What does the Health & Social Care Bill mean?

Let's make it plain from the very beginning, the Health & Social Care Bill introduced by Andrew Lansley should never have been introduced and broke David Cameroon's pledge of no "top down" reorganisation of the NHS. I, along with most Liberal Democrats, think it would have been better just to concentrate on letting the NHS settle down after the endless reorganisations under Labour while the £20 billion savings were being made.

That said it was introduced. The Tories would not see sense and let it die after last year's pause in its passage through Parliament, caused by the Liberal Democrats saying we could not support it as was. Liberal Democrat MPs & Peers, led by Shirley Williams, have worked very hard over the last year to change it from a damaging bill to one that is much more constructive. Here are a few of the changes Liberal Democrats have introduced:

• Rules that mean for the first time no Trust can do more than 5% of private work without convincing the their own governors that this will not adversely affect other health care in the area.
• Any profits from private work must be ploughed back into the Trust to benefit the community. Also for the first time the accounts for private work will be kept separate from the rest of a trust's accounts so there are no hidden costs.
• An end to the rules, introduced by Labour, which allowed privately-run NHS Treatment Centres to be allowed to undercut NHS Hospitals on simple operations. The Bill also stops other Labour rules that meant these Centres were paid for operations whether or not they were carried out.
• Re-introduces mechanisms, the Health and Wellbeing Boards, for the local community to influence health care in their area for the first time since Labour abolished the Community Health Councils in 2003.
• Insisted that any competition in the NHS is based on quality not costs to make sure care is improved and not cut price
• Guarantees the Secretary of State's responsibility for a comprehensive health service, his power to intervene if things go wrong and his accountability to Parliament
• Brings Out of Hours Care, privatised by Labour, under the wing of the Care Quality Commission
• Puts the NHS in the vanguard of medical research.

I cannot accept the hypocrisy coming from the Labour party which opposes many of the measures in the Bill that they would have introduced if they had stayed in power in 2010. It was they, with Andy Burnham as Secretary of Health, which introduced privatisation into the acute care arena with Treatment Centres. It was the Labour party that increased GPs pay while not covering out of hours care. It was Labour that wasted billions on a National Program for IT which has failed to deliver the quality computer systems our NHS needs. It was Labour that were forever tinkering and reorganising the NHS structures.

Given that Liberal Democrats are in a Coalition, we do not have the luxury of opposition for opposition's sake. We have done our best to transform the bill so that now it will deliver better health care for a population that is growing older and sicker. This is what being in government is all about, having the guts to make hard choices; to work for the benefit of all, not just party interests; to make sure that legislation, any legislation, is reviewed and improved. The Health & Social Care Bill will now be passed into law and will be a better piece of legislation because of the Liberal Democrats.