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Baroness Judith Jolly writes: The House of Lords will challenge, revise and improve the Health Bill

October 12, 2011 10:28 AM
By Judith Jolly
Originally published by East Midlands Liberal Democrats
Tony Blair, on the eve of the 1997 General Election, famously proclaimed that we have just "24 hours to save the NHS". A nice rhetorical flourish, but lacking in objectivity. Perhaps somewhat like the Labour party. Similar language is once again being used this week as the House of Lords debates giving a second reading to the Health and Social Care Bill. Opposition groups have jumped on this by suggesting that this is the last chance to 'stop' this Bill. Perhaps unsurprisingly, given the complexity of the inner workings of the House of Lords, this doesn't properly reflect the role of peers in the 'other place'.

When we vote on Wednesday, we will not be voting to wave the Bill the through. Voting 'yes' does not mean we are simply saying 'yes' to the Bill. It means we are voting 'yes' to full scrutiny of a Bill, on the floor of the House so every peer can have a say, that we have already improved through the "Pause" after our Sheffield conference, and which will allow us to oppose issues that would undermine the NHS.

I have no doubt that many things still need to be changed, clarified or improved in the Bill. And as our Liberal Democrat Health Minister, Paul Burstow, said at conference:

The House of Lords revises, it improves, it challenges and that is what it will do with the Health and Social Care bill. That is exactly what it should do.

And that is exactly what we will do. Every minute I have spent in the House of Lords leaves me with absolutely no doubt that that Health and Social Care Bill will get full line-by-line scrutiny. For that reason, there is nothing wrong in agreeing to properly consider something that we know requires further changes.

We also shouldn't forget that this is a better Bill because of the Liberal Democrats and the changes we fought for. The Conservatives wanted Monitor to promote competition. Instead we changed Monitor's overarching principle to be the promotion and protection of patients' interests. Private providers will no longer be able to compete for huge numbers of services. Our changes now mean they will only be allowed to provide services for a very limited number of treatments; and only where there is a tariff, ensuring that competition is on quality and not price. This will help bring an end to Labour's competitive tendering where private companies were awarded contracts for services, such as community and mental health treatments, not because they were better quality than the NHS, but because they were cheaper.

So instead of near-blanket coverage of Any Qualified Provider, we will now have a situation where private, voluntary, and charity providers are only allowed to offer their services for 8 treatments - including mental health services. What's more, all of these services have been agreed by commissioners and most crucially, by patients. And we shouldn't forget that it is because of Liberal Democrats that the Bill now includes changes to ensure that no government, present or future, will be allowed to deliberately favour the private sector in the way the last Labour Government did when they paid private providers gold plated contracts which ensured they were given £250 million for operations they didn't even perform.

Some people are still concerned about the accountability of the Secretary of State. I was personally greatly encouraged by Paul Burstow's words at Report in the Commons, when he said that

…we are willing to listen to the concerns that have been raised and, if necessary, offer clarifications or make amendments to put beyond legal doubt that the Secretary of State remains responsible and accountable for the comprehensive health service we all want to see.

It's now our role in the House of Lords to make sure that those words are put into practice. Aside from the role of the Secretary of State, there are a number of issues that we must consider:

What will happen, for example, where a Clinical Commissioning Group and its Health and Wellbeing Board cannot agree on the contents of the Joint Strategic Needs Assessment or Health and Wellbeing Strategy? Will Directors of Public Health have sufficient tools and resources at their disposal, financial and otherwise, to hold local authorities to account and make sure that they take their public health responsibilities seriously? And given the impending demise of Strategic Health Authorities, what will be done to stop the existing medical education system from disintegrating before anything can be set up to replace it? All of these are issues, and many others require careful scrutinising from the House of Lords.

Liberal Democrats can rest assured that this is exactly what we will do.

Baroness Jolly is Co-Chair of the Liberal Democrat Parliamentary Party Committee on Health and Social Care.