Lib Dem Voice survey shows members narrowly oppose Coalition’s NHS reforms

Lib Dem Voice has polled our members-only forum to discover what Lib Dem members think of various political issues, the Coalition, and the performance of key party figures. Some 550 party members responded, and we’re currently publishing the full results.

Lib Dem members vote 43% to 37% against Coalition’s NHS reforms

LDV asked: The Health and Social Care Bill which will implement radical reforms to the NHS was passed on 6 September. The Bill was changed significantly to reflect Lib Dem policy proposals passed at the Spring conference. Critics say the changes do not go far enough to address concerns that the Bill will lead to creeping privatisation of the NHS. The Bill’s supporters say that the reforms will introduce more patient choice and improve healthcare. From what you have read or heard about these plans, do you support or oppose the Bill overall?

  • 37% – Support
  • 43% – Oppose
  • 20% – Don’t know

The party’s Birmingham conference may not have been given the chance to vote on the NHS bill, but our survey did give members the opportunity to give their views. And a clear albeit narrow plurality — 43% to 37% — feel the changes to the NHS reforms negotiated by the Lib Dems do not do enough to address the perceived problems with the Bill. Interestingly, though, this is a significant shift since last we asked about the NHS reforms, in April, when the margin of opposition was 61% to 24%. The concessions in response to Lib Dem pressure have won over some of the sceptics, though not enough yet.

Here are a sample of your comments:

For the Bill:

Ultimately I don’t have a problem with private providers, provided the NHS remains true to the “Free at the point of use” principle
The PCTs are grossly inefficient and ineffective, staffed by bureaucrats on salaries well in excess of private sector rates
Nick Clegg needs to resist the anti-market militant tendency Evan Harris is stirring up and start talking about European healthcare systems that are far more mixed than the UK whilst retaining the universal principle absent in the US. The government reforms are far more European than American
Support so long as investment continues especially in long term underfunded areas such as psychiatric hospitals and care. An increase in freedom of choice is not a bad idea due to disparities in qualitity of treatment.
It clearly doesn’t increase patient choice, but the innovation caused by the increase in internal competition should be a force for good in the NHS. I’m tired of people screaming “privatisation” without explaining why they think that will make things worse.

Against the Bill:

It’s not the end of the nhs, but I think the bill will be an expensive and pointless reorganisation with little chance of major improvements.
We have changed a lot, but there are further changes to make before I will be able to tolerate it.
Our NHS is currently one of the most efficient systems in the world. These reforms will just lead to private companies cherry-picking the most profitable services.
I strongly dislike the idea that foreign businesses should have a stake in the NHS, and think that any form of privatisation would mean profits for them at our expense. The NHS could be improved, but not like this.
As an NHS worker I am strongly opposed to the Bill – particularly the problems with the Secretary of State’s responsibilities, EU competition law, private companies running GP consortia and the potential for a postcode lottery in commissioning services.
The party leadership has failed to address clearly enough the criticisms of people who are very closely familiar with the detail, such as Evan Harris, Andrew George, John Pugh and Shirley Williams. The message from the centre seems to be “we have won a stunning victory, lets not get too worried about the detail”. Pretty patronising and with a party such as ours, almost certainly counter productive!

Don’t knows:

It’s very difficult to judge bills that are directed at improving cost-effectiveness and quality, rather than matters of principle or well-defined problems.
Too hard to tell at this stage but I would encourage pilot schemes. My local doctors are keen.
I’ve worked in the NHS for more than 2 decades. Changes seem to go full circle every so often depending who is in government. Keeping changing cost money. The NHS needs stability with chnages based on evidence that those changes will improve it not just someone’s whim at the time.

  • Over 1,200 Lib Dem paid-up party members are registered with LibDemVoice.org. Some 550 responded to the latest survey, which was conducted between 11th and 15th September.
  • Please note: we make no claims that the survey is fully representative of the Lib Dem membership as a whole. However, LibDemVoice.org’s surveys are the largest independent samples of the views of Lib Dem members across the country, and have in the past accurately predicted the winners of the contest for Party President, and the result of the conference decision to approve the Coalition agreement.
  • The full archive of our members’ surveys can be viewed at www.libdemvoice.org/category/ldv-members-poll
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8 Comments

  • Steve Hicks 22nd Sep '11 - 3:16pm

    It’s a real shame the party wouldn’t allow a vote on this issue at conference.

    Well done to Andrew George our Health Select Committe member for sticking to his principles on the health bill. Mark his words, ‘It’s the NHS stupid’. This issue will haunt us. To read and watch his conference speech in full, follow the link.

    http://andrewgeorge.org.uk/featured-articles/andrew-george-mp-warns-the-health-bill-would-hurt-the-nhs-but-risks-hurting-us-more/

  • Tony Greaves 22nd Sep '11 - 3:50pm

    As someone who agrees with most of the comments in “those against” and none of those in “those for”, I just make the following points:

    (1) the Bill is half way through its passage through parliament: it has passed the Commons and is about to start in the Lords. There will be further changes.

    (2) I am not sure that all the people in “those for” understand what the Bill now does – perhaps they are still talking about the Bill that Lansley presented to Parliament.

    (3) I am not sure it would have been sensible for the conference to pass another shopping list. It may be more sensible to trust the Lords (and those still negotiating within the government) to get it right (or at least better).

    (4) Whatever happens the NHS will have to cope with the changes that are already happening in response to the shadow of the Bill casting forward. In many areas what exists at the moment as people have anticipated the changes – and respond to the draconian “efficiency” cuts laid down by the Labour Government is fairly chaotic.

    Tony Greaves

  • David Rogers 22nd Sep '11 - 6:51pm

    Neither Stephen Tall’s original piece, nor the comments, address the significant role envisaged for councils. This includes Health and Wellbeing Boards involved throughout – from Joint Strategic Needs Assessments, through Health and Wellbeing Strategies, to a voice in commissioning. Combined with the “coming home” to local government of public health, true integration will be given a significant boost, with service users/patients involved and much more “in control”. Then there’s the extended remit of scrutiny, thus giving both executive and non-executive councillors far more say locally than they ever had over top-down targets imposed on PCTs.
    As a party whose strength (still) lies in our local government base, and whose values derive from community politics, these new opportunities should not be under estimated. It is up to us to make the most of them!

  • Patrick Smith 22nd Sep '11 - 7:18pm

    The creation of `grass-roots’ Health and Well Being Local Boards will act as a breakwater on executive powers.They will be greatly welcomed by all those who support an input in the community governance process in `checks and balances’ by voluntary health groups, including advocates of mental health awareness and disability rights.

    I support the inclusion of public health and its reattachment to local government in belief that community health service is better defined and improved when personal health owes most to a cleaner public environment and higher air quality.

  • Tony Greaves 22nd Sep '11 - 9:54pm

    The problem with public health and the H&WB Boards is that they are not at grass roots at all – they are at County Council level which in large sprawling counties like Lancashire are remote, out of touch and bureaucratically useless.

    Publo health is not “coming home” – before 1974 it was at the lower tier in two-tier areas. It is all rather depressing.

    Tony Greaves

  • So most of the Lib Dem MPs have supported this, and even the membership is almost evenly split on it?

    If I am firmly against it, that’s a pretty big disincentive for me to vote Lib Dem in the future.

  • Paul Pettinger 23rd Sep '11 - 1:36pm

    This question misrepresents the main objection to the health and social care bill: that it will lead to greater marketisation in the NHS, not privatisation. The debate about greater privatisation is a false choice presented by proponents of the Bill, including some of the small number of proponents in this Party.

  • Oh, the wishful thinking or sheer naivete of the belief that it really doesn’t matter who provides essential services. Perhaps, someone could explain what precisely has been the public gain, as opposed to that of shareholders, from the privatisation of the railways and the energy and water suppliers. Better services at better prices? Look at the current efforts to come up with legislation to break up the inevitable cartels that have developed.
    Believe it or not, and despite the malevolent interference of successive health secretaries going back to the market competition-introducing Kenneth Clarke , there is still an NHS ethos with the emphasis on care, rather than a self-serving commercial interest, amongst much of the health service staff. Marketisation puts this much-valued quality at risk and the vocational motivation of health workers is likely to become increasingly marginalised with each new intake.
    The profit motive is inescapable if making widgets more efficiently than the competition is the aim. It is most definitely inappropriate, however, in a comprehensive health service that sets out to meet the needs of all over the long term. Decentralisation and far closer scrutiny of individual units and their budgets is a better way of enabling the NHS to meet its challenges. Marketisation is a quick-fix cop-out that would rapidly give the UK an American style selective health service with its immense administration costs. Any party willing to gamble by supporting such a move would not be readily forgiven by the voters for whom the NHS remains by far the most valued national institution. As a world-famous American surgeon said to me back in the 1980s, as the Thatcher government set about introducing competition and market forces into the NHS, “Why on Earth are you bent on imitating our health system when I and many of my colleagues firmly believe that we should be emulating yours?”.

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