm

    Thanks for your article, Paul. The NHS is potentially explosive for us – more so than the Coalition in general, as I suspect our supporters – and former supporters from pre-May 2010 – care rather more about it than Tory voters.

    One thing i’d like you to clear up is the ‘any willing provider’ clause I’ve read about. Does it mean that any provider, private or voluntary, can bid to run a formerly NHS service? If so, doesn’t this mean that they will fragment the service, taking away business from NHS hospitals that are subsequently forced to close? A guarantee around this would be very welcome.

    thanks!

  • Tony Greaves 10th Mar '11 - 3:12pm

    There are no such guarantees to be given, and the spin that matters is that from Andrew Lansley for Tory audiences, not Paul’s attempts to cover up a thoroughly Tory policy (not in the coalition agreement in the form it has been put forward) with nice sounding words.

    I do think that the debate and votes on this motion at conference will go quite a long way to determining whether there is still an autonomous Liberal Democrat party in existence in the future or whether we will be absorbed as the National Liberals were absorbed. It is a crucial issue, and probably more toxic for this party than tuition fees.

    But the real question really is whether the purpose of the Liberal Democrat conference is just to rubber-stamp Coalition policies whatever they may be, or to declare distinctive Liberal Democrat policy.

    A secondary question (on which I have less confidence in the outcome) is whether Paul will not only “listen” but – if conference goes against his coalition policies – he will go back to his department and argue strongly for some serious changes.

    Tony Greaves

  • Depressed Ex 10th Mar '11 - 3:18pm

    Shouldn’t the “listening to members” have been done BEFORE the provisions for health in the coalition agreement were ripped up and replaced with Andrew Lansley’s scheme?

    It would be interesting to know who exactly in the party was consulted before that was done.

  • Having intended to resign the party over this issue – I was persuded to wait until th eoutcome of th edebate this weekend.

    Paul’s article does absolutley nothing to restore my faith in our Party. Tony G as so often hits the correct nail on the head.

    As worried as I am about the damage this will do to our Party – I am so far more woprried about the damage to our NHS and to the nature of the relationship between GPs and patients

  • Emsworthian 10th Mar '11 - 4:03pm

    I agree with Tony. No service private or public is perfect but the NHS since its inception has done a good job and no doubt could do an even better one but not under Lansley. Like Cassius this guy has a lean and hungry look some might say obsessed and angry to boot. He’s toiled into the wee small hours for years to bring his personal dream alive. Patient choice is pure crowd pleasing guff-I want an effective service when I need it and whether it comes from Dr Spock or Tooting General is not important All the effort replacing the present bureaucracy with a new one is scandalous and I hope conference has the guts to say so.

  • And at the last general election the Liberal Democrats stood on a manifesto commitment to “commission services for local people from a range of providers on the basis of a level playing field”.

    Actually, the Liberal Democrat manifesto at the last election said on page 43:

    “Giving Local Health Boards the freedom to commission services for local people from a range of different types of provider, including for example staff co-operatives, on the basis of a level playing field in any competitive tendering – ending any current bias in favour of private providers.”

    I see you conveniently left out the first part of the sentence about Local Health Boards commissioning services, but why did you feel the need to cut out the bit about staff co-operatives? Are staff co-operatives not going to be allowed to provide NHS services under the Lansley plans?

  • It is fundamentally a misallocation of resources to put competition into the provision of health services.

    If the NHS has the money to pay for a private provider to supply the service (and make a profit) then the money should be there to provide the service in house.

    It is only dogma which states that “private sector = more efficient” that is the rationale behind this whole movement. The fact that the private suppliers are able to externalise the costs onto the public (e.g. if something goes wrong the patient will be taken to an NHS hospital, their staff will be trained at the public expense) is all that will give them a cost advantage to generate the profits.

  • This statement from a report in Pulse yesterday shows that the government intends that the Any Willing Provider policy to be about wholesale privatisation of care pathways:

    ‘Ms Parbinder Kaur, project lead for the hubs, said: “The push has come from GPs. They are open to the market coming in with new ideas.” She said a string of meetings with GPs and private providers had shown both had “appetite” for the idea, with the next stage a bidding process for contracts, which are due to go live in April 2012 to fit with the Government’s ambitious transition timetable: “It will INVOLVE A COMPETITIVE TENDER. We expect this to involve a combination of third-sector, independent-sector and NHS providers.”‘

    The intention is actually to exclude patients and to offer only “integrated pathway hubs” that have been competitively tendered to private contractors.

    Why are you albeit flimsily defending this policy , Paul? Have private providers funded your private office, have they funded the party like they have in the case of Lansley?

    If the answer to either of these is yes then you should resign immediately – there’s a clear conflict of interest.

    I just don’t get this, we lie 20th in the world in terms of healthcare funding (way behind France and Germany who are 3rd and 4th respectively) and have one of the finest health services in the world with outcomes due to overtake France this year. Why can’t you look at the evidence and just leave the NHS alone as was promised – is it Labour’s fault?

  • Stephen Donnelly 10th Mar '11 - 9:04pm

    @Dominic Curran : “Does it mean that any provider, private or voluntary, can bid to run a formerly NHS service? If so, doesn’t this mean that they will fragment the service, taking away business from NHS hospitals that are subsequently forced to close? ”

    Why is this necessarily a bad thing for patients ? Why do some ‘liberals’ think that healthcare can only be provided by the public sector ?

    I am very worried by the Lansley proposals, but not for those reasons.

  • Listen to members? Well that will make a change. But I am afraid Burstow, who has been wet wet wet all along, a lapdog to Lansley’s deeply flawed and ideologically driven master plan, has zero credibility now with anyone who knows anything about the NHS. There is so much wrong with this bill, and the political balance of power so weighted, that there is no solution but to reject this in its entirety, and go back to the drawing board, with full consultation and involvement of public and professionals, a full process, and then we might have something resembling intelligent, well designed policy to build up the NHS for the future, not tear it down no matter how many people tell you it is a mistake.

    Burstow has said ‘ not doing anything is not an option’ – fine, it is in the nature of the thing that the NHS will need to constantly change and adapt – but we need the RIGHT change. It has to be said that there truly is NO mandate for this change, the Tories deceived us and I am disgusted to have read somewhere yesterday a LibDem message to the effect that this was not in the coalition agreement so we can get away with supporting this. WHAT? Is that all the respect you have for the people who elected you? Is that the kind of policy you want to be making? Is that the kind of NHS the people of the UK deserve.

    Seriously – have the guts to tell Lansely that he has not only been devious and deceitful but incompetent – no surprise really given the undue haste and lack of consultation and process that underlies this – and to pack his bags. He is not the right man to reform the NHS. We need you to have the political courage to stand up to him and Cameron and stop propping up this rotten bill.

  • ‘They say that Caroline Nash, wife of John Nash, the then chairman of Care UK, gave a personal donation of £21,000 to Andrew Lansley, to fund his office when he was shadow health secretary.

    John Nash is one of the founders of Sovereign Capital, a private equity firm with interests in the healthcare sector. He is also a member of the Independent Challenge Group, set up in June last year to advise George Osborne on spending, which has previously pushed for efficiency savings across the NHS and cuts to social care and cancer research charities.’

    Andrew Lansley must resign – this conflict of interest shows that he has ‘influential’ friends in the wrong places.

    As for you, Paul Burstow, why are you just acting like his poodle?

  • Steve Hicks 11th Mar '11 - 4:19pm

    St Ives Liberal Democrat MP, and Health Select Comittee member Andrew George has outlined why he will be urging delegates at Conference to send Paul Burstow a big raspberry over the leadership’s health motion: http://bit.ly/gTsDsi

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