Tag Archives: health and social care bill

From the Red Benches: Health and Social Care Bill

The Health and Care Bill, which is about to reach its end after the Easter break, has been a good example of a Bill which had not been thought through by the Government but massively improved in the Lords.

It is also a good example of what can be achieved by cross party working and a Minister who has been willing to listen, except when the Treasury has stuck its oar in and prevented compromise.

The Bill replaces the current Care Commissioning Groups in England with 42 Integrated Care Systems, each headed by an Integrated Care Board responsible for commissioning health and care services across its very large area. In principle the move towards integration of care is very welcome but the detail is crucial.

The ICS may include more than one Local Authority. The appropriate representation on these very powerful boards of Local Authorities and others with the right skills, knowledge and experience has been a big issue which we were determined to get right. I think we got a good result.

The Bill also introduces an advertising ban for foods high in sugar, salt and fat on TV before 9 pm and online. It also sets up a new system for investigating cases where things go wrong and where lessons can be learned by the whole service.

Crucially here we have been able to alter the Bill to ensure that people can give candid evidence in a ‘safe space’ without danger to their own future career. This is fundamental to the success of the system. Too often in the past, potential whistle-blowers have been deterred from saying what happened for fear of bullying and damage to their careers and potential learning has been lost.

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The Health and Social Care Bill needs a complete rethink

The Health and Social Care Bill 2021 is currently in the House of Lords and will shortly be returning to the House of Commons where it is likely to receive a mixed reception with some believing that it will lead to further privatisation and others opposed to the 1.25% precept on National Insurance.

In recent months the “cost of living” crisis has been added to that of health and social care.

Rising food and energy prices will hit those on low incomes disproportionately as they are essential items. The recent two-part BBC programme “The decade the rich won” highlighted the widening income inequality of the last decade. And according to a report by the Paris-based World Inequality Lab, 2020 saw the steepest increase in billionaires’ wealth on record.

Britain has one of the lowest state pensions in the western world with 2m older people living in poverty. There is a wealth of empirical evidence on the “social determinates of health” which has demonstrated the correlation between income and demand upon the NHS, so it is hardly surprising that 80% of the expenditure of the NHS goes on older people.

Unless Government does something to lift people out of poverty it will never keep pace with the increasing demand for health care. It is no use throwing more money at the first aid camp at the bottom of the cliff rather building a fence at the top. So, what would the outcome have been if the Government had used some of the additional £57.5b it has committed to health and social care to increase the basic state pension and lift older people out of poverty?

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David Heath MP writes… Freedom of Information and the NHS risk register – we should publish as much as possible

It was 12 years ago that I sat on my very first House of Commons bill committee, and a pretty important bill it was too. We were considering what was to become the Freedom of Information Act 2000, and I was helping Bob McLennan try to stiffen up what was in danger of becoming, in the hands of the last government, an increasingly flaccid piece of legislation.

After decades of campaigning, the 2000 Act was certainly a longtime in coming for Liberal Democrats. It was Clement Freud who first introduced a Private Members Bill in 1978 that attracted considerable support, …

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Opinion: It wasn’t in anybody’s manifesto, was it?

I haven’t read the Health and Social Care Bill (soon to be Act). More pages than a Harry Potter novel, and qualified by a thousand amendments, I’m not sure reading it would throw much light on my darkness. However, there are aspects of the bill I am aware of.

I know, for instance, that the NHS Bill was in no one’s manifesto, and I know there wasn’t the slightest hint of its major elements in the coalition agreement. The government has absolutely no mandate for NHS reform at all. It all seemed so clear … and then I made a foolish …

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Baroness Shirley Williams writes… Making sense of the Health Bill amendments

If you are trying to explain to Liberal Democrat members and interested potential voters how the Lib Dem peers changed the health bill, much the best source of information is the House of Common’s library standard note, which is non-partisan and available online at the Parliament website.

In my view, no local Lib Dem group should be without it! It describes all the more significant amendments, from Lib Dems and also from Cross-Benchers and Labour peers, in a way that most of us can understand.

It brings out the changes to the powers of the Secretary of State; the removal …

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Opinion: How democratic are doctor politicians?

A group of 240 doctors recently threatened to stand against leading members of the government in the next election, in protest at the NHS Bill (Now the Health and Social Care Act). They are ‘shocked at the failure of the democratic process and the facilitating role played by the Liberal Democrats in the passage of this bill’. They follow the example of Richard Taylor MP, a consultant physician who won his Wyre Forest seat from a junior health minister in 2001, campaigning against the closure of the …

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Baroness Judith Jolly writes: Why Lib Dem peers have supported an amended Health and Social Care Bill

Twenty five days of debate in the chamber of the House of Lords have now concluded on the Health and Social Care Bill. Our health team in the Lords has been involved in numerous meetings, events and correspondence discussing the Bill over the last eighteen months. We made it plain throughout the process that we could not have voted for the Bill without significant series changes that Liberal Democrats and professional organisations demanded. We believe that great care is now needed over how it is implemented in order to avoid the dangers of which many have warned and in order to restore the confidence of professionals in the NHS.

Posted in News and Op-eds | 66 Comments

House of Lords approves Health and Social Care Bill – Lord Owen is the last redoubt

From PoliticsHome:

The controversial Health and Social Care Bill has been passed in the House of Lords, with a ditch attempt by Labour peers to delay its progress voted down 269 to 174.

The approval from the Upper Chamber comes after the Speaker earlier granted Labour an emergency debate in the House of Commons on the Risk Register of the NHS reforms.

This afternoon Labour’s Shadow Health Secretary Andy Burnham argued that MPs should have the opportunity to debate the Government’s ongoing refusal to publish the register.

Also this afternoon, the

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Baroness Claire Tyler writes… Shining a spotlight on health inequalities

Today is Third Reading in the Lords of the Health and Social Care Bill. That this is one of the longest, most complex and contentious piece of legislation of this Parliamentary session barely needs restating. That it is unloved in many quarters is a statement of the obvious. And of course you only have to read the many articles and threads on Lib Dem Voice about the Bill to know that views still vary widely on whether it is necessary to address the fundamental challenges faced by the NHS.

Having been a member of the Lib Dem team in the Lords – working alongside far more experienced colleagues than I – I do know that the Bill has improved out of all recognition from the Bill we received from the Commons. Of course it does not bear the hallmarks of a Bill that has come from a Lib Dem stable – because it didn’t – but that is the nature of coalition government. And whilst I fully recognise that some in the party would rather part 3 of the Bill dealing with competition didn’t exist, I think it’s necessary.

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PMQs: Your boys took a hell of a beating

I’m looking forward to the comments this week.

We saw a newly confident Nick Clegg at Prime Minister’s Questions today.

I’ve written before that Nick’s early Dispatch Box appearances were a bit like bear bating. He stood there, red-faced and growling as Labour MPs jabbed at him from all angles.

But, today, we saw an assured and relaxed Nick Clegg who was convincingly combatative. Most impressively, he discharged the session with barely a single reference to a piece of paper. Not for him the “chained to my indexed folder” look of David Cameron. In short, Nick Clegg was Prime Ministerial. “Best ever” was …

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What Lib Dem bloggers have been saying about the NHS Bill after Lib Dem conference

Unsurprisingly, there’s been plenty of post-conference reaction to the weekend’s events.

A quick recap of what happened: on Saturday, Lib Dem conference representatives narrowly voted not to debate a motion that called for the NHS Bill to be dropped. Then on Sunday, Lib Dem conference representatives narrowly voted following a debate not to support part of a motion that called for Lib Dem peers to back the NHS Bill.

Here’s how Lib Dem bloggers have responded to these events:

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Opinion: #KillTheBill – but not for a reason you may be aware of…

This weekend saw the LibDems argue both for and against the Health and Social Care Bill. It may be a cliché, but whilst I’m in the #KillTheBill camp, I am still proud of our democratic system that allows votes on both sides of the argument to be counted (interestingly, I had to explain to supporters of the bill that those of us arguing against don’t want NO bill, just not THIS bill – for some reason they seemed surprised at that).

I spoke to both Paul Burstow and Judith Jolly about some of the concerns I have, and I pay tribute …

Posted in Op-eds and Party policy and internal matters | 21 Comments

Round-up of initial reactions to the Lib Dem conference NHS Bill vote

There’s been no shortage of reaction to the vote by the Lib Dem conference this morning to vote by 317-270 to approve an amendment which implicitly calls on the party leadership to drop its support for the NHS Bill.

I say “implicitly” because the motion as passed — pasted at the foot of this post — does not call on Lib Dems to ‘Kill the Bill’. However, conference did vote (albeit narrowly) to remove the call for Lib Dem peers to support the Bill. This follows yesterday’s pre-debate conference vote (again narrowly) to choose not to debate the motion which would …

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Health Bill debate at conference: live blog

Welcome to our live blog. Updates added at the foot.

No, the packed hall isn’t here to see my questions to the reports of the Parliamentary Parties (shocking, I know). It’s people filling up the hall early ahead of the big debate of conference: the NHS.

First up, moving the motion is Judith Jolly: “No one thinks this bill is perfect … but it is a hugely better, safer bill because of Lib Dems”. Shirley Williams is presumably waiting in the wings to make the last speech of the debate. She goes on to detail many of the doors opened to privatisation …

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Opinion: Let’s unite behind the Protecting the NHS motion

I adore Shirley Williams, always have, always will. She’s one of my political heroes. The way she has fought for women’s rights and helped emerging democracies to develop shows a truly liberal and compassionate spirit. So that’s my declaration of interest out of the way. But I’m not alone. I’d say most of us in Gateshead this weekend feel the same way. Policy decisions we make, though, are not about her.

The future of the NHS is not something that you can pin to personalities. That’s why I was not best chuffed when Nick Clegg said this afternoon that you were …

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Do Lib Dem members’ views differ from conference representatives’ views? Here’s what our survey says…

We published yesterday the results of our survey of Lib Dem members’ views of the Coalition’s NHS reforms. Given the importance of this weekend’s debate at the party’s spring conference, we have also tried to test how Lib Dem members who are conference representative might vote on Sunday, when there is likely to be an emergency debate on the future of the Health & Social Care Bill.

All party members registered on the LibDemVoice forum were able to vote: 507 did so, including 147 who said they would be attending the conference as a voting representative. To compare their views …

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The Independent: Lib Dems should “make peace and move on” from the Health Bill

Today’s Independent has an editorial with some friendly advice for the Liberal Democrats. The paper praises the party for the amendments made to the Health and Social Care Bill but advises that it’s now time to “make peace and move on” by passing the Bill:

With the Liberal Democrats in Gateshead for their spring conference this weekend, NHS reform is once again top of the agenda. And once again grassroots activists are threatening rebellion. It would be a mistake – for the NHS and also for the party. It is time to make peace and move on.

Last year’s conference was a

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Baroness Shirley Williams writes… I am fed up with lies about Lib Dems and the Health Bill

Last March, I spoke at the Sheffield Conference in support of the motion that led to radical changes in the Health and Social Care Bill. By the Summer, much of the Bill had been changed and I was able to write that the Bill was much improved.

I felt that we should be proud as Liberal Democrats for thwarting the initial plans.

My colleagues in the House of Lords have made more very important changes to the original plans. On Tuesday I told the House that, “I believe that that culmination of changes will enable us to bring about an …

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John Pugh MP writes … TINA and NHS Choices

Mrs Thatcher was reputed to declare in more than one context that There Is No Alternative – earning herself the sobriquet of TINA . In life that is rarely the case and as an avowed existentialist I am disinclined to believe that is ever the case.

The party will be told that there is no practical alternative to the Lansley Bill. That could be true. I have no doubt that the Bill has been substantially changed and improved as a result of the listening exercise and amendment in the Lords.

It is, however, still a massive set of changes to the NHS and a continuation …

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A letter from Andy Burnham to Liberal Democrat members

I never expected to see the day when I could say, hand on heart, that I was more interested in events at a Lib Dem Spring Conference than the weekend’s football. But life’s full of surprises and that moment has arrived.

It is no over-statement to say that this weekend’s gathering in Gateshead could determine the future of our country’s best-loved institution.

As you prepare for the weekend, I wanted to make a direct appeal to the grassroots members of your party: please stand out against the current direction of reform and stand up for the NHS model we all have been …

Posted in Conference, Op-eds and The Independent View | Also tagged , and | 62 Comments

Opinion: Why the Leader’s letter hardened our Health Bill motion

For a year a group of Liberal Democrats who know something about the NHS and the delivery of healthcare have been working to modify Lansley’s Health Bill with the aim of preventing irreversible damage to the NHS.

Until last week our draft motion still offered the hope of amending the Bill. When we saw Nick’s letter we realised that there was no point.

On preventing competition by price the letter is doubly misleading. David Nicholson warned about this in January 2011 and the Government conceded the point in February. However, even now competition on price has not been completely prevented. Government Peers …

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Shirley Williams sets the record straight on NHS reform

It has been suggested by one of our readers that we give a higher profile to a speech made in the House of Lords on Tuesday, especially in light of the ongoing debate on these pages. And so, without further ado…

Baroness Williams of Crosby

I want to say a word about competition, and it is appropriate to do so given that the noble Lord, Lord Warner, has just been speaking. He has always spoken with some courage on this issue, which I recognise is not exactly popular with his party. However, I say quite directly that I feel very strongly that …

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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 …

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Opinion: We need to talk about the NHS

Later this week , at spring conference in Gateshead, the Liberal Democrats will have the opportunity to debate issues and define party policy. Now, more than ever, this internal democratic process has the opportunity to actually influence what the government does. The NHS is likely to be on most people’s minds, and possibly on the agenda as an emergency motion.

I’m a member of the Liberal Democrats, but as a doctor, I’m also a member of a number of other organisations too. I’ve become acutely aware of the very different ways that these organisations have responded to the health …

Posted in Conference, Op-eds and Parliament | Also tagged | 34 Comments

The Independent View: You should be worried about the NHS changes

I am a consultant paediatrician* (I am writing under a pseudonym to protect family, colleagues and patients) with over 20 years experience. I work with parents, many of whom have problems with mental health, substance misuse or learning difficulties. My job is to help protect their children and prevent them from following a similar life path.

I know what the effects of the Health and Social Care Bill will be because I can see it happening already. Looking after vulnerable children who are at risk of harm is becoming much more difficult because of the needless reconfiguration of services, whilst simultaneously …

Posted in Conference, Op-eds and The Independent View | Also tagged | 29 Comments

Opinion: Save the NHS Bill

I must admit I’ve been wondering a little at being so contrarian.

My mobile phone address book and filofax (yes, I’m a certain age) is full of people who say they are too busy to talk to me this week because they are working hard to kill the NHS Bill.

I am not. What’s the matter with me?  I’m going the right way to being thrown out of the lunatic fringe.

So please, if you read this blog. Have a heart. Tell me where I’m going wrong.

Here’s my problem. I cannot see why we should be striving to maintain the NHS exactly as …

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Baroness Barker writes… Liberal Democrats protecting the integrity of the NHS

We trust that doctors and nurses will care for us to the best of their ability, and we trust the decisions they make about our treatment are always in our best interest. It is clear that for patients and medical professionals alike, maintaining the integrity of the NHS is essential.

Clinical Commissioning Groups (CCGs) will bring their unique knowledge of the health needs of their patient population to the design and commissioning of health services as part of the proposals contained in the Health and Social Care Bill.

We know that CCGs must be transparent and accountable to the public and …

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PMQs: Beccles, Bungay, swivel-eyes and the hysterically happy DUP

Did you know that the happiest people are in Northern Ireland? Laugh-a-minute DUP MP Nigel Dodds told us so at Prime Minister’s Questions yesterday. The DUP’s Jeffrey Donaldson, on his feet following this announcement, bore something of a burden. Not known for his cheery disposition, a colleague twice entreated him to “Smile Jeffrey”.

High pantomime was the order of the day. Dear Gerry Kaufman seems to think that longevity in the House should be matched by longevity of questioning. Well into his sixth paragraph, it seemed, the Speaker gave him fierce winding up signals and commented: “The right hon. Gentleman has …

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Opinion: Lib Dems should support the NHS reforms to secure its long-term future

Listen to the Labour spin, the media furore, or the special interests in the healthcare unions, and you’d think that the Health and Social Care Bill had been crafted by the evil Tories and naive Lib Dems to maliciously snatch all hope of critically needed health and hospital care from the poor and vulnerable, dooming great swathes of the population to lives of miserable illness and suffering, all to help the ‘rich and profiteering’ private healthcare companies milk every last penny and drop of human decency out of society.

Left leaning voters are angry – indeed opinion polls show that a

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Coming up in the Lords… 5-16 March

Welcome back to Liberal Democrat Voice’s coverage of the House of Lords, our attempt to let you know what is coming up and when in the second chamber. Think of it as your reminder to lobby our Peers, or any others, in advance of the debate. And with no further ado, we’ll turn to the legislative agenda…

With the Welfare Reform Bill having gone through its final stages this week – and we’ll be covering that separately – attention returns to the other items of unfinished business. The Report …

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