The Lib Dems have voted almost unanimously to reject Torybplans to reform the NHS.
But will coalition work?
And will Lansley listen?
If not Coalition is dead.
If it does the Lib Dems have a life line (no more).
I remain unconvinced that much change was needed. The Lib Dems seem to share that view - because all the Lib Dems seem to want is a change of PCT board structure when all is said and done. And that may be enough.
• No decision about spending of NHS funds should be made in private, which could have happened under the proposed GP consortiums.
• NHS commissioning must be retained as a public function, rather than sub-contracted to private companies.
• No new private providers should be allowed where there is risk of cherry-picking.
• GP commissioning boards must construct annual plans in conjunction with new health and wellbeing boards.
• There must be a continued separation of commissioning and provision of services to prevent conflicts of interest.
• Half of the members of the new commissioning consortiums must be local councillors appointed as non-executive directors.
For Downing St to say:
This is not about significant changes to the policy but about reassuring people with minor changes to the language of the bill as it goes through the House
is nonsense. This is about putting democratically elected councils in charge. It's about saying GPs should be GPs. It's about saying it's impossible for the NHS to survive if Lansely has his way.
But can the Lib Dems deliver? We're watching, without much hope.
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it’s difficult to know how this will pan out. The three main possibilities are:
(1) cosmetic concessions by the Tories which don’t alter the substance of the NHS reforms, and the Lib Dems spinelessly back down (as they have done on pretty much every issue so far in the coalition)
(2) the Lib Dems put their foot down and the Tories back down – watering down or delaying the NHS proposals in the hope that they will get their own working majority at the next election after boundary changes and be able to implement the full reforms then
(3) both parties refuse to back down and the Coalition collapses fully or partially. For example, the Lib Dems could split with a rump of orange book right wingers staying to maintain a small working majority, and the rest forming a new progressive liberal party.
Based on the Lib Dems’ record so far, my money is on (1) – I don’t have much faith in them at all to be honest, and in some ways Labour is relying on the Lib Dems staying right of centre to be able to mop up the centre-left vote at the next election. But who knows how this will play out?
@Howard
1 or a combination of 1 and 2
Can’t see 3 – yet
But I share your lack of faith
@Richard
I watched the part of Clegg’s clossing speech to the LibDem faithful in which he gave a number of examples of how being in the coalition has allowed them to influecne policy in a way hat otherwise wouldn’t have happened. The problem he – and they – have is that every one was more than cancelled out by a Tory policy. I don’t say that in a partisan way, but as an evidence based observation. So, if Clegg and his advisors – and the party generally – can’t see that then I think they are seriously deluding themselves.
As for the NHS. I’ll go for Howard’s #1. I don’t see 2. I agree 3 will happen, but not until after they are wiped out (and probably loose the AV vote, which I personally support)in May. Realistically that means at the Autumn conference.
Please see submission HS77 from myself and friend who suffers from hereditary kidney disease on the health Bill on the Parliament UK website. We argue for changes to improve the NHS, keeping the idea of GP consortia, many of which have been formed already but we ask for cross-communication and interaction, taking advantage of new networks, stopping the consorita from being cut adrift rather than enabling it. we also suggest a new role (perhaps chartered) of planner experts to work within the new system with GPs as downgrading/eliminating NHS managers would otherwise lead to increased use of management consultants and further fragmentation.
#1 – nailed on
What is more alarming is Red Ed’s vapid response:
Labour leader Ed Miliband accused the Government of conducting an “experiment in right-wing ideology” on the NHS, and warned that public anger over the changes will dwarf the recent protests over privatisation of the forests.
It would be nice for the public’s anger to have an effective tribune in Parliament.
Richard,
The thing to remember about the Liberal Democrats is that in the honeymoon period following the Coalition Agreement they have had to largely dance to the Conservative tune. They have about one-sixth of the seats that the Conservatives possess, and in this honeymoon period the failure of the Coalition would have led to a repeat election that only the Conservatives could afford and in most likelihood would have won outright.
However, the latest poll figures show that Labour have a 10-12% lead, so it’s now in the Conservatives interest to listen to their Coalition partners if they want to see out the term.
In essence, given the choices that the public made a year back, the Lib Dems have in fact been taking one for the team as most vitriol has been directed to them rather than the party with its hands on the levers. But it’s from this point onwards where we get to see if the power they now hold will have an effect.
The conference at the weekend has shown what the party members think. And given the structure of the Liberal Democrats , the senior leadership are going to have to work extremely hard at discounting their opinion.