High Peak Liberal Democrats

NHS Reforms – It is not too late to pull back from the edge

Despite last minute amendments in the commons, there are still not enough concessions offered by the Government to convince many that this is anything other than an ideologically driven piece of legislation led by the Tories in pursuit of privatising the NHS.

The problem we have is with a rather misplaced public perception that the Lib Dems have colluded and handed this privatisation on a plate, to what should have been a minority Tory government too weak to pursue such a controversial and painful reorganisation on its own.

If we are still licking our wounds and reeling from the catastrophic loss of public support over student tuition fees and the kicking we received in the May 2011 local elections, then please be in no doubt, that the punishment we will receive from the electorate for our perceived co-operation in, and reluctant endorsement of, the demise of a much loved and unified national health service, will be on another planet entirely! And that will be despite the valiant efforts and guerrilla warfare carried out by our Peers led notably by Shirley Williams and others.

Essential to Cameron's election campaign was the promise to protect the health service - his dishonest break with that commitment will prove toxic, not only for him but also for Lib Dems. The public and media will not fail to remind us that the current reforms are in direct contradiction to commitments in the Coalition Agreement's detailed programme (The Coalition: Our Programme for Government), signed by both the Prime Minister and the Deputy Prime Minister.

Cameron will certainly be challenged by voters about having lied about the NHS's future in the lead up to the 2010 election and will face criticisms about the lack of a mandate. Whilst the Conservative Party with its greater access to city funding and bedrock of tribal support may very well be able to ride out the storm, I am fearful about our Party's ability to do the same - With reduced levels of Party income and membership levels, we will have a steep mountain to climb in protecting our 57 MPs in 2015! Can we really afford to continue to endorse such an unpopular and difficult piece of legislation in the first term of this coalition?

Though time is now very limited, we can still pull back from the edge and save ourselves the embarrassment of being perceived as collaborators in an incompetent health service re-organisation which is so evidently not supported by the majority of staff and professional bodies within the NHS.

Whilst GPs and other clinicians do in fact support the concept of clinically-led commissioning, they believe that this expensive upheaval of the health service fails to achieve that and acts as a distraction from the financial challenge facing the NHS. The Royal College of General Practitioners (RCGP) - the UK's largest medical Royal College supports a greater role for GPs in the planning, design and delivery of services within their local communities - but it does not support a Bill which in their view would damage the care and services that GPs deliver to patients. RCGP Chair Dr Clare Gerada called instead for the 'consolidation of the current organisational structure, such that PCT clusters remain, with GPs placed as the majority of the Board'.

If Cameron really wants to put clinicians in control he should by definition listen to what they are saying - louder and louder each day - to withdraw this legislation. Instead, the government's response to the uproar and howls of protestation from respected health leaders and bodies across the sector is to remain in a continued state of denial partnered by a strange mix of injured innocence and insincere bafflement!

But it is still not too late for the Lib Dems…Nick Clegg should withdraw our support for the Bill and in doing so halt a damaging, unnecessary and expensive reorganisation which has the potential to leave the poorest and most vulnerable in society to bear the brunt. This position is strengthened through the recently published joint editorial by the Health Service Journal, Nursing Times and British Medical Journal, which predicted the changes would be so destructive that another expensive reorganisation would be needed within five years.

Taking such a bold decision would mark out clear lines in the sand in a public manner, differentiating us from the Tories and creating that vital space for debating our social liberal ideals on the doorstep. As a get out clause, the Deputy Prime Minister could argue that the growing public and professional outcry now shows that the consequences of the bill have turned out to be entirely different from the principles which were originally agreed. This is a plausible position and one which the party grass roots, patients, professionals and wider public will understand and respect.

The alternative is to leave an indelible legacy which will continue to poison our relationship with the electorate and shatter any future credibility within our promises that the NHS is safe in our hands.

If we continue along this trajectory, the impact will be disastrous not only for public health services in England, but also for our Party in terms of grass roots de-motivation and further erosion of public confidence in the face of a very difficult General Election campaign in 2015.