Baroness Liz Barker writes: Liberal Democrat peers working to secure an NHS fit for the future

After five weeks of detailed, intensive scrutiny the House of Lords is about to start discussing Part 3 of the Health and Social Care Bill. This is the part which deals with the role of Monitor and EU competition law.

Building on the work of Nick Clegg in June this year following the listening exercise, Liberal Democrat peers are working hard to ensure that the legislation fully reflects our policy that competition should be strictly limited to those areas of commissioning and provision where there is evidence that it improves patient outcomes.

We will continue to argue that there should be nothing in the Bill that will open up the NHS to challenge by large private healthcare companies.

Liberal Democrat peers will be tabling a series of amendments which question the role of Monitor. The main duty of Monitor, as currently set out in the Bill, is to “protect and promote the interests of people who use health care services by promoting provision of health care services which –

(a)    is economic, efficient and effective, and

(b)   maintains or improve the quality of services.

In exercising its functions Monitor must “prevent anti-competitive behaviour” and “enable integrated services” when to do so will improve the quality of services or reduce inequalities.

We  have tabled several amendments which probe how Monitor will balance those three functions.

We will also argue that complete removal of the cap on Private Patient Income is likely to increase the risk that Foundation Trusts would be deemed to be undertakings. If that were so, private companies might be in a position challenge the right of the NHS to run hospitals. Since that is not the Government’s intention, we think it would be best to avoid any doubt by limiting the amount of private work undertaken by NHS hospitals.

Liberal Democrat peers are working to secure an NHS free at the point of need and fit for the future.



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  • Simon Bamonte 7th Dec '11 - 7:02pm

    We were promised “no top-down reorganisations of the NHS”.

    These “reforms” are not in the coalition agreement. Nor are they in either party’s manifesto.

    The public and medical profession alike do not want these reforms. These are probably the most unpopular and unwanted reforms of this whole government. Why is it so hard for Lib Dems in government to do what the people want them to do, rather than what the Tories want YOU to do? Is giving us reform we were told was not on the cards not highly anti-democratic?

    Coming to a graveyard near you, a tombstone that says :”R.I.P. Lib Dems – destroyers of the NHS”

  • Why are you trying to privatise NHS Would you have backed this bill if you were not in coalition with Tories I suggest you support it like the Tories supported electoral reform.You are acting like an abused wife always making excuses for your husbands behavior

  • Tony Greaves 7th Dec '11 - 8:46pm

    We are not “trying to privatise the NHS”. We are doing our best to make sure that the Tories cannot use this Bill in future to “privatise the NHS”. If you had read and understood what Liz wrote you would have seen this.

    A little attention to the 60 hours of discussions in the Lords committee stage would show you that far from “destroying the NHS” we are working very hard to prevent that happening. Some support from outside instead of knee-jerk condemnation would be helpful.

    Tony Greaves (Lord Greaves)

  • Well I’m afraid you’re still allowing the public health function to be decimated and lost and there are risks for the NHS overall but thank you for trying. The public health issue is huge but a v small part of the Bill and most people (including ministers) don’t really understand the impact of the changes.

  • Daniel Henry 7th Dec '11 - 11:32pm

    What Tony said.

  • …………………..A little attention to the 60 hours of discussions in the Lords committee stage would show you that far from “destroying the NHS” we are working very hard to prevent that happening. Some support from outside instead of knee-jerk condemnation would be helpful………..

    Sadly, even Shirley Williams ( who spent most of September complaining that many of the ‘reforms’ were cosmetic) abstained in the October vote, even though most of her concerns had not been met.
    “Hansome is as hansome does”

  • David Allen 8th Dec '11 - 4:55pm

    “Sadly, even Shirley Williams ( who spent most of September complaining that many of the ‘reforms’ were cosmetic) abstained in the October vote, even though most of her concerns had not been met.”

    Yes, and it would be nice to know why. My suspicion is that it is what happens when you try to drive some sort of bargain when negotiating from a weak position. At some point, the guy on the other side offers you the option of either shaking hands and thereby gaining a few concessions towards your point of view, or refusing to shake hands and gaining nothing at all.

  • Leekliberal 8th Dec '11 - 7:02pm

    Keep up the good work you Lib Dem peers! While others prance around and display it is you who will make this ugly duckling a little fairer!

  • I am a fairly old grandmother and before I am accused of being a troll, as frequently seems to happen, on this website, where contrary views are expressed,this is my first,last and only comment on this website.
    I have tried and failed to get my head round the LD position re the NHS changes, which are now opposed, in their entirety, by the B.M.A and majority professional and public opinion.
    It beggars belief to me that on the first two readings, all of your MPS voted for this Bill and on the third reading, which was bounced, at speed, through Parliament, only four voted against, to my recollection.
    According to the Guardian, senior LD sources said at the time, that Nick Clegg had said that your party would not be long in power, if the bill was unduly delayed.
    I am doubting that Clegg even read the entire Bill, but his name and that of your party, is on it and you will be held to account by the electorate, when the time comes.
    In the Lords, your peer, [sorry, name forgotten, senior moment,]accused members of the public, e mailing him,in order to exercise their democrat right to be heard, as being a rentamob.
    First of all, Mrs Williams, [another fallen hero, so far as I am concerned,]hails some minor tinkerings, as a great triumph for Nick Clegg and then does a total u turn, in her criticisms of the proposed changes to health,[I will not call them reforms.], but then does not vote.
    So many of the peers, of all parties, have private health interests and I understand that your party has had money given by a private health company.
    I am a member of no politicial party, but am saddened that the gains in health, in the last decade, are being jeopardised, by this coalition and their unwanted and unmandated changes, which have been enabled by the LDs.
    I am afraid that there will be a day of reckoning and for many, health is the one big issue.So many of my friends, who voted LD, because they thought you were different, would never consider voting for you now.
    It really looks as if hanging on to power is the main consideration.

  • David Allen Posted 8th December 2011 at 4:55 pm

    David, is that what the LibDems have been reduced to? Thankful, in accepting a place in the house, for “crumbs from a rich man’s table”

  • David Rogers 9th Dec '11 - 8:07pm

    It’s very clear to me that Baronesses Jolly and Barker, Lord Greaves, and indeed many other Peers (not limited to Liberal Democrats) are striving to ensure that this Bill leaves the House of Lords in a much better shape than when it entered. Key principles are being re-stated, and much detail clarified.
    If “according to the Guardian” is the prism through which “a fairly old grandmother” and others are viewing what is happening, then it surprises me not at all that they should hold such views as they express. Fortunately, the circulation of that once great newspaper is relatively small.
    Furthermore, none of the comments above make any mention of the considerably enhanced role for local government which is envisaged, both through Health and Wellbeing Boards, and the return of Public Health to its rightful home alongside all the other functions that shape the communities where we live. The proposals in this Bill extend local democracy and accountability; have the potential to achieve far greater integration between social care and health, and should be welcomed as such.

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