Lord Clement-Jones writes… Limiting competition in the NHS

This week Liberal Democrat peers achieved yet more success in limiting the application of competition in the National Health Service. Our party members believe, and our conference policy passed last spring affirms, that while competition can play a role in improving the quality of health, it should never be given higher priority than the interests of patients. And I completely agree.

Competition Commission

I was concerned that the Competition Commission should not be reviewing how effectively competition is working in the health service. In the private sector, the Competition Commission plays a crucial role in ensuring that companies compete fairly, and prevents cartels. However, in the health service Liberal Democrats want publicly-run hospitals, charities, social enterprises and other providers to co-operate. Competition Commission staff are steeped in competition principles and have a bias in favour of the benefits of competition.

I argued it was inappropriate for them to review competition in the NHS or how effectively Monitor are applying competition law. So I am delighted to say that my arguments carried the day with support across the House of Lords. This clause has been struck from the bill entirely, as Nick Clegg and Shirley Williams argued for last week.

Foundation trusts

I was also concerned that Foundation Trusts – the organisations which will run each district general hospital – must not be left to their own devices without regulatory oversight. They are the core of public provision in the health service. For many months I have been arguing the case in the chamber and in meetings with government ministers. As a direct result of this, the government did a 180° u-turn and put forwards amendments that ensures Monitor will remain an effective regulator of with powers of intervention. This was asked for by Nick Clegg and Shirley Williams and delivered by the Lib Dem health team in the House of Lords.

Liberal Democrats have made changes to this Bill so that competition will no longer be given a higher priority than the patient’s interest. We’ve also brought an end to Labour’s preferential treatment of the private sector – which saw them pay private providers 11% more than NHS hospitals for the same service.

Without this bill, Labour’s 2006 Act – which deliberately opened up the NHS to widespread competition – would still be in force. I have absolutely no doubt that the NHS needs this legislation to close Labour’s loopholes, and with the changes Liberal Democrats have achieved we can support this bill.

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  • I am rather confused by the first link that you provide; it shows Lord Clement-Jones and other Liberal Democrat Peers voting against Amendment 163BZZB, which was tabled by… Lord Clement-Jones.

    Lord Clement-Jones, why did you (and other Liberal Democrat Peers) vote against your own amendment? It seems like a very odd thing to do.

  • Tony Greaves 8th Mar '12 - 3:33pm

    “However, in the health service Liberal Democrats want publicly-run hospitals, charities, social enterprises and other providers to co-operate. ”

    “Other providers” are of course the private sector which is hovering ready to scoop up many more contracts from the new Clinical Commissioning Groups. Nothing that has happened in the passage of the Bill in the past year has changed this, except that competition must now be on quality not price. Can anyone explain how this is going to work? In practice, if you are providing a better service or more wervices for the same price, what has changed? How is it going to stop the private sector scooping up the easy and common stuff so putting NHS hospitals at a competitive disadvantage?

    Tony Greaves

  • One additional point to remember is that increasingly, private providers are arguing to be allowed to ‘supply’ on grounds of giving a ‘choice’ to patients, as distinct from anything about competition law.

  • Sorry but this is not good enough. Evan Harris very clearly lays out here what parts of the member’s motion from last conference have been met – and more importantly those (around competition) which haven’t.


    The NHS bill was never in the coalition agreement and remains opposed by a majority of the membership, as well as the public. Some of the parliamentary party may be comfortable with the competition element having been worn down by pro-privatisation government advisors but many of us are not. What’s more, passing this bill will do irreparable damaging to the parties standing amongst the general public.

    To proceed is pure political expediency. You and your parliamentary colleagues risk losing the support of a large swathe of centre left members (and former staff) like me who have sweated blood and tears for the party in many election campaigns.

    The NHS needs reform, but this is a cure that kills. If the membership votes against it, you will should respect that vote and oppose the bill – or we can’t really call ourselves a democratic party anymore.

  • Nick (not Clegg) 8th Mar '12 - 3:59pm

    “How is it going to stop the private sector scooping up the easy and common stuff so putting NHS hospitals at a competitive disadvantage”.

    Delete “NHS hospitals” and insert “The Royal Mail” and you have exactly the question which was put before a previous “reforming government ” removed the Royal Mail’s monopoly. for the carriage of letters while, of course, leaving the poor old Royal Mail to complete its competitors’ jobs for them by carrying the letters “the final mile”. A few years down the track, it was “poor old Royal Mail; it can’t compete, it can’t make a profit. I know, let’s privatise it”.

    The recent history of the Royal Mail should serve as a terrible warning for the trajectory upon which the NHS is now being launched

  • AndrewM:

    Voting against your own amendment is not odd.

    A Peer tables an amendment.

    The Government makes an on the floor concession in the House.

    Cynical opportunistic Labour Peers press the amendment to a vote, alienating some of their own colleagues and corssbenchers in the process, with the intention of causing confusion.

    The Peers who tabled the amendment vote against the amendment on the basis of the ministerial assurance.

    The amendment is overwheming defeated.

    It is simple really.

  • Jonathan Hunt 8th Mar '12 - 5:07pm

    Sorry Tim,

    I know that you and other peers have worked very hard to make the Bill less destructive.

    But in doing so, it has become incomprehensible not only to the general public, but most party members as well.

    The only sensible course is to kill a bad Bill now.

    Let the public see that we really do care about the NHS created by Liberals. .

    And let us take the brownie points and not Milliband.

  • Richard Dean 8th Mar '12 - 6:42pm

    Voting against your own amendment seems peculiar to me. If a ministerial assurance was going to be enough to satisfy me, I would have asked for the assurance, not tabled an amendment.

  • Richard Dean:

    The thing is you need to table an amendment to get the assurance. Without having an amendment down to peg a debate to then it would have not be possible for the minister to say what he did.

  • Richard Dean 9th Mar '12 - 11:01am

    Mike, Thanks. The peculiarity is, I suppose, another good reason for abolishing the Lords. They could easily do things in a more sensible fashion.

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