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.