Norman Lamb’s announcement today that the government will re-write regulations on competition in the NHS seals up one source of grief for the Lib Dems ahead of their spring conference this weekend. Activists had been threatening an awkward showdown with the leadership on the section 75 regulations, and instead ministers (its notable that Lib Dem Lamb was sent out to bat for the government today rather than a Conservative) can go to their party and argue that they are keeping check on the Conservatives when it comes to the NHS.
But this has a flipside, which is that the row over secret courts will gain more momentum now activists’ minds are focused. Two emergency motions on the subject have been submitted to the conference committee, so there is little likelihood of the leadership being able to keep this off the conference floor. If it did, arguing that conference already expressed a view in the autumn, the fury from activists would be quite something to behold. Those Lib Dem MPs who voted against the government last night might feel a little more relaxed than their colleagues.
But the problem Nick Clegg – who will again almost certainly be grilled on it in his Q&A session on the Saturday afternoon – has is that he needs to convince his activists that he did everything he could to secure the changes already in the legislation. Sources close to him have already told Coffee House that they did the best they could with the political capital they had, but Clegg will want to avoid suggesting to his party members that he is powerless in the Coalition, particularly on an issue that the grassroots feel so strongly about.
Of course, Labour is arguing that it was the threat of a ‘fatal motion’ on the regulations, which would have forced the Lib Dems into a vote against the government, that led to the U-turn. But it’s worth mulling Labour’s communications strategy on this issue. Last night Andy Burnham tweeted the following:
‘2 weeks to save the #NHS (& this time we mean it): Mon 18th March set for Lords debate & vote on s75 regs. Lab tabled ‘fatal’ motion.’
There’s obviously a problem with saying ‘this time we mean it’ about a campaign as it suggests that the last time you said the NHS was doomed, you were just making it up. So why believe Burnham this time around? Or the next, when there’s another change involving competition in the NHS? And if he thinks that the encroachment of the private sector on the health service is a death knell, then how come Labour didn’t kill it off with the poison when it embraced private finance initiatives or when it encouraged private companies to tender for contacts?
Burnham blunted his attack by claiming when the Health and Social Care Bill was moving through Parliament that it would end the NHS, when patients will continue to enjoy healthcare that was free at the point of access now that the legislation has gained Royal Assent. His campaign on the reforms, no matter how poorly communicated they were by the Coalition itself, suggested the sort of seismic change in delivery that patients found when they continued to turn up to doctors’ surgeries with money to pay for their consultations after the NHS was originally set up. It doesn’t, and, like the boy who cried ‘wolf’, it’s difficult for Burnham to issue the same warnings all the way up to the next election, particularly if he doesn’t view the future of the NHS as being a return to a service without any competition at all. That would be another top-down reorganisation of the NHS, after all.
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