Opinion: Lib Dem MPs must vote against the health reforms – not for health, but for democracy

Lately, we have heard much about Andrew Lansley’s proposed reforms of the NHS, both from within the party and without.

Grassroots site ‘Conservative Home’ writer Tim Montgomerie came out in opposition to the bill, calling it ‘unnecessary and unpopular’. Lansley’s supporters have been less professional in their counter-briefing.

Lib Dems on all sides are throwing their all in to the debate about the biggest shake up to our health service in decades. I’ve found it difficult to have an opinion on either side – so as the debate [read: flaming row] has flamed around me, i’ve noticed a trend that I find very troubling – The Parliament Act.

The Parliament Act is a government failsafe – that in the event of a stalemate between the Commons and the Lords, the government can ignore the ‘veto’ of the Lords and push a contentious bill into law.

It was first brought in by the Liberal administration of David Lloyd-George, who was having trouble enacting a land tax against the wishes of the then mainly Conservative upper house. It took several snap elections in quick succession, and the threat of flooding the upper house with Liberals, to get the law into place.

The Parliament Act is there to combat vested interests – that when an elected lower house has a clear mandate for what it is doing, it can overrule the vested interests of the Lords. Use of the Parliament Act is not something to be taken lightly, and yet mutterings get louder and louder about using it for the Health & Social Care bill.

I think this stems from the promise by David Cameron to use the Parliament act to help enact the LibDem manifesto commitment of an elected upper house. Here, the mandate of the lower house overrules the privilege of the upper house (many of whom may lose their ‘right’ to be part of the governance process), and the law gets passed.

But the NHS reforms do not have a mandate. No matter how essential Lansley may say they are, they were not in the Conservative Manifesto. Nor were they in the LibDem manifesto.

There is just as much mandate in the Upper house as there is in the lower house for these reforms – very little.

The Lords serve the country as a scrutiny panel, and while party lines are drawn in the house, there are strict traditions that confine the Lords to voting based on scrutiny of the bill, and because ‘I don’t like the Tories/Labour/Those Yellow B*stards’.

These people are not planning to vote against the Bill because of tribal divides, but because of genuine concern for the state of the NHS.

Regardless of your views on the Lords’ mandate, they exist as part of our democratic structure (whether elected or appointed) to oversee the Commons and to ensure that populist laws which could be damaging to the country do not see the light of day. They are there to protect the country, to provide damping – through expert opinion – for violent swings between ‘left’ and ‘right’.

An upper house with a ‘veto’ is essential to a fair democracy, and if the government can play fast and loose with the Parliament Act, the upper house is left as nothing more than a parliamentary pressure group.

So, Liberal Democrats. If Cameron wants to use the parliament act to overrule the genuine concerns of the Lords, you must stop him in the Commons. Not to be the heroic saviours of the NHS, like Miliband wants to be – but to be the unsung saviours of the democratic process.

* Jack Holroyde is a political campaigner and founder of Gaining the Advantage, an organisation dedicated to improving access to democracy in the UK. He tweets at @theGladstonian.

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14 Comments

  • Curious Lib Dem 11th Feb '12 - 10:35am

    Just curious, but at which remaining stage of the legislative process do you think the Lib Dem MPs should vote against the NHS bill?

  • Agreed… but not just in the interest of democracy but also to save the NHS. We were told to swallow the bitter pill of coalition with the Tories in order to temper their excess and nasty streak – well here is our chance to prove it. Lets put our money where our mouth is and do want the public have been told to expect; temper the tories by killing off this Bill.

  • Daniel Henry 11th Feb '12 - 11:03am

    I was very disappointed that we allowed the Tories to get away with using the parliament act (by declaring the Welfare Reform Bill to be a “financial” Bill) to bypass the Lords.

    Using the parliament act to bypass the Lords on health would be out of the question for sure!

    It might be necessary to beat vested interests on Lords reform.though.

  • Jack Holroyde 11th Feb '12 - 11:07am

    Indeed Daniel.
    I was utterly horrified to see it being used on the Welfare Bill. There were genuine concerns which were steamrollered. It defeats the point of the Lords and leaves our democracy in a precarious position.
    I’m up for the Queen flooding the House with Liberals, though.
    It would make debate a lot more interesting!

  • I don’t think there’s much chance of the Parliament Act coming into play. I think the more worrisome democratic matter here is that parts of the Bill have already been implemented, and that this is then used as a reason not to kill it. If that’s not a subversion of democracy and the legislative, I don’t know what is.

  • Patrick Smith 11th Feb '12 - 2:31pm

    The vast majority of NHS affiliated groupings are scepitical that the NHS Bill is required at all.

    I believe that the L/D Coalitionist groupings have now succeeded in protecting and preserving the `free at the point of delivery’ and public service principles encoded into the NHS that have existed since 1945 and is the envy of the free world

    I agree that the Parliament Act should not be used to override the House of Lords veto on the Health Bill as this reform was a product of Tory Central Office and not the `Coalition Agreement’.

    The Upper House Reform is another matter and was contained in the `Coalition Agreement’ and is L/D policy.

    It could well be David Cameron`s personal `pariah’ if he as PM chooses to back the NHS Bill against his own `grass-roots’ Conservative Home opinion polling and close confidants in Cabinet..

    As a Liberal Democrat I care not of the consequences to the Tory voters in the 2015 next Election as a result of their leader choosing to ignore their opinion.I do however,want to see greater door opening local representation of community and Health Boards at local level that can only happen if the PCT gate-keeping bureaucrats are abolished.

    There has to greater focus on care for the Elderly and `fairness’ in respecting aging patients requiring hospital operations and treatment as the population is growing older in vaster numbers.The maternity care must also be improved as there is a shortage of trained professional midwives to cope with the number of births and choices of women.

    There has been 136 L/D H of L`s led changes made to the original NHS Bil.It has now be mutated beyond recognition, as a result of Liberal Democrats at Conference.

    Baroness Shirley Williams statecraft,wisdom and concern for the primacy of the NHS has also ensured that it remains under the purview of the Secretary of State for Health.The question is now ,which one?

  • Daniel Henry 11th Feb '12 - 2:51pm

    Dave Page has a point.
    The problem seems to be with the title that suggests the party should vote down the NHS Bill. Perhaps the title should be changed to take out “vote down Bill” and instead say “disallow use of parliament act”.

  • Tony Greaves 11th Feb '12 - 4:31pm

    One or two things. The Lords amendments to the Welfare Reform Bill were overturned on grounds of the “financial privilege” of the Commons which is different and a lot older than the Parliament Acts. (Though the Lords refusal to accept the Commons financial privilege on the “People’s Budget” was a major part of the row a century ago).

    The Prime Minister in the Liberal Government that introduced the first Parliament Act was Asquith, not Lloyd George. (And LG has not got a hyphen!)

    If the Parliament Act were to be used for the Health and Social Care Bill (which I personally would consider to be outrageous) it could be done at the start of the new session this spring/early summer.

    Tony Greaves

  • Daniel Henry 11th Feb '12 - 4:54pm

    I didn’t know that.
    Learned something new today! 🙂

  • John Carlisle 12th Feb '12 - 11:39am

    Jack
    I don’t think it just a matter of democracy. It is matter of well-being of the UK population, so, how it is passed or not is less important than the application of bad thinking about what system delivers good health, i.e. not restructuring, but improving service delivery based on what really matters to the users.
    Any LibDemmer who is serious about the NHS must listen to this BBCYou and Yours excerpt about an elderly NHS user.
    http://www.bbc.co.uk/iplayer/console/b01bmltb . Start on the 32nd minute and listen to why Whitehall is consistently in denial over key issues like the NHS and education, and what this is costing the country.

  • If this Bill is to be pulled, those involved cannot avoid “playing games” in doing so. It would actually be wrong for Clegg to come out with a blunt statement of opposition to the Bill. The reason is that it would be the Lib Dems making a pitch to become national heroes, the party who famously got the Bill scrapped and restored a nation’s faith in them. That would be electorally very nice for us, so nice in fact that the Tories would not be able to stomach it happening. They would just become the more determined to drive the Bill through, and they would vilify their coalition partners while doing so.

    However, it would be equally wrong for Clegg to position himself as the last defender of Lansley, even as ConHome cut the rug from under his feet. That would just look supine, toadying, and breathtakingly contemptuous of the spread of opinion within the party. Yet that seems to be what is happening, if we believe the Guardian:

    “In a bizarre twist, the Liberal Democrats, who have been wracked with internal divisions over the bill, called on their coalition partners to get a grip.

    The Lib Dems were pointing to the way in which Baroness Williams on BBC1’s Question Time on Thursday night had staunchly defended the revised bill.”

    http://www.guardian.co.uk/politics/2012/feb/10/cameron-force-nhs-reforms

    Say it ain’t so, Nick!

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