Last March, I spoke at the Sheffield Conference in support of the motion that led to radical changes in the Health and Social Care Bill. By the Summer, much of the Bill had been changed and I was able to write that the Bill was much improved.
I felt that we should be proud as Liberal Democrats for thwarting the initial plans.
My colleagues in the House of Lords have made more very important changes to the original plans. On Tuesday I told the House that, “I believe that that culmination of changes will enable us to bring about an improved NHS. I may be proved wrong. I freely accept that I may be proved wrong. But I believe that the changes that have been made are so far reaching that we can make the NHS better than it is today.”
I hope that party members concerned to see what we have achieved will read what my colleagues have said in the the debates in the Lords. We should be proud of our key role in safeguarding core principles of our NHS. I firmly believe that starting all over again with another year of debates and another year of uncertainty over the future of the NHS would damage those principles.
Arguments about competition have been at the heart of the changes that we have made to the Bill. In this week’s debates, I said that it was wrong to say that, “either we have a competitive market for the National Health Service or we have no competition at all.”
You can see my remarks on this subject on parliamentlive.tv
I said that, “We all know that there is a role for competition but the argument is about what the restraints on it should be, what it should be addressed to and whether it is then balanced by, for example, equally strong duties in relation to co-operation, integration and the bringing together of services.
“We all recognise that competition can make a significant contribution in innovation and bringing in new ideas. For example, we have only to look at the recent developments in the treatment of stroke victims and victims of heart conditions to see that there has often been an innovatory role for the private sector.
“However, many of us also believe, as I certainly do, that the National Health Service should continue to be primarily a public service, that it should be available free of charge and that it should be accessible to all.”
In response to Labour’s campaign on the bill, I also had to say that “I am thoroughly fed up with reading pieces on social network sites, such as Twitter, which have presented this debate in terms of how we voted on the last amendment and if we did not vote for it then we must be in favour of the marketisation of the NHS. That is simply absurd and it makes me very angry.
“It adds to what has become a silly debate, a fictional debate which has led a great many people to believe that what is being discussed here is not at all what is being discussed, but some other strange, nightmare battle between marketisers and public service supporters and no possible compromise can properly be reached between the two. I feel very strongly about that. I am fed up with reading about how I am actually a secret marketiser, when I know perfectly well that I am not.”
* Baroness Shirley Williams is a Liberal Democrat member of the House of Lords, a founder member of the SDP and the Liberal Democrats and author of several books including her autobiography, Climbing the Bookshelves.
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Why take the risk, when the outcome is so uncertain, the measures so overwhelmingly opposed by majority professional and public opinion and in the light of a neccessity to save £20 billion ? It does not make any sense.
Shirley
Let’s aside the excesses of Twitter debate, Labour’s campaign, and justifiable pride at reducing the dreadfulness of the draft Bill. Instead, perhaps you could outline why the Bill is what the NHS needs, and how the objections raised by Evan Harris and others are addressed by the Bill in its current state.
Well done Shirley. You are correct. You are seeing the big picture, the long view. The unfortunate arrogance of Tories, their connections to big business, the consequent absence of careful explanation, the poor drafting of the original bill, and our unfortunate relative weakness, has traumatised many supporters. I suspect that people will also need a little more reassurance on some of the more detailed issues, and some assurance that there will be active and competent parliamentary oversight that will catch any issues that do arise in future, and to update parts of the Act if necessary.
I can understand Dame Shirley being angry about slurs on her personal character and beliefs, but has she freely admits she may be wrong on the bill.
I think that she is, and as an someone who greatly admired the principles and beliefs of her mother and then Shirley herself, I hope that if it all goes pear-shaped she doesn’t get the flak.
There are just too many risks in this bill as far as I am concerned.
@margaret – but are they opposed by patients? Of course professionals should be listened to yet we seem to have this huge religion in this country that the NHS can’t change or be reformed. It’s time for that reform (as it is in all the other reforms that have been ignored over the past 30 years). None of the critics put forward any alternatives – it all seems to be like far-left rantings.
I very firmly hope that politicians do get serious flak when their acts go pear-shaped. Sticks are helpful as well as carrots. But I don’t think this one will.
“It adds to what has become a silly debate, … some other strange, nightmare battle between marketisers and public service supporters and no possible compromise can properly be reached between the two.”
I think that gets to the heart of what Shirley Williams has tried to do. She has worked very hard to negotiate a compromise which is not as bad as the original plans. Now, if negotiation is what you aim to do, then you must at some point be prepared to swallow all your remaining objections, shake hands, and say “It’s a deal!” Because, if instead you say “Please make some concessions to my point of view, and then I’ll just carry on opposing you and slagging you off as loudly as possible”, then you don’t persuade the other side to make any concessions.
So what Shirley has done is honourable. That doesn’t mean it has to be right.
Like most people, I don’t honestly have much of a clue as to which bit of Section 3 is critical and which isn’t. I sense that it is Shirley’s side which has had to make the important concessions on this, if only because nobody on Lansley’s side is screaming that the latest changes ruin the whole thing from their point of view.
But even if I’m wrong about that – which I might be – Just look at what is now the settled view of the profession and of the public, that this is a lemon. Just think what will be the publicity as the cuts bite over the next few years.
Good try, Shirley. But we ought to walk away from the deal you negotiated, all the same.
Richard and John have it right, in their support for Shirley’s long-term view . There is no doubt that many factions have conspired to create fear and disbelief amongst Lib Dems and the public as a whole. As Nick said last September: “I’ve also encountered fierce resistance from those who do so well out of the status quo. But for liberals the only struggles worth having are the uphill ones……..All controversial. All difficult. Not easy, but right.” And as I heard directly from a GP yesterday, anxious to get on with the challenge of CCGs and local democratic accountability, “If all the Royal Colleges are against it, it must be right!”
Instead of complaining about the lies, why don’t you explain why this bill is needed, how it will work and the problems it will fix. I’ve yet to see anyone who can demonstrate that this bill is a good thing – but you want to try? Go for it.
If someone says they are going to burn down a school building when it is filled with school children you don’t then celebrate when they compromise to letting the children leave first. You stop them burning down the school full stop.
We need positive reasons why this bill is required and we need clarity in explaining what it actually does.
Simply saying “there is no alternative” or “we’ve tabled 1000 amendments” doesn’t then mean the bill is good.
@Timak. But the building is burning right now, and the bill is the fire brigade that will save everyone.
I’m afraid today’s detailed debate on this or that ammendment is just part of the rapid, wholesale Liberalization of UK society which New Labour began and will surely continue into the next government.
Given the overwhelmning strength of Neoliberal beuracrats running the major parties, there seems little hope to halt or reverse the process of Liberalization in areas such as health, primary edeucation or the police.
Of course, Labour could lurch back to centrist politics. and given an electoral victory in 2015 could repeal this bill even before it was implemented.
However, even if our political parties remain aligned in their undemocratic Neoliberal triumverate , there is the additional factor of cessation from Westminster to consider.
The LibDem party should be under no illusion that cessation in Wales and Scotland was a direct outcome of the loss of social democratic options at the ballot box, if you have no progressive option to vote for, then your only option is to leave the sinking ship.
Scotland is already well down a path to cessation, as is Wales. In the near future, we will hear more demands from the regions of the UK to separate from our Neoliberal Establishment. Potential regions which may leave the UK in the near future are the Unitary authority in Cornwall and the North of England, which has already seen a proposal for devolution under New Labour.
Whatever the outcome of the above scenarios, the LibDem party faces a catastophic loss of its MPs in 2015 and the dissapearance of the LibDem party in the House of Commons. Tme is running out to return to the 2010 manifesto, party policy and conference motions, boycott Coalition policies and save the NHS.
@ Riff, an excellent challenge.
I hope someone takes you up on it.
Paul – “Scotland is already well down a path to cessation, as is Wales. In the near future, we will hear more demands from the regions of the UK to separate from our Neoliberal Establishment. Potential regions which may leave the UK in the near future are the Unitary authority in Cornwall and the North of England, which has already seen a proposal for devolution under New Labour.”
They won’t – because they know where the money comes from. PS – I think you mean secession.
every politician could be proved wrong by the passage of time, shirley at least has the humility to admit such, if only brown had said he may be wrong about abolishing boom and bust, and acted accordingly, if only blair had admitted he may be wrong on iraq…
but politicians should not refuse to act unless they are certain, if they do that, nothing will ever be improved
Paul, I didn’t think it was all over for Scotland – but maybe it is now!
As Wikipedia says: “Threats of secession also can be a strategy for achieving more limited goals.”
my spelling isn’t brilliant, but I’m always learning, so secession vs cessation was today’s lesson!
Remember the University fee debate in the late 90s, and how everyone debated the detail, the safeguards, the bursaries and so on, and now we are being brainwashed into thinking it’s OK to charge a 17 year old 9k for their degree. Now with the HE budget cut about 90% and fees tripled, we are seriously debating coporate universities.
We can make similar comparisons with welfare, schools and so on, today’s proposed safeguards to protect services usually turn out to be deliberaltely flimsy, impractical and effectively a whitewash.
Shirley Williams and many LibDem zelaots might be sold on the NHS bill ammendments or not, but we need to remember those examples I’ve mentioned and how this bill is typically just a phase in a process to a much scarier liberalization round the corner.
“I’m afraid today’s detailed debate on this or that ammendment is just part of the rapid, wholesale Liberalization of UK society which New Labour began and will surely continue into the next government.”
I wish that we were seing the ‘liberalization of UK society’. I’d quite like that, being a liberal and all. Seriously, ‘liberal’ is a beautiful word. I don’t ever understand why people on the right (o,r less frequently, the left) use it as an insult.
I’m disappointed that the party are so scared of a proper debate on this that they have
…put Shirley Williams’ motion up as an attempt to stop the emergency motion on the NHS as a rival. Many of us respect Shirley tremendously.
@Riff. “I’ve yet to see anyone who can demonstrate that this bill is a good thing ” I made a start at this a couple of days ago (a thousand posts ago!).
Essentially I see benefits from (a) the re-distribution of power away from the centre, which should help to motivate health professionals and others involved in the NHS, makes better use of people’s skills, and encourages innovation, and (b) using competition as a driver for increased quality as well as for reducing costs while maintaining quality. I also think that the new system will be more transparent and accountable to the general public, and more responsive to people’s needs, and that the proposals will ensure unified standards of quality across the country. The actual bill is available on http://www.parliament.gov.uk, and you can check that it does do these things, and that it is realistic about things like control of potential bad behaviours (through Part 3 and Monitor).
I’ve also looked at the Pugh proposal, which is to drop this bill and replace the current NHS with a number of separate local healtth services, without any centrol control or accountability for spending or for decisions on what services to provide locally, and without any guarantee of unified standards of care. You won’t be surprised that I find the Pugh proposal ridiculous.
But yes, this doesn’t address all the questions you ask, and I do think that the positive benefits of the proposed system need to be better explained at a higher and more competent level than humble me.
Two words I’m afraid; Electoral Suicide. This is what happens when a government, for whatever reason and with its eyes wide open, decides that it will go in a diametrically opposite direction to the (almost universal) will of the people. After this, the only people who the LIbDems can blame for the inevitable “disaster at the poll” will be themselves.
Shirley, you called for the with drawing of section 3 on competition at one stage but seem to have rowed back from that rapidly with the Clegg letter. It’s possible you may have been misquoted or misrepresented at that time but at no point have I seen you rebut that statement.
It seemed like a sensible compromise to me, so why did you get cold feet?
The Country is in thrall to neo-liberal economics. There are institutions that are worth having even if running at a loss. Witness the crazy money spent on the banks. Look what happened to student fees. Some things have an inherent value that is beyond price.
I came across this article accidently from a guardian cif post. And whilst I don’t condone individual name calling, I also cannot condone this complete privatisation by the back door of the nhs and police or the cuts to disabled people and genuine benefit claimants to name but a few of the atrocities currently being voted in. I have often toyed with the idea of voting Lib Dem, but never have. I have in the past been dismayed with myself for not doing so, but right now am feeling more than a little vindicated in this decision. I feel that the Lib Dems have passed up the best opportunity they have ever had for making a real difference. When I first realised that there was not going to be a majority parliament, I was worried sick for the future, but the thought of the Lib Dems stemming off the worst of the Tories made me slightly easier and even hopeful that this could work. It hasn’t though. It most definitely has not worked. Where is the Lib Dem fight? Why get into bed with the Tories at all if you cannot stick to your founding beliefs? Walk out, oppose their extreme bills, stand up for yourselves goddammit. I had thought a lot more of you than this. The Tories started the privatisation, New Labour moved that forward somewhat, that doesn’t make it right. It doesn’t mean you can stand by with amendments saying you’ve done your job and it could be worse. Fight! Only the Lib Dems are in the position that they can do that. Fight like you’ve never fought before, because by 2015 there is going to be nothing left. Once something is privatised, it is extremely difficult/impossible to reverse.
“Good try, Shirley. But we ought to walk away from the deal you negotiated, all the same.”
How patronising can you be? How many of the people posting here have anything like the knowledge of this issue that Shirley has acquired during these long months in which she (with her colleagues) has been fighting the kind of battle that she has been doing for all her long life. I admit that my knowledge in this complex area of policy is limited but I do know who I trust. Who has done more to earn that trust than Shirley Williams? She has my support.
Denis: the party machine counts on the majority thinking your way, hence the desperate attachment of a “brand” to the motion. Seen that ever before? Hmmm.
Godfrey is spot on. But political judgement is in very short supply in our leadership. Oh for Charlie Kennedy!
The”party machine” you talk about, Growler , consists of the people who are running the central organisation of what is a uniquely devolved party. Do you think they have some hidden agenda which is trying to do us all down – in effect working against Liberal Democracy? Is there some other party with a more acceptable “party machine” or do you just not like any “party machine”.
Of course there are differences of view within any party and we get plenty of opportunity to air them. I just get a bit fed up with those who regard anything our leaders do as some sort of conspiracy against us. If I thought that I would leave the party.
Denis: the party machine to which I refer is the group of people intent on keeping themselves in government, regardless of the views of the grass roots of this party. Elsewhere someone has pointed out that “the Shirley Williams motion” is not an emergency motion at all.
When the big guns are wheeled out in this way, you know the leadership are scared of the membership. That is anti-democratic and illiberal, IMO.
I hope people realise that Labour do not really want us to drop the bill. And I hope they realise why it is crucial for the NHS, the nation and the party that we do the right thing and kill the bill. And I hope we prevent any other hare-brained schemes not in the coalition agreement from seeing the light of day.
If the Liberal Democrats do not block the NHS bill, which the overwhelming majority of all health professionals oppose then they will be finished as an electoral force.
Why are many Liberal Democrat members supporting a bill that they would oppose and kill in any other circumstances ? Why are the Liberal Democrats staking their future on such an unmandated, unpopular and dogs dinner of a bill ?
The risk register relating to possible difficulties of the bill must be published. It is likely that the risk register identifies the gaping holes and clearly spells out the difficulties of the legislation. It is very instructive that the Conservatives do not wish this document to be published until after the legislation has been passed.
It will be published or become available at some point. Those that passed the bill will be held to account for all the coming difficulties and mess over the next 10 years. This will be brought back to the doorsteps of those that passed it.
A reminder on last years liberal democrats amendments requested. Only 3 of the 8 amendments have been met. Not good enough.
http://www.guardian.co.uk/science/political-science/2012/mar/06/health-social-care-bill
Kill the bill for the majority of the country’s health and well being.
I would like to add that If the work is being given to Serco, Capita, Allied Health Care than that is more or less privatisation of the service. The existing NHS organisations will not stand a chance.
GP Commissioning will be given wholesale over to specialist private commissioning companies who may give whole services out to a private provider. The PCT is in effect being replaced by private commissioners. The NHS will be just a logo. Marketisation and competition will replace co operation. Service standards and availability will deteriorate whilst the private companies enrich their shareholders at the British Tax Payers and health users expense. All for Conservative dogmatic ideology that free market competition in every single area of life is the only way.
It makes me angry and weep that we are losing the most cost effective health system in the world. It can be improved but not these changes. If the Liberal Democrats do not stop this bill, I and millions will not forgive you (or vote for you) until our dying days. Thatcher had the Poll Tax, Blair had the Iraq war and the Liberal Democrats (and the Tories will have the NHS).
“And I hope we prevent any other hare-brained schemes not in the coalition agreement from seeing the light of day.”
I think the coalition ministers have learned their lesson from this health Bill. Namely, that exploitative privatisation of life & death infrastructure like our health service is not unpopular across the entire electorate.
So now, we see a new phenomenon, the secret, back-office negotiations for liberalization of the police force. The Conservatives only have a few more remaining years guarenteed in power and they have many other objectives in store, such as dismantling Royal Mail. We can guarentee the model of secret liberalization via non-legislative routes will be the norm until 2015.
…and we wonder why Scotland wants to break away from Westminster…
for ” not unpopular ” read “unpopular”…
What you ‘know perfectly well’ Shirley, will , I am sorry to say, be of very little consequence, to those who will suffer from your contribution to the selling of peoples health; their lives, Shirley, not yours.
It is not accurate for Shirly to maintain that Lib Dems contived amendments to a bad bill: Lib Dems peers do not have a majority in the House of Lords and could not have achieved anything without Labour and crossbench co-operation. Shirly has duped herself and it hurts me to say so. I fully expect the supine Lib Dem Peers to achieve nothing more and that they will stand with the Tories in quest of public office.
“It is not accurate for Shirly to maintain that Lib Dems contived amendments to a bad bill.”
More to the point, this “ba d bill” wouldn’t ever have seen the light of day if the party leadership hadn’t approved it – in its entirety – in the first place. They didn’t have to approve a word of it. It wasn’t in the coalition agreement – in fact the coalition agreement explicitly ruled out any major reorganisation of the NHS.
People like Shirley Williams can perhaps claim some credit for mitigating the effects of the Bill. Nick Clegg can claim absolutely none.
Shirley, I think it says it all when the conference members at at Gateshead did not believe you and voted against your motion, It was a disgrace that your motion was presented as a choice between supporting you or Andy Burnham as though it was a popularity or beauty contest. This trivialised an important debate, it is not about your popularity Shirley, but the future of the Health Service which people care passionately about. You also split the vote with your motion, but we all know that this was the intention in order to save Nick Cleggs face. People really resent it when you keep saying that people do not understand the bill, as though you have got a monopoly on understanding. People understand it only too well and that is why they are against it. It is a disgrace that you continue to try and insist that this bill is fit for purpose when we all know that it is not. Why does David Owen say that it will lead directly to privatisation of the NHS, are you saying that he does not understand the bill either. Thank God that many of your colleagues at the conference that more courage and integrity that yourself and spoke out against the bill. Ditch this bill.
Shirley, reading you article again and you expression of anger, well it makes me very angry that you turned a serious vote at the Lib Dem conference into a popularity vote between yourself and Andy Burnham. The future of the Health Service is a serious business, not some sort of party game, Disgraceful
If a Bill is half-bad then it is still bad!
This Bill is unpopular in the country and unpopular amongst the professionals . There is no mandate for these reforms and now, there is no support for the Bill from within the rank and file from one of the partners in the Coalition Government.
For Nick Clegg to paint this as ‘better than it would otherwise have been,’ or to goad his own party as seeing it as a tribal ‘Shirley or Burnham’ argument is profoundly and desperately wrong. If Nick Clegg is a true leader then he will order his Peers to vote against the Bill at Report Stage in the Lords, then his MPs to withdraw their support for the Bill when it returns to the Commons. Failure to do this, will be bad for his party and catastrophic for the Country – which, at the end of the day, is more important than Nick Clegg desperate desire to demonstrate that coalition’s work.
Follow the link for my full piece on this:
http://www.allthatsleft.co.uk/2012/03/lib-dems-vote-to-save-the-nhs-so-where-does-this-leave-nick-clegg/
@Ray North. Do you have any evidence to support your claim that the bill is unpopular in the country?
There are plenty of journalists making noises for their bread and butter, but has there been a survey of the electorate on this matter? It also seems that not every health professional is against the bill.
@Richard Dean
All the polls have pointed to the fact that a “majority” of the public are against this bill, so I would pretty much say that is evidence.
I think it is also clear that the majority of the health care professionals are against this bill.
What the RCGP have said today is that they are “prepared” to engage with the government on how to proceed forward. That should not be spun into something it’s not, implying that they now support the bill.
What they are saying is, lets get round the table and “talk” and work together on improving the bill and the NHS Reforms.
Which is exactly how it should be, but only if Cameron and Lansley pull their heads out of their backsides and engage with everyone, rather than just inviting those that agree with them
@matt. Thanks. I don’t want to be a bother, but do you happen to know a link to a newspaper report of one of the polls, or to the actual poll results? If we know what people think in detail, then we have a chance of addressing their concerns, and of recovering from the present place..
Sure it’s no bother Richard Dean 😉 here you go for starters
http://ukpollingreport.co.uk/blog/archives/4940
http://www.onmedica.com/NewsArticle.aspx?id=d2cad18c-b180-4e0e-ad8d-9afd7fa2f2dd
http://www.telegraph.co.uk/news/politics/9094948/Poll-reveals-more-than-half-of-voters-back-abandoning-NHS-reform.html
http://news.uk.msn.com/uk/scrap-nhs-reforms-say-msn-readers
there are many more, but I am sure with a little effort you will find that a majority of those people who have been asked how they feel about these reforms, The majority are against and want the bill dropped. If you include the those who are not sure because they don’t understand the bill, I would imagine most of them would also be against the Bill if the Government decided to be honest about these reforms and include the risk register.
@Matt. Thanks! That’s an extremely interesting report and I hope people look at it. The report seems to demonsytrate quite clearly that Ray North is inaccurate, and I wonder if you yourself have looked at what it says? Here are some of the things:
> the first sentence of the report points to a Health Service Journal report that says the public is SPLIT over the use of private companies in the NHS – this i quite different from the impression given by Ray North’s comment!
> Item 1 in the report says “an awful lot of people don’t seem to know enough about the policy to have any opinion”. This seems to suggest the electiorate don’t care that much
> item 2 says the most people USED TO think that competition would make things worse, but that today’s IPSOS pol shows people EVENLY SPLIT on the question “as long as health services are free of charge, it doesn’t matter to me whether they are provided by the NHS or a private company” (slightly more people agreed than disagreed)
> item 3 says that a recent poll for the well-known “38 degrees” gorup, who are anti the bill, says 2/3 of NHS staff oppose the bill, implying I suppose that 1/3 support it
> Items 4 says that people still trust the conservatives on the NHS
All this is good news for Clegg, WIlliams, and what appears to be the majority of the LibDem partliamentarians’, who seem to want to make some further amendments but the basically pass the bill. I suggest that it gives a rather strong indication that the anti-bill feeling in the electorate is not very strong at all, and that the anti-bill half of the LibDem voting reps are out of touch!
Comments on my analysis would be very welcome!
Andrew George MP has apologised for saying that Shirley Williams didn’t write the motion:
https://twitter.com/#!/AndrewGeorgeLD/status/179302492985761794
He previously wrote:
“1. it came from the Leader’s office;
2. Shirley was the last to see it, close to the submission deadline”
Perhaps this nasty rumour will be put to bed now!
James
Let’s kill a few myths.
Over 600 Lib Dem delegates voted in the emergency resolution ballot which was a choice – by STV – between 4 different motions, 2 on the NHS and two that had nothing to do with the NHS. Unless people are implying that Lib Dem delegates are unable to distinguish between 2 different views on the NHS Bill or that they are so stupid as to vote indiscriminately for anything put up by Shirley Williams, then it is fair to say that the resolution on the NHS that was chosen could not have been influenced by the views of the leadership because too many people voted for that to happen. Ipso facto conference delegates preferred the motion put forward by Shirley Williams to the one put forward by the Social Liberals.
It is also completely inaccurate to say that the conference voted against the NHS Bill. That’s not what the resolution that was passed said at all. It called for further changes. What did happen was that 2 lines were removed that called on the Lib Dem Peers to vote for the bill if certain changes were made. This means, in effect, that the conference decided to leave that decision to Lib Dem peers, because no instructions were issued one way or another.
The debate on this bill has been riddled with inaccuracies and most of the people attacking it don’t actually know what it says, mainly because it has been changed radically since its original inception. I understand that we wouldn’t start from here but this is where we are.
http://www.guardian.co.uk/society/2012/mar/15/devon-nhs-childrens-services-privatisation
The taste of things to come. Richard Branson and Serco, who have no knowledge of a specialist service battling it out to run a whole specialist and vulnerable area wholesale.
They have plenty of knowledge how to bid or contracts and how to use competition law if they don’t win.
The NHS is being given away to be run by private providers. Note also how the bidding process is in the 4th stage.
Has the Health & Social Care Bill actually been passed yet ?