I’m going to start with a few comments on Deputy Prime Minister Nick Clegg and the Liberal-Democrat Party. This involves the wider political situation and is not strictly NHS news but it does have relevence to the Con-Dem bill to destroy the NHS.

There were many elections in UK last Thursday. There were local elections for local councils in England and Wales, elections for the devolved Scottish and Welsh parliaments and a vote on the Alternative Vote electoral reform.

Nick Clegg’s Liberal-Democrat party is ruling in coalition with David Cameron’s Conservative Party, the stronger party in the coalition. Nick Clegg’s Liberal-Democrats achieved remarkably poor results in Thursday’s elections – losing 700 hundred councillors and control of many local councils, losing many Members of the Scottish Parliament (MSPs) to the Scottish Nalionalist Party (SNP) and losing the vote on electoral reform. Cameron’s Conservative Party, by contrast, made moderate gains.

This has led to claims by the Liberal-Democrats that they are getting blamed for unpopular Conservative policies. Further, there is the clear implication that such blame is undeserved – that the Lib-Dems are getting unfairly blamed for unpopular Conservative policies. In turn, this has led to Lib-Dems proclaiming that they will distinguish themselves more from their Conservative coalition allies and also that they may veto the bill to destroy the NHS.

Clegg threatens to veto NHS reforms in bid to reassert himself – UK Politics, UK – The Independent

Nick Clegg threatened to veto the Government’s controversial health reforms yesterday as he warned David Cameron that the Liberal Democrats would adopt a more independent stance inside the Coalition.

After a drubbing in last Thursday’s elections and the referendum on the voting system, Mr Clegg bowed to pressure from his party to reassert its separate identity from the Conservatives. The move also reflects the anger in Liberal Democrat circles that Mr Cameron allowed the No camp in the referendum battle to launch personal attacks on Mr Clegg for “broken promises” such as the rises in VAT and university tuition fees, which are government policies.

…

In an email to all Liberal Democrat members, Mr Clegg admitted he was “deeply disappointed” by a “bad set of results” last week. In a nod to his internal critics, he said: “I think it is clear that we need to do more to show people in the party and beyond what we are doing in Government and, perhaps more importantly, why.

After last week’s referendum showed the public’s limited appetite for constitutional reform, the Deputy Prime Minister has put health rather than an elected House of Lords at the top of his list of policy priorities. He wants to campaign on bread-and-butter issues such as the economy, education, welfare and health.

Yesterday, Mr Clegg declared that he would order his party’s MPs and peers to vote down the NHS reforms unless there are “substantial, significant changes” to the proposals from the Health Secretary Andrew Lansley.

“As far as government legislation is concerned, no Bill is better than a bad one, and I want to get this right. Protecting the NHS, rather than undermining it, is now my No 1 priority,” he told the BBC’s Andrew Marr Show. He said GPs should not be forced to take on the role of commissioning services before they are ready, and that there should be no artificial deadlines. His warning throws into doubt the April 2013 target set by Mr Lansley.

Mr Clegg said: “I am not going to ask Liberal Democrat MPs and peers to proceed with legislation on something as precious and cherished – particularly for Liberal Democrats – as the NHS unless I personally am satisfied that what these changes do is an evolutionary change in the NHS and not a disruptive revolution…. What you will see in this legislation are clear guarantees that you are not going to have back-door privatisation of the NHS.”

There are issues with this analysis.

Firstly, the Lib-Dems are responsible for imposing unpopular Conservative policies and shitting on their pre-election promises e.g. tuition fees and the rise in V.A.T. Putting aside the issue that these were local rather than national elections, it is the logical conclusion that the Liberal-Democrats should be blamed for imposing unpopular Conservative policies. They would not be possible without Liberal-Democrat support.

Secondly, the Liberal-Democrats position is to veto the bill to destroy the NHS. The Liberal-Democrat spring conference in early March overwhelmingly passed a motion opposing the NHS bill.

Nick Clegg suffers defeat as Liberal Democrats reject health reforms | Politics | guardian.co.uk

Nick Clegg suffered a humiliating defeat at the hands of his own party as Liberal Democrat activists voted overwhelmingly against coalition plans for a radical overhaul of the NHS.

Delegates rejected the “damaging and unjustified market-based approach” being championed by the health secretary, Andrew Lansley, as anger over the Tory-led NHS agenda boiled over at the party’s spring conference in Sheffield.

The Lib Dem leadership had gone into the session backing a motion unreservedly supportive of the Lansley approach – only to see the grassroots insert changes that would undermine the basic principles behind it.

After the crushing defeat, Clegg immediately faced demands from former education secretary Shirley Williams that he take the message back to the cabinet and demand that Lansley change the NHS bill to conform with Lib Dem demands.

…

Motion carried with amendments: Updating the NHS: Personal and Local | The Liberal Democrats: News Detail

Spring Conference 2011: Lines 6-15 deleted, Amendments 1 and 2 carried, Main motion carried as amended.

Twelve conference representatives
Mover: Paul Burstow
Summation: Cllr Richard Kemp

Conference believes that the NHS is an integral part of a liberal society, reflecting the social solidarity of shared access to collective healthcare, and a shared responsibility to use resources effectively to deliver better health.

Conference welcomes our Coalition Government’s commitment to the founding principles of the NHS: available to all, free at the point of use, and based on need, not the ability to pay.

Conference welcomes much of the vision for the NHS set out in the Government’s White Paper, Equity and Excellence: Liberating the NHS which commits the Government to an NHS that:

i) Is genuinely centred on patients and carers.

ii) Achieves quality and outcomes that are among the best in the world.

iii) Refuses to tolerate unsafe and substandard care.

iv) Puts clinicians in the driving seat and sets hospitals and providers free to innovate, with stronger incentives to adopt best practice.

v) Is more transparent, with clearer accountabilities for quality and results.

vi) Is more efficient and dynamic, with a radically smaller national, regional and local bureaucracy.

vii) Gives citizens a greater say in how the NHS is run.

Conference particularly welcomes the proposals to introduce real democratic legitimacy and local accountability into the NHS for the first time in almost forty years by:

a) Extending the powers of local authorities to enable effective scrutiny of any provider of any taxpayer funded health services.

b) Giving local authorities the role of leading on improving the strategic coordination of commissioning across the NHS, social care, and related childrens’ and public health services through councillor led Health and Wellbeing Boards.

c) Creating Health Watch to act as a local consumer champion for patients and to ensure that local patients are heard on a national level.

d) Returning public health duty to local government by ensuring that the majority of public health services will now be commissioned by Local Authorities from their ring-fenced public health budget.

Conference recognises however that all of the above policies and aspirations can be achieved without adopting the damaging and unjustified market-based approach that is proposed.

Conference regrets that some of the proposed reforms have never been Liberal Democrat policy, did not feature in our manifesto or in the agreed Coalition Programme, which instead called for an end to large-scale top-down reorganisations.

Conference therefore calls on Liberal Democrats in Parliament to amend the Health Bill to provide for:

I) More democratically accountable commissioning.

II) A much greater degree of co-terminously between local authorities and commissioning areas.

III) No decision about the spending of NHS funds to be made in private and without proper consultation, as can take place by the proposed GP consortia.

IV) The complete ruling out of any competition based on price to prevent loss-leading corporate providers under-cutting NHS tariffs, and to ensure that healthcare providers ‘compete’ on quality of care.

V) New private providers to be allowed only where there is no risk of ‘cherry picking’ which would destabilise or undermine the existing NHS service relied upon for emergencies and complex cases, and where the needs of equity, research and training are met.

VI) NHS commissioning being retained as a public function in full compliance with the Human Rights Act and Freedom of Information laws, using the skills and experience of existing NHS staff rather than the sub-contracting of commissioning to private companies.

VII) The continued separation of the commissioning and provision of services to prevent conflicts of interests.

VIII) An NHS, responsive to patients’ needs, based on co-operation rather than competition, and which promotes quality and equity not the market.

Conferences calls:

1. On the Government to uphold the NHS Constitution and publish an audit of how well organisations are living by its letter and spirit.

2. On Liberal Democrats in local government to establish local Health and Wellbeing Boards and make progress developing the new collaborative ways of working necessary to provide joined up services that are personalised and local.

3. The government to seize fully the opportunity to reverse the scandalous lack of accountability of publicly-funded local health services which has grown up under decades of Conservative and Labour governments, by:

a) Ensuring full scrutiny, including the power to require attendance, by elected local authorities of all organisations in the local health economy funded by public money, including Foundation Trusts and any external support for commissioning consortia; ensuring that all such organisations are subject to Freedom of Information requirements.

b) Ensuring Health and Wellbeing Boards (HWBs) are a strong voice for accountable local people in setting the strategic direction for and co-ordinating provision of health and social care services locally by containing substantial representation from elected local councillors; and by requiring GP Commissioning Boards to construct their Annual Plans in conjunction with the HWBs; to monitor their implementation at meetings with the HWBs not less than once each quarter; and to review the implementation of the Annual Plan with the HWBs at the end of the year prior to the construction of the Annual Plan for the forthcoming year.

c) Ensuring commissioning of health services has some degree of accountability by requiring about half of the members of the board of commissioning consortia, alongside GPs, to be local councillors appointed as non-executive directors.

d) Offering additional freedoms only to Foundation Trusts that successfully engage substantial proportions of their local populations as active members.

Applicability: England.

Clegg is directed by his party conference to oppose the NHS bill. Liberal-Democrat MPs are also directed by this motion. For further discussion of this motion and the Liberal-Democrat position see

Making sense of the ‘pause’ in Lansley’s Health Bill | Red Pepper

Nick Clegg has said he will not support privatisation of the NHS but he has repeatedly shown himself ready to sacrifice popularity with his supporters for the sake of his wider political ambitions, and Cameron and Lansley maintain that the Bill is not about privatisation, leaving Clegg plenty of room for fudge. The political calculation that he and Lib Dem MPs have to make in deciding whether to let Lansley get away with a fudge is going to be complicated. A key dimension will be how far they think the electorate will forget and forgive them if they allow the NHS to be eviscerated for the sake of their other goals.

Thirdly, Clegg still either doesn’t understand the effects of the bill to destroy the NHS or he supports it. He’s failing to comply with his conference’s directions by proposing only the slightest changes. The bill abolishes the requirement on the Secretary of State for Health to provide a health service. A comprehensive, national health service free at the point of use is to be abolished. Privatisation is what the bill is all about so that patients will have to pay for services no longer provided by the health service and private providers are given hugely preferrential terms to cherry-pick what services are provided.

Just as Clegg and the Liberal-Democrats have been blamed for tuition fees and V.A.T. they will be blamed for destroying the N.H.S. This bill should be opposed in its entirety.

Here’s another opportunity for the Liberal-Democrats to be accused of enabling unpopular Conservative policies. Thousands to march through London in protest over cuts to disability benefits | Society | The Guardian

A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.

David Cameron sends his own spin doctors to help Lansley with NHS reforms – Telegraph

The crisis over NHS changes has already forced David Cameron to “pause” the reforms.

Now the Prime Minister has agreed that a civil service press adviser and his closest health special adviser will transfer from No10 to the Department of Health from Monday.

Much of the criticism of the health reforms from within the Coalition has concentrated on Mr Lansley’s inability to “sell” the reorganisation of services that includes the handing over of £80 billion to GP to provide services directly, stripping out Primary Care Trusts.

…

Clegg threatens to veto NHS reforms in bid to reassert himself – UK Politics, UK – The Independent

Nick Clegg threatened to veto the Government’s controversial health reforms yesterday as he warned David Cameron that the Liberal Democrats would adopt a more independent stance inside the Coalition.

After a drubbing in last Thursday’s elections and the referendum on the voting system, Mr Clegg bowed to pressure from his party to reassert its separate identity from the Conservatives. The move also reflects the anger in Liberal Democrat circles that Mr Cameron allowed the No camp in the referendum battle to launch personal attacks on Mr Clegg for “broken promises” such as the rises in VAT and university tuition fees, which are government policies.

…

Lansley health reforms may wreck NHS, doctors warn David Cameron | Society | The Guardian

The leaders of Britain’s 42,000 family doctors are warning David Cameron to radically overhaul the government’s unpopular health plans or risk them wrecking the NHS.

The Royal College of General Practitioners has written to the prime minister demanding major changes are made to the health and social care bill. It is undergoing a two-month “pause” while Cameron, his deputy, Nick Clegg, health secretary Andrew Lansley and a panel of health experts undertake a listening exercise designed to improve Lansley’s plans, which have drawn much criticism.

In a strongly worded submission – the first by a major health organisation during the renewed consultation – the college urges Cameron to remove or substantially amend many of the bill’s central proposals to radically reorganise the health service in England.

Without a major rethink, the NHS will cease to be a truly national service, postcode lotteries in care will be exacerbated and foreign firms will use EU competition laws to take control of hospitals and doctors’ surgeries, it says.

…

Calls for central funding of research | GP online

University of Cambridge academic and GP Dr Jonathan Graffy warned that ‘responsibility for research will fall to GP consortia’ after the government’s NHS reforms.

In an editorial in the British Journal of General Practice, Dr Graffy, senior clinical research associate in the department of public health and primary care at the University of Cambridge, said the NHS Commissioning Board would be responsible for promoting research nationally.

But it seemed likely that ‘GP consortia will need to review studies planned in their area, not least because of the impact of research on services they commission’, he said.

‘Commissioners who grasp the opportunity to collaborate with researchers in developing and testing their services will attract the best staff and bring new resources and insights to their work,’ Dr Graffy added.

GPC negotiator Dr Beth McCarron-Nash said that research should be funded centrally, especially during at time of economic crisis. She warned that failure to secure investment could put the NHS at risk. ‘Medical research is vital to remain at the forefront of best practice,’ she said.

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27/11/13 Having received a takedown notice from the Independent newspaper for a different posting, I have reviewed this article which links to an article at the Independent’s website in order to attempt to ensure conformance with copyright laws.

I consider this posting to comply with copyright laws since
a. Only a small portion of the original article has been quoted satisfying the fair use criteria, and / or
b. This posting satisfies the requirements of a derivative work.

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