I spent some of last Saturday morning in the briefing session at the Lib Dem Conference with the Lib Dem parliamentary health team sitting just in front of Andrew Sparrow and Patrick Wintour (both of the Guardian) as Shirley Williams laid into Polly Toynbee’s account in their paper of a key amendment on the Health Bill. For those of us who are fed up with Toynbee’s ‘tribal’ attacks on the Lib Dems it was a joy to listen to.
Andrew Sparrow wrote a great account of Shirley’s clear rebuttal of the Toynbee attack. He tweeted that, “It wouldn’t be a Lib Dem conference without someone having a go at the Guardian”. I then tweeted that it “Wouldn’t be the Guardian without some distortion from some columnists of #LibDems”. Patrick Wintour was quick to point out to me that he wasn’t a columnist. I actually think that he is one of Britain’s best journalists and his account of the Health debates at conference was probably the best that appeared this week.
The debate continued on Monday as Polly Toynbee hit back at Shirley Williams claiming that the cap on private income for hospitals would not prevent trusts seeking to rise to that level. The problem with this argument is that it ignored other concessions secured by the Lib Dem team such as the one last week ensuring that any proposal to increase beyond 5% can be challenged by Monitor. It also ignores the series of major amendments that were resisted for so long by Andrew Lansley such as those guaranteeing the Secretary of State’s responsibility for a comprehensive health service, power to intervene if things go wrong and accountability to Parliament. Polly Toynbee justified her her position by drawing attention to how “a second NHS hospital this week put itself up for takeover or private sale, after Hinchingbrooke was called a ‘one-off’. But she ignored the facts that the process for selecting Circle to operate Hinchingbrooke hospital started under the last Labour government, and the decision to transfer the management was made using powers set up by Labour in 2001.
A good defence of Shirley’s overall position also appeared in the Independent on Monday. For many Lib Dems it will be a question of whose judgement you can trust as well as what you know of the facts. Some of us will remember Polly Toynbee’s rejection of the pro-merger views of her fellow SDP members and her decision to back the ill fated Owenite SDP in its attempt to spoil our efforts to launch the Lib Dems. Owen’s ‘party’ failed spectacularly but its spoiling role contributed to the Tories narrowly winning a fourth term in 1992 he backed Major. Nor will we forget how she urged people to ‘put a peg on their nose’ and re-elect Tony Blair in 2005. If Labour had failed to get an overall majority then, Britain would probably have a very different government and political system today.
The most offensive attack on Shirley Williams, however, did not come from the Guardian but from Labour’s Lord Hollick (in comments tweeted by Labour’s front bench). He compared her to Lord Haw-Haw. Given that her mother was high on the list of people of people the Nazis intended to deal with if they invaded (her name was close to Churchill’s on the list) this is particularly offensive. Having attended some of the health team meetings in the Lords I also know that it was completely false for some of her opponents to suggest that she did not write ‘her’ motion to the Conference.
In terms of where are now, I thought that Shirley made another brilliant contribution to our debates in the Lords yesterday. It was not the position of someone betraying principles, nor of someone being subservient to the leadership but a candid view of what is best now and it is well worth reading.
* Chris Rennard is a former Chief Executive of the Liberal Democrats. He has led for the Party in the House of Lords on the Electoral Registration and Administration Bill
Follow @libdemvoice.org on Bluesky
Like us on Facebook
Subscribe to our feed
Sign-up for our daily email digest
Will Labour fail to act on key child poverty issue?
Marion Mould jumps The Sound of Music on Monty Python
Re-opening The Whinnies
Another former Labour councillor joins Lib Dems in Dudley
West End weekly ward surgery tonight #dundeewestend
Michael BG
Nonconformistradical
Mick Taylor
Peter Davies
23 Comments
Thanks for clafifying that Shirley Williams actually wrote the Shirley Williams’ motion. One key question would be did she also choose unprompted that it should be titled (in part) the Shirley Williams’ motion?
“Lord Haw Haw”? I thought that the House of Lords was meant to be a sober and serious place for debate (and therefore not in need of any reform)?
The debate over the NHS goes into details that I and I suspect most people cannot possibly comprehend. However I would feel a lot happier if the professional bodies within the NHS that do not normally have an axe to grind would recognise the advances made by the Lib Dem Lords teams. Yet they remain implaccably opposed.
My perception is that these NHS reforms were dreamt up by a bunch of ideological Tories working for Andrew Lansley who see opposition from the NHS as a sign that they are doing something right, that they are attacking the vested interests who want to resist change. On top of that of course, these changes will also benefit many private health companies of which many Tory MPs and peers – plus some in the Lib Dems and Labour as well, will benefit.
I was talking to a Lib Dem MEP recently who is an expert in the NHS and she told me that it is possible to make big savings in the NHS and that this can be achieved by working with the professional bodies rather than ignoring them.
I cannot make that case myself. Unfortunately it was Andrew Lansleys decision to impose these reforms without proper consultation or a desire to win some kind of concensus for these changes. This makes me instinctively feel this is wrong, just like the poll tax the Tories tried to implement many years ago.
During the general election David Cameron famously claimed he would not support a top down reorganisation of the NHS. Nor did the Tories ask that this go into the Coalition agreement. There is no democratic legitimacy for the bill just as there was no democratic legitimacy for tripling tuition fees. So why are we repeating this same mistake all over again?
Correction, end of paragraph 2; “will benefit as shareholders”
Excellent piece Chris! Certainly a change from Toynbee’s 2009 view that “The wholescale mass privatisation of a service is rarely needed, but a little gingering up round the edges has an electrifying effect on sleepy outfits.”
It is also good to see Andrew George MP apologising for putting it about that Shirley did not write the conference motion, was showed it 5 minutes before the submission deadline, and that it was drafted by the leaders’ office (as he wrote here and here.
James
I attended a meeting of the Liberal Democrat peers this afternoon. The discussions are of course confidential but my observations were and are that they are not living in the same universe as most of the people in this country, or indeed in our party.
I have no time for Toynbee and I don’t even know who Lord Hollick is I (that is to say I could not put his name to his face – just about to look him up) though the idea that some Labour people will not be thoroughly unpleasant is not realistic! But I’m afraid that denouncing either of them in a political manner will not win this argument for the party, even assuming it is winnable (which I doubt) or not irretrievably lost (which I suspect is the case).
The point about Labour doing bad things in government is that we strongly opposed them. Justifying doing bad things now by saying Labour did bad things in the past does not seem to me to be a strong argument.
Tony Greaves
+
Tony Greaves
For anyone wondering where the truth really lies in Polly and Shirley’s claims, FullFact have a fact check on it: http://fullfact.org/factchecks/NHS_bill_Shirley_Williams_Polly_Toynbee_49-3395 (spoiler alert: Polly was mostly correct)
Doesn’t the fact that what the Bill actually says is in dispute between two such heavyweights as Polly Toynbee and Shirley Williams suggest the need for a pause for more discussion amongst stakeholders, proponents and opponents?
An already hugely complex Bill has been amended many times. Where is the link to the Bill as currently amended? Where is the website that explains in layman’s terms the rationale for each clause, and how they relate to other clauses? What consultation has taken place on each of these amendments?
As I’ve argued, this is no way to make laws.
The truth is that, as Shirley Wiliams has herself said, her objective throughout has been to broker a compromise between Tories and Lib Dems. The nature of a compromise is that you end up accepting, and probably going strangely quiet about, some things which you don’t like. What then happens is that the opponents of compromise make a big noise about those things, and attempt to cause you maximum embarrassment. That is what Polly Toynbee has done.
The ad hominem (ad feminam?) attacks on Toynbee are predictable, but wrong. It might have been better to point out that Polly had the easy time of it, since she only had to appeal to the facts, whereas Shirley had it much more difficult, since she was trying to negotiate a complex compromise on what will actually go into the Bill.
What Shirley did was honourable. That does not mean that the party as a whole should have accepted the deal which she and others brokered. If the profession had wavered in their opposition while the debate was still live, if the public had been won over by the arguments for “reform”, then maybe the party should have accepted the deal. But they didn’t do, and we shouldn’t have.
It now makes no sense at all to drag this debate further through the mire by pretending that we didn’t make big concessions, when (as Andrew M’s fact check shows) we patently did. If we cannot change our stance, then we should at least do something to minimise Shirley’s inevitable sense of hurt, by keeping schtum and moving on.
The cap on private patients in “NHS” hospitals will assuredly rise to 49%, if the business proves to be there, without major hindrance. Indeed, I am sure any successor Tory government will happily legislate to remove the cap altogether, if it gets in the way of the transformation from state to private services they undoubtedly intend to push through. Whether the British public will let them is another question.
“The problem with this argument is that it ignored other concessions secured by the Lib Dem team such as the one last week ensuring that any proposal to increase beyond 5% can be challenged by Monitor. ”
Can we clarify if that is an increase of 5% a year or 5% in total??? I have seen it described as both…
@Tony Greaves
Please can you clarify:
if your observation on attending today’s meeting of LibDem Lord’s, is that they ‘are not living in the same universe’ as the majority of the population, does this also include you, as one yourself?
I really don’t think the argument is to justify doing bad things now because Labour did bad things in the past, rather that 13 years of Labour saw a complete revolution where the issues are mostly the back to where they were when they began and we now have a bigger stack of costs for the pleasure of deferring dealing with them.
Thanks Andrew M for putting up the link from Fullfact.org. It is unfortunate that many columnists in the press of all political viewpoints, often spoil their arguments, by stretching the hyperbole almost to breaking point, which then become the distraction that allows questioning the veracity or not of the source. Thus it is with our Parliamentarians sometimes I fear. The 49% figure (or 49.99% for accuracies sake) is a theoretical maximum but not as yet a reality and perhaps never. Somewhat similar I would suggest, to some claims recently made by some of our Coalition partners, regarding the more fantastical sums available to benefit claimants and distortions regarding Disability Living Allowance, during the recent Welfare Reform debates. But I digress.
The whole point of the issues of the HSC Bill is not that the NHS does not need constant development/reform. I really don’t think that anyone is seriously arguing that. To just dismiss many people who are opposed to this Bill (including me) as either not understanding, or merely having vested interests, especially if (Health care professionals) is really no argument.
Our problem is that we do understand it and that is where the trouble is to be found.
Shirley herself made assertions (hyperbole?) regarding the benefits of competition in health care, which are far from having a robust evidential base ( see http://t1ber1us.wordpress.com/2012/02/25/the-evidence-on-nhs-competition/).
Judging by the way the majority of the PLDP voted on Tuesday, I fear it is unlikely that they will come to their senses over this Bill. Despite the amendments it really does not do what it says on the tin. It is still not too late to listen folks.
It is the general direction of Travel of this Bill which disturbs me. The fine words of Mr Lansley about “Liberation” and “no decision about me, without me”. Really are a smokescreen. for the introduction of a Social Insurance model, including the increasing level of transaction costs, which will rise even higher than those engendered by Labour’s faux market experiments.
Unfortunately, there will inevitably be a lot of humble pie to be eaten in the next couple of years. If that is by the opponents of this bill then fine. Somehow, unfortunately, I don’t think so. The tears are going to last way past bed time on this one.
Shirley Williams wrote the Shirley Williams motion herself? Really? That is not the impression given to many at conference.
@Dave and David,
As I understand it the 49% figure refers to the amount of income that hospitals are allowed to make from private patients.
Labour have put this about as being the Number of private patients or beds .
As hospitals have always charged private patients a lot more than they charge the NHS , the number of beds will be a lot less than 49%.
Is this not still the case?
I think it would be very helpful if a plain English guide to the bill could be published, because then everyone would be certain what we are actually talking about!
At the moment we are in a world where everyone believes that what they say about the bill is factual, whereas at least half of them, if not more, must be wrong since they contradict each other.
It is a question of trust for most people; for my part I trust The Royal College of Radiologists far above journalists and politicos, because I worked for them from many years and know them to decent and honourable and trustworthy, etc. :
‘ . . Given our widespread concerns over many serious and as yet unresolved issues, The Royal College of Radiologists (RCR) cannot support, and must continue to oppose, the passage of the Bill in its current form. The College has grave concerns over several areas of the Bill:
• There should be an overriding duty on the Secretary of State to ensure that a high quality and integrated health service is delivered in the best interest of patients.
• There is a potential for widespread and potentially embedded health inequalities across the NHS.
• Recognising that competition has for some time played a role in the NHS, we remain alarmed that the dangers of unfettered competition as outlined in the Bill will adversely affect integrated care in both clinical oncology and clinical radiology.
• The NHS will lose its State Provider status and in doing so open services to EU competition law, which would have serious implications on the provision of patient care.
Whilst not specifically part of the Bill, the College also remains deeply concerned about the consequences for education and training as a result of the Bill’s passage . . ‘
http://rcr.ac.uk/docs/newsroom/pdf/RCR_statement_re_HSC_Bill_270112.pdf
I have created a page of links to articles and speeches about the Bill at: http://twickenhamlibdems.co.uk/en/page/ahealth-social-care-bill-2011
I agree with Lon Won about the sort of web resource that is needed but it would be a huge task beyond the wit of anyone not already familiar with the subject area. It is very time consuming, for example, just to keep track of the fate of amendments in the house of lords committee stages, even without trying to work out their effect on other parts of the Bill.
If it’s enacted, as seems likely, another bill will be needed to revise it to make it workable in this Parliament.
I read the FullFact blog. Looks like a lawyer’s charter to me. Polly Toynbee seems to be using the ‘straight banana’ argument – any possible action will always be taken to the extreme position.
Simonsez,
You’re right. The figure relates to income, not the number of patients. The hospital must not earn more money from private sources than from public sources. So yes, it is in breach if it charges 3 private patients £20K each while it charges for 5 public patients at £10K each. Quite how reassuring you find this is up to you, I suppose.
Why, I wonder, did that nice Mr Lansley come up with this formula? Is it because, if he actually allowed an NHS hospital to make an actual majority of its income from private sources, even as supine an organisation as the modern Lib Dems might have had to jib at it?
@ Simonsez Mar 14 – 11:00 pm
Sorry it has taken over 24 hours to come back with an answer, I was doing other personal life related things. You are right, the Bill is talking about revenues, not physical beds. Unhelpful hyperbole again. Trouble is, Shirley, in her riposte to to Polly Toynbee delivered in an interview to Guardian Journo Andrew Sparrow referring to lies said, “Point three. Labour never had any kind of cap at all – 49%, 80%, 100% – no cap of any kind.”. Unfortunately, Shirley is wrong about that, as the post from Andrew M earlier linked to the FactCheck website shows. Essentially, since the Health and Social care Act 2003, there was a cap basically set at the level of Private Patient income they were receiving when the Labour Party initiated their faux market in health. This varied depending what they were doing at the time from a small 2 to 3% in most Trusts to around 30% in places like Great Ormond St, due to it’s international reputation.
There has indeed as Shirley has said in the last minute amendments, a level of 5% private income been set. Trouble is, it is, according to some legal analysts, so worded as to allow incremental increases in private patient cap levels at 5%, year on year. The responsibility of the “elected” Foundation Trust “Governors” to hold accountability for this is great in theory. Unfortunately, on the ground so far, they have not quite lived up to these sort of governance issues. As far as I can see (and I ain’t claiming to be legally expert in this) the Bill does little, if anything to correct this.
All of which is worrying.
As an ex member of the SDP, I have not agreed with anything David Owen has said for twenty five years. I must say though, I do tend to agree with him that it is a Constitutional outrage that this bill has been placed before parliament at all, it not being in the Coalition agreement (minor point). And please spare me the “it really was arguments” quoting selectively from bits of various documents in the best traditions of quoting the disconnected “small print”in a hire purchase agreement of old. I also agree with him that it is a second Constitutional outrage that implementation of the Bill has been forged ahead with, far beyond the conventions allowed when a bill has passed it’s second reading. So much so in fact, that it has actually been argued that the Bill must be passed as the changes have been made anyway!. Finally, the refusal to publish the risk registers before the bill becomes law in defiance of the Information Commissioner and the Courts is a third constitutional outrage. David Owen has published a paper which voices his concerns, which I venture to suggest are worth looking at (see below)
After the Spring conference I rather hoped that the PLDP would take some notice of the conference. Not just regarding the HSC Bill but also on the Justice Bill (LASPO). Regrettably it seems that most of our Parliamentarians have become quite disconnected from the Party at large. It seems we are likely to be disappointed in our hopes.
Anyway some references:-
Re David Owen see – http://www.lorddavidowen.co.uk/wp-content/uploads/2012/02/HSCBillstatement3.pdf
For the whole sorry saga of Labour’s private patient income caps, drifting into Lansley’s bill as well see – http://www.nhscampaign.org/NHS-reforms/ppi.html
You might also be interested in why the Risk Registers should be released see http://www.healthpolicyinsight.com/?q=node/1354
If you have the time you might be interested in academic alternatives to Lansley (apart from the excellent paper by John Pugh) see – http://t1ber1us.wordpress.com/2012/01/25/non-market-principles-by-which-the-nhs-might-be-reorganised/
Lastly, I cannot resist quoting from a Science Fiction author Robert Heinlein who termed an aphorism in one of his stories, closely related to Murphy, Occam and Sodd’s law et al and known as “Heinlein’s Razor” which is; “Never attribute to malice that which can be adequately explained by stupidity, but don’t rule out malice”
For me at least it rather sums up Lansley’s Bill
Dave E.
p.s. Unlike, (according to various blogs), many others it seems in recent days, I will not be resigning from the party. But I won’t be happily just re-arranging the deckchairs on the Titanic. See Shirley and Polly, anybody can do hyperbole?. Not sure it’s much use though!
As an ordinary voter, the one thing that I am absolutely sure of, is that we were lied to before the last election.
It has been interesting reading the contributions on Liberal Democrat Voice but I shall not be doing so in future. I no longer think the Liberal Democrats are democrats. I no longer think that the party has principles, and I am grateful that you have been given the taste of power, because it has taught me that in the past, I have been voting for a party that only existed in my imagination.
“No Top-down reorganisation of the NHS”. Remember that? Anyone? Was on lots of big posters, included in the coalition agreement?
Of course, we expect the Tories to lie for power then attack the public sector, but do any of your party remember having principles? Actually opposing something rather than just tutting loudly as you vote en masse for it? (Or in the case of the rebels, just not turning up for the vote then saying “ooh, I was always against it. But I was busy that day.”)
Anyone?
As a post script for signing off from this site, I remember the lies.
I am immensely cheered that doctors are going to stand at the next election to try to remove those who have shown such little regard for our democracy.
At last, candidates that have principles that we can throw our weight behind. They are being advised by Richard Taylor the retired consultant who won Wyre Valley when he stood in protest at the down-grading of his local hospital.
As Docotr David Own has pointed out, many of the changes are already taking place before the bill becomes law. We have the prospect of a second hospital being handed to the private sector. Children’s health in Devon being handed over to the likes of Serco or Virgin who according to reports have no experience of running any such child health programmes.
All in the week when a judge condemned a BUPA nursing home for putting profits and cost-cutting before care.
Good luck to the doctors. At a stroke, they are giving people like myself who are now so cynical and angry about this government that have so blatantly lied to us, a new lease of life. I am only too willing to provide money and any other help that I can give to help them succeed.
.Chris Rennard……………………Nor will we forget how she urged people to ‘put a peg on their nose’ and re-elect Tony Blair in 2005. If Labour had failed to get an overall majority then, Britain would probably have a very different government and political system today………..
I agree. As both Conservative and LibDems promised to match Labour’s public spending (and the Conservatives demanded less, not more, financial regulation) the global meltdown would have hit the UK perhaps even harder. The resultant blame would have been directed on the incumbent government and resulted in a 2010 landslide victory for Labour.