Four Lib Dem MPs vote against NHS Bill; three vote for Dorries on abortion

On the NHS Bill four Liberal Democrat MPs rebelled: Andrew George, Julian Huppert, Greg Mulholland and Adrian Sanders.

On the Nadine Dorries abortion vote, three backed her proposals: Alan Beith, Gordon Birtwistle and Greg Mulholland.

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63 Comments

  • Allan Heron 7th Sep '11 - 9:51pm

    Who were the abstainers?

  • David Thompson 7th Sep '11 - 10:10pm

    Good for those four that voted against this terrible NHS bill and shame on all the rest. The bill is a disgrace as was the whole Dorries abortion amendment.

    Not a good day for the English people, nor a good day for the House of Commons.

  • Adieu NHS. Hello foreign companies looking to make a profit from private patients.

  • Every Lib-Dem who voted for or abstain this wretched bill have just cuts their own throats and ensured that the Lib-Dems will be obliterated in every election for years to come.

  • Truly shameful. This was not in the coalition agreement, the medical profession agrees that this is a sham, the LD grassroots are against it – I am utterly ashamed with the LD MPs right now. I only have to hope that our Lords prove less of a doormat.

  • It is an absolute disgrace that only four Liberal Democrat MPs voted against a bill that is opposed by the vast majority of nurses and doctors. In my opinion this is just further confirmation of where the Liberal Democrat party is heading.

  • I cannot believe it, how could any of our MP’s vote for Nadine Dorries appalling proposal, I am truly shocked.

  • Cathy Meeus 7th Sep '11 - 10:34pm

    How shameful that so few LibDems opposed this bill – the death warrant not only of the NHS but of the Party’s election prospects for a generation and beyond

  • A broad Church is one thing – acting in direct contravention to the principles of liberalism is another. How on earth can any liberal vote for an amendment which would see ‘faith groups’ getting involved in abortion counselling? That sort of thing is the antithesis of liberalism.

  • I can’t believe the Liberal Democrats have voted for this ill thought out bill through, rushed and disastrous NHS Bill. 12 hours to debate how many hundreds of amendments or was it a thousand. When people look back at this parliament, they will think of hurried and bad legislation with disastrous consequences. An abdication of responsibility for the secretary of state and EU competition law cases adding massively to the costs of providing health.

    The start of the end of the NHS and for the Liberal Democrats, who will pay a very heavy price in every election until the end of the Coalition. How can the Liberal Democrats every stand on an election platform and promise the electorate that they will not help foister something very unpleasant on the country or claim to be truthful or honest to their word / platorm ?

    A sad and terrible day for the NHS, the country and the Liberal Democrats. A good day for private health providers and the Conservatives.

  • “It is also thought that a small number of Lib Dems unhappy with the legislation did not vote at all.” – That is possibly the worst part. If Liberal Democrat MPs are unhappy with the legislation then vote against it! The public have entrusted them with that responsibility and they should damn well honour their duty to the public.

  • jacktimms…My sentiments exactly….I’ll listen to the cheers when Clegg attends the conference and feel like vomiting.

  • Tom Fairclough 8th Sep '11 - 12:28am

    The bill is the facilitating agent, the silent enabling activity behind the scenes is ensuring that the worst will happen by stealth in coming years and it will go largely unnoticed by the media. This is duplicity and incompetence of the highest order and, ultimately, it will be the Liberal Democrats (or most of them) that will be seen to have held the door open for this.

    The names are on record and, as the truth unfolds, they will be held to account for however many years they wish to have a political career. You could have expected the tories to try and erode the NHS, even Blair’s labour, but why on earth have the LDs been roped in as accessories to what can only be described as a crime without mandate.

  • “we have won major concessions and would look very silly if we rebelled again in the commons.”

    Three of those MPs voted for the orginal bill, then rebelled on the bill after we’d won the concessions. Go figure! 🙂

  • @Hywel – didn’t they vote for it at Second Reading, which is to agree with the broad aims, whereas this was Third Reading, which is the final vote? If so then it’s entirely consistent to vote for a Bill at 2nd reading in the hope that the detailed problems would be sorted out, only to vote against at 3rd reading if you didn’t think they were.

    @Goerge Kendall – I entirely agree. As liberals we shouldn’t be seeking to ‘shame’ anyone for sticking to their principles (which Alex Marsh praises the 3 who voted against the NHS bill for supposedly doing).

  • Thanks for that clarification, James. I likewise wasn’t sure about the wording of the Dorries amendment, and thought it wasn’t worth putting to a vote once Anne Milton said that the Government would be looking into the issue of ensuring women have access to genuinely independent and non-directional advice (a worthy liberal aim).

  • Not sure why I thanked myself there…! I meant to thank you, Alex, for your clarification! Oops.

  • Nigel Quinton 8th Sep '11 - 8:07am

    Whilst very disappointed with the vote I cannot say I am surprised. Many of our MPs and a good number of party activists whose views I normally respect appear satisfied that enough has been achieved since the pause. I do not agree. If Shirley Williams, Andrew George, and others, have concluded from close hand that the changes are cosmetic rather than substantive, then it was wrong to allow the bill to go forward.

    What our MPs (excepting the four who did the right thing) need to answer is this: were the changes demanded by the motion in Sheffield all met? If not, how can they claim to be part of the party that got them elected?

  • I think Hansard also has Stephen Gilbert in the NO list on Division 342 (third reading)
    There has been 5 Lib Dem MPs (George, Horwood, Huppert, Lloyd and Rogerson) rebelling on an amendment earlier (division 340)

  • Andrew Suffield 8th Sep '11 - 8:58am

    What our MPs (excepting the four who did the right thing) need to answer is this: were the changes demanded by the motion in Sheffield all met?

    If they were, will you accept that the MPs have actually done their jobs well and achieved what they were told to achieve?

    There is entirely too much unsubstantiated outrage here. The first time around, there were a handful of actual problems with the bill (reflected in the conference motion), but most of the ranting in the media had got nothing to do with them and had no basis in reality. This time, the ranting is still here, but nobody seems to be able to identify specific problems. The kind of crazy that we’re seeing is: “Sure, the government say they have no plans for privatisation and they’ve made the bill explicitly forbid it and require that people work to ensure this does not happen, but it’s all a lie really and they secretly want to destroy the NHS and make themselves unelectable. You can tell this because all they would have to do is pass a whole new bill changing the law to say the opposite and then they could do whatever they want”

    Let’s not forget that the bill has not been passed. After one of the most lengthy and detailed Commons examinations in recent history, it will now go to the Lords for an extended polishing and probably thousands of amendments will be made to improve the details and eliminate loopholes. This is probably the most carefully considered piece of legislation that I’ve ever seen, and while it would probably be more beneficial for more bills to receive this level of attention, claims that this one has been rushed are just a farce.

    Now, if anybody has any real, identifiable problems they can describe, then let’s hear them. But another round of “I heard from this other group of people that something bad might happen, but they didn’t say what and I didn’t ask” is unproductive and tiresome.

    (On an unrelated note: a bill being paused for extra consultation and changes to fix issues, instead of just being whipped through parliament despite public outcry? This government is so much better than Labour was)

  • @Neil Bradbury: e have won major concessions and would look very silly if we rebelled again in the commons. We need to keep our end of bargains.

    What about keeping your end of the bargain with the majority of the public who did not vote for NHS reforms and nor want this bill? These reforms were not outlined in either parties’ manifesto. Why is your bargain with the Tories more important than your bargain with the public? Why is this more important than the words of doctors, nurses and charities who warn this bill is a disaster and will lead to a 2-tier NHS?

    I’m appalled and disgusted this bill passed with such large LD approval.

  • Tony Dawson 8th Sep '11 - 9:25am

    This is a silly Bill. It will NOT do the damage which its opponents claim, neither will the GP purchasing proposals etc do any real good. The modifications of the Bill, pushed for by the Lib Dems and others, have clipped the wings of the Tory marketeers severely and anyone who does not see this is probably biased beyond reason in attempts to gain political capital on the issue. There will be another upheaval and a lot of pay-offs to bureaucrats who will end up doing much the same job on more money plus the one-off payment, as well as lots of money for stationers printing new headed notepapers. We have seen it all before in the NHS.

    This is just another in a massive series of NHS reforms by Labour and Tories over the past 20 odd years which have effectively consisted of schoolboy ministers getting into power and shifting the bits around for their own mental stimulation with the taxpayer picking up the tab and management consultants booking more expensive holidays on the proceeds. Unfortunately, all the good bits of the Bill, regarding local accountability and the return of some form of consumer power and advocacy have been largely-ignored by the media.

  • @James – at least one of those MPs (Adrian) has made statements which imply they didn’t support the general principle of the bill

  • Perhaps we should listen to the belief behind the words….

    Health Minister Lord Howe (in a speech to private health groups in London) said….”The overhaul presents private groups with “huge opportunities” and it does not matter “one jot” who provides NHS care”……

    David Cameron….The reforms are supported by the Royal College of GPs, the physicians, the nurses, people working in the health service”……except they don’t

  • Malcolm Todd 8th Sep '11 - 2:33pm

    Tony Dawson has it right, I think: this Bill isn’t going to destroy the NHS (a claim which has been made far too many times in my life for me to take it seriously), it has some good bits and some bad bits, but above all it’s an entirely unnecessary enormous upheaval of an organisation that’s actually pretty damn good at what it does – which at a time of inevitable tightening of resources makes it a criminal waste of money. I don’t even think the main motivation is evil Tory market-worshipping ideology; it’s just the usual politicians’ inability to accept that the best thing to do is often to leave well alone.

  • Mark Pack “Andrea: Stephen Gilbert voted for and against ”

    Thanks. I just checked the No list. I should have known better

  • Oh dear. That sinking feeling again, when, as with tuition fees, Lib Dem MPs vote to assist the Tories in potentially wrecking something good and social democratic in the UK.

    I’m no expert but I’ve read enough about the NHS bill to be worried; at best, it seems like a thin end of a wedge to privatisation. And surely Lib Dems can’t be naive enough to really believe that the Tories are doing this to maintain a free, general-taxation NHS? (Lansley is probably currently celebrating at the ‘Stonecutters Lodge’ with his mates from Tribal Healthcare, for those who’ve seen that episode of ‘The Simpsons’!) Tories believe that private is best, the NHS is a socialist aberration (which, annoyingly for them, generally works well and stands up internationally) – that’s their viewpoint, they’re not going to willingly go against it, whatever cosmetic changes or ‘promises’ they make.

    I was the first in my modest-income family to go to university. My mum & dad both had their lives saved by the NHS. Despite living a generally healthy, exercising, non-smoking/drinking life, my dad had to have two major ops – and despite working all his life, I doubt whether we could have easily afforded the cost/insurance for these.

    The future? Taking in a Serco (RTM) ambulance to see a Dr, who him/herself is up to their eyes in student debt (because, obviously, despite treating 1000s of people & being a great asset to society, it would be wicked for the taxpayer to pay a penny for that Dr’s training…)

    With this undemocratic coalition – broken pledges, bills out of the blue – I can’t help thinking a lot of good, common-sense things are slipping away…

  • Alun Griffiths 8th Sep '11 - 7:29pm

    I am disengaging from the national party now

  • Power, especially exercised from positions in government, or the prospect of them, outweighs principle. Good on the 4 MPs (4!) who, recognising that virtually the whole of the medical profession knows more about the NHS and the likely impact on it of the NHS Bill, stood firm with the majority of their voters (and party members, I’m guessing) and voted against. The coalition is spinning out a whole raft of policy, far to the right of anything Thatcher was able to implement, that featured in no manifesto. A Liberal, then Lib Dem, member and activist for 30 years – and the West Country Agent and Media person for much of that time – I saw the writing on the wall and resigned from the party back in the spring. I believe the Lib Dems are headed for the sink hole of history and, if you doubt my judgment, imagine yourself as a writer of Labour election leaflets. (Incidentally, who were the abstaining Lib Dem MPs?)

  • Stuart Mitchell 8th Sep '11 - 9:25pm

    Al: “How on earth can any liberal vote for an amendment which would see ‘faith groups’ getting involved in abortion counselling? That sort of thing is the antithesis of liberalism.”

    And your comment sounds more like authoritarianism than liberalism.

  • Stuart Mitchell 8th Sep '11 - 9:41pm

    Andrew Suffield: “…This time, the ranting is still here, but nobody seems to be able to identify specific problems… Now, if anybody has any real, identifiable problems they can describe, then let’s hear them.”

    You might want to check out the BMA website, which has reams of documents identifying problems with the bill, including the briefing they issued prior to the third reading :-

    http://www.bma.org.uk/lobbying_campaigning/bmapositionhealthandsocialcarebill.jsp

    The BMA’s current position is as follows :-

    “We remain concerned that the Bill presents unacceptable risks to the NHS and continue to call for the Bill to be withdrawn.”

    I don’t think it’s helpful to dismiss people like the BMA as a bunch of ranting fantasists – we should be listening very carefully to what they have to say.

  • A plague on both houses of the coalition. This is how history will see this government that is slowly destroying the building blocks of society for corporate gain. Appalling that this was voted through last night, and damns the Lib Dems to oblivion.

  • One of the most damaging revelations that has accompanied the passage of this bill is the unravelling of the system BEFORE any legislation has been passed. Speaking from Devon, I am aware the same process is under way in the Education field at County Hall. For our party to be in Govt and NOT try to arrest this hugely damaging process is appalling. This will turn the clock back to a situation where the democratic will of the people, and the public services to support that will, can only be exercised under quite limited circumstances.

    Les, as someone who has given the Party an awful lot over the years, I am very sorry you have chosen to leave. But equally, I can quite see the factors which have led to your decision.

  • Andrew Suffield 9th Sep '11 - 7:44am

    You might want to check out the BMA website, which has reams of documents identifying problems with the bill, including the briefing they issued prior to the third reading

    It is important to state that the briefing was produced before publication of the Government’s Commons Report Stage amendments.

    Most of those issues have been fixed. The rest all seem to be complaints that the bill does not destroy the private medical industry in the UK, which is such a very Labour thing to say.

    I don’t think it’s helpful to dismiss people like the BMA as a bunch of ranting fantasists – we should be listening very carefully to what they have to say.

    I think we did. I also think that the BMA is fundamentally a Labour union and they will find a way to object to anything the government does. “Listening very carefully” means we take their list of actual problems and fix them, and then we take their list of attempts to bash the government for Labour’s benefit and file it in the recycling bin. This is what is happening.

  • Andrew, what an enormously “tribal” (ie anti Labour) viewpoint you take here. Of course many of us in our party have shared the anti-privatisation view and activities (along with many Labour activists, ordinary people, and, yes, a few Tories as well, notably some of the “Wets” in the 80s). Just because we are suddenly in coalition with the Tories should not mean we sell those particular principles down the river.

    IMO most of the main problems we face as a society are because of the way the private sector operates, nothing to do with the public sector. Deregulation and privatisation has caused enormous problems for us all, putting us all at risk of speculation. As stated by others much more authoritatively than me, both here and in public forums, the huge problems the world faces are environmental and resource constraint issues, and clearly with all the arguments now about “economic growth”, a need to employ people and give everyone an income. To assume we can just carry on as usual is a damaging kneejerk reaction. The sooner people realise this, the sooner we can start taking effective action about it – no doubt on an international basis.

    We are the party of the “new politics”, not the old.

  • Incidentally, Andrew, why do you say these things are specifically “Labour” views, when under the nuLab incarnation, much of what they did was to buttress deregulation and privatisation? Of course, there are many nuanced views in all parties about these matters, so to be as party political as you are is simply not credible.

  • I found this page after searching on the web to see who the four Lib Dems were who voted against the bill. I was very much hoping that my MP, Julian Huppert, was one of them. Delighted to see that he was. Julian, you’re playing the long game and you’re playing it very well …

  • Even dumping Clegg will not save you now.

    The Lib Dems just became an anti-NHS party.

    The voters will destroy you.

  • You have been conned by your Tory pals into removing the State from the NHS in order to give taxpayers’ money to cowboy and spiv health companies. Next you will support the Tories in their dismantling of the state school system which will eventually, once Gove changes the goalposts, give taxpayers’ money to cowboy and spiv education suppliers. Feeling proud of yourselves?

  • @Alex Marsh – Well done Alex for summing it up so well. At the moment the party seems incapable of stepping back and thinking about the consequences of its actions as the public see them (and Alex is absolutely right – the public doesn’t have to get all its facts right to form an opinion) – instead leaving the decisions to a bunch of economic liberals drunk on power.

  • Ian Robertson 9th Sep '11 - 12:54pm

    Put together this is upsetting information, and from now on I will not be voting for the liberal democrats, (just individuals such as Evan Harris,) and when tactical voting requires it.

  • Has any LibDem been able to explain exactly why they voted for this bill when:

    a) The public don’t want it
    b) the medical profession don’t want it

    It seems LibDem MPs value the coalition and their jobs more than they value what the public want. The public did not vote for this bill. The public voted for “no large top-down reorganisations of the NHS.” The public voted for “I’ll cut the deficit, not the NHS.”

    Why do LibDems keep voting against what the public want? And don’t try to tell me the public want these “reforms”. Public opinion polls have shown, repeatedly, that they don’t. Is your place in this coalition really worth angering the public en masse and electoral oblivion?

    What happened to the “democratic” in Liberal Democrats?

  • Stuart Mitchell 9th Sep '11 - 7:16pm

    Andrew: “I also think that the BMA is fundamentally a Labour union and they will find a way to object to anything the government does… We take their list of attempts to bash the government for Labour’s benefit and file it in the recycling bin.”

    Which “BMA” are you talking about? The Bathroom Manufacturer’s Association? The Bolton Malayalee Asociation? You can’t seriously be talking about the British Medical Association.

    It’s pure hubris for you to think that critics of the bill must all be ranting, Labour-supporting fantasists.

    The fact is that the Labour government (in its later years) was pretty much universally despised by the medical profession. A doctor acquaintance of mine who was heavily involved in various anti-government BMA campaigns between 2005 and 2010 told me that in 25+ years she had never experienced such widespread anger among doctors against the government of the day.

    This was borne out by opinion polls before the 2010 election which showed, for example, that only 15% of GPs were going to vote Labour. 53% supported the Tories and 17% the Lib Dems. The vast majority of doctors were delighted to see the back of Labour and had a fair amount of good-will for Lansley when he took office. The fact that it turned so sour, so quickly, really ought to tell you something about how bad the bill is.

  • Andrew Suffield 10th Sep '11 - 7:59pm

    It would be worth entertaining the possibility that If pretty much everyone involved in a sector says – speaking from a range of different perspectives – that the proposals are problematic and flawed then it may be that they speak from knowledge of what is needed to make the system work

    And if pretty much everyone involved in the sector was saying this, then this statement might be relevant. But the reality is that many people in the sector support it, and the split looks suspiciously similar to a division along party lines.

    You can’t seriously be talking about the British Medical Association.

    Why not? They are a trade union (hint) that is arguing this bill is bad because it does not preserve the current exclusion of widespread private medicine in the UK. (They’re old Labour, they didn’t like Blair/Brown at all)

    The argument that the BMA is making is that medicine in the UK must be run as a government monopoly, with all medical professionals working for the government, and centrally controlled from Westminster. I am firmly opposed to this belief: it is illiberal, it is bureaucratic madness, and it is wrong. People should be free to choose whether to use public or private medicine, and private medicine should not be exclusive to the rich.

    It’s pure hubris for you to think that critics of the bill must all be ranting, Labour-supporting fantasists.

    However, it is a simple observation that these ones are. I’m sure there are some critics other than those, but they aren’t showing up to the argument.

    Earlier this year, the LD conference laid out a set of requirements for things which had to be fixed in the bill for it to be acceptable. So far as I can see (and some actual expert examination of this question would be very much appreciated), those things have all been fixed. If the requirements for the bill to be acceptable – laid out by both experts and party members – have been met, then the bill is acceptable. That’s not so difficult to understand, is it? Heck, even Labour endorsed that list when they introduced it in Parliament.

    (Note, the bill is a long way from being passed, it still needs more work, and it is going to get that work. Also, the suggestion that the bill is an ineffectual waste of money, causing neither good nor harm, is an interesting one which deserves serious analysis and debate)

  • Re: Competition law and the Secretary of State’s duty on provision

    Graeme Cowie
    Posted 8th September 2011 at 11:49 am | Permalink

    @jacktimms

    The Secretary of State’s duty to provide a universal service has not been diluted. Under the current arrangement it is held by the SoS but exercised through Primary Care Trusts. The change here is that with PCTs being abolished the delegation of duties is being transferred to GP Commissioning groups. The principal statutory duty remains, and must still be exercised by the Secretary of State; merely through a different structure.

    Please check the below, Graeme which I hope you find interesting reading.

    http://www.38degrees.org.uk/page/content/NHS-legal-advice/

    http://38degrees.3cdn.net/75856a0564e9244f2a_rum6i66sh.pdf

    3. Effectively, the duty to provide a national health service would be lost if the Bill becomes law. It would be replaced by a duty on an unknown number of commissioning consortia with only a duty to make or arrange provision for that section of the population for which it is responsible. Although some people will see this as a good thing, it is effectively fragmenting a service that currently has the advantage of national oversight and control, and which is politically accountable via the ballot box to the electorate.

    4. As set out in case law relating to the 2006 Act and its predecessor, the NHS Act 1977, when the Secretary of State or his delegates carries out the section 3(1) duty to provide services, the duty to promote a comprehensive health service in England, under section 1(1), has to be borne in mind at all times. There will be severance between the two duties, if the Bill becomes law, as the bodies that will have the duty to arrange services pursuant to section 3(1) (the commissioning consortia) do not have a duty to promote a comprehensive health service.

    42. But what this response does not make clear, is that the s3(1) duty has been lost by the Secretary of State and it has not been moved to the NHS Commissioning Board. Instead it has been moved to the commissioning consortia.


    Shirley Williams is concerned about this NHS Bill.

    I agree with Tom Fairclough that this terrible NHS bill is an enabling agent for the fragmentation and handing over of medical provision to the private sector, Alliance Health Care and Serco will wipe out the public sector.

    It does matter who runs the service.

  • Graeme Cowie
    Posted 8th September 2011 at 11:49 am | Permalink

    @jacktimms

    As for EU competition law, it already applies to NHS procurement! There is absolutely nothing new there.

    In response: Jack Timms

    In terms of Competition law, NHS Procurement is open to EU Competition as you suggest.

    The point is that vast swathes of NHS provision will now be opened up and subject to EU Competition law. The effect of this has vastly underestimated the complexity and costs that this will add into the procurement process. The private health companies are in a much better place in terms of set up and cost to challenge contracts. They have the expertise and resources in contract litigation as opposed to charities or public bodies or charities.

    The increase in competition for contracts will inevitably favour private health providers from Allied Health Care to Serco. The cost of provision to manage contracts (including lititagation) will be borne by the tax payer.

    Private companies will be able to provide commissioning services who can then parcel the contracts out . In effect a privatised PCT which can privately provide multiple million pound contracts and services, cutting out and undermining public bodies, who will have little expertise in challenging the decisions in the Courts.

    http://www.38degrees.org.uk/page/content/NHS-legal-advice/

    http://38degrees.3cdn.net/b01df9f37ac81ffb2e_zhm6bnldz.pdf

    This NHS Bill will enable mass privatisation of services. There will be a fragmentation of services, with increase in costs at a time of the NHS having to make very large savings. Wages and conditions for Health Staff will deteriorate, any (debatable) savings will go into procurement & legal costs and. to shareholders profits. No discernible improvements in services look likely with great risks that the system will have unintended and terrible outcomes.

    The Liberal Democrats have enabled the dismantlement of the NHS. The electorate will be living with the results of this legislation for years. There is going to be a very heavy price to pay at the ballot box for the Liberal Democrats. I am sorry for that as I am sorry for Health Care professionals, NHS service users and the detriment and the loss of the social contract that has made this country bearable to live in.

  • david thorpe 13th Sep '11 - 11:11am

    did the four vote aginst the manifetso commitment given at lib dem conference to abolish NHS primary care trusts? or are they going back on that..because thats what this bill implements, among other things. The scaremongering about privatisation and reluctance to change anything shows the small ‘c’ conservtaism that is the blight of the lib dems

  • Malcolm Todd 13th Sep '11 - 12:45pm

    @david thorpe

    I’ve got so sick of this claim that abolishing PCTs was Lib Dem policy so really this bill is just doing what we said it should do and we’ve got no right to object. Let’s have a look at what the manifesto (p. 22 of 57) actually said:

    “Empowering local communities to improve health services through elected Local Health Boards, which will take over the role of Primary Care Trust boards in commissioning care for local people, working in co-operation with local councils”

    Can you spot the difference?

  • Been exposed by who exactly ?

    Your statements that ‘regulated choice should see long term savings and better care across the board’ is based on no evidence on whatsoever. That is just a hope of yours. You present nothing to support your argument.

    When the mass privatisation and fragmentation of service happens, and the costs have escalated, it will be too late and our great (but imperfect) health service will be wrecked. The Liberal Democrats will not be forgiven for what you have done. The Liberal Democrat electoral platform will never be trusted.

    Any proposed changes should have been piloted and tested so the best elements could have made the NHS stronger and better. We know that would not happen because the Conservatives wanted to break up the NHS, parcel it out and hand it over to Private Health Care providers who will make a lot of money.

    Lansley will end up sitting on a lot of boards and make a lot of money as well in consultancy fees.

    The alleged victories and concessions of consultation that will be PR spun and trotted out at Conference have not changed. It is a sham.

    I am sorry for the start of the end of the NHS and for the start of the end of the Liberal Democrats.

  • Stuart Mitchell:
    ‘Al: “How on earth can any liberal vote for an amendment which would see ‘faith groups’ getting involved in abortion counselling? That sort of thing is the antithesis of liberalism.”
    And your comment sounds more like authoritarianism than liberalism.’

    So having principles constitutes authoritarianism? Your comment sounds like a hard-right caricature of a supposedly ‘liberal’ argument.

  • Before the debate at conference on the NHS Bill, it might be as well to consider the following stats. from 2009:

    􀁺 OECD figures show that UK total health expenditure as a percentage of GDP (8.4%) is actually below the OECD average and a long way below that of the USA, which has easily the most expensive system at 16%, nearly double UK spending
    􀁺 The UK spend per head of population is $2,992 as opposed to $7,290 in the USA.
    􀁺 The UK NHS is largely free of the huge transaction costs associated with revenue collection and marketing that blight other systems, such as the USA.v As a result, the cost of administration in the UK is estimated at around 12% compared to more than 30% in the USA
    􀁺 The UK spends 3% of its budget on management costs, as opposed to 17% in the USA.

    You might conclude, as I do, that we have nothing whatsoever to learn from the USA on the provision of health services. Or indeed, on any other social matters: the USA being a society with a wholly different set of values. If there is a need to look elsewhere for a role model, I suggest we look to countries closer to home. Looking across the Atlantic for a quick fix for shortcomings, real and imagined, in the provision of essential services, a seemingly unstoppable wave of neoliberalism has been surfed by every PM from Thatcher through Major, Blair and Brown to Cameron (see Stuart Hall in Tuesday’s Guardian.)

    This week’s conference provides an opportunity for the party to begin the extremely difficult process of re-establishing itself as a left-of-centre party. Sarah Ludford, however, (Guardian Letters 13 Sept.) believes that representatives could “shoot ourselves in the foot at conference by showing continued legislative controversies”. In short, don’t question, don’t argue, just roll over, accept and approve.

  • Malcolm Todd 14th Sep '11 - 4:24pm

    @Les Farris

    Whilst everything you say about the comparison between the USA and UK is absolutely spot-on, it’s not particularly relevant. I’m no fan of what this government’s doing to the NHS, but it really is just rhetoric to suggest that it’s moving it towards a US-style health service. Even Lansley’s original proposals would probably be regarded as outright socialism (and therefore completely unacceptable) by all but the left of the Democrat Party there.

    What the government ministers usually point to in terms of comparisons is western Europe – a much more reasonable comparator both in terms of costs and structure/culture. Countries like France and Germany have much less monolithic systems, with far more privately provided (but publicly funded) and insurance-based care than we have here, but nowhere near the outrageous costs of the US.

    Having said that, most of those countries *still* spend more than the UK, and despite the fact that expenditure here was well below most of (western) Europe until this century (so that the cumulative effect of health spending for most people alive today is still well below their average) our fundamental indicators – infant mortality, life expectancy at birth and age 65, are broadly as good as theirs, which hardly suggests that the existing NHS model is so badly broken it needs radical reform.

    In short, we don’t need straw men or spurious comparisons to show that government policy on this is badly grounded and likely to do more harm than good.

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