The main NHS news is that a vote by the House of Lords on political accountability has been postponed for months. There were two amendments: one by Lib-Dem Shirley Williams seeking to maintain that the Home Secretary is responsible for providing a health service and one by Tory Lord Mackay seeking to have the government responsible in exceptional circumstances. Williams and Mackay withdrew their amendments which are expected to be reconsidered at report stage in three or four months time.

This isssue of responsibility seems to be fundamental to the very notion of a National Health Service – that it is the government that is responsible for providing the health service. It appears that the Williams amendment may have passed were it not withdrawn. The Lib-Dem coalition government can’t be trusted on the NHS – we need to watch for gerrymandering, more lies and misdirection, etc…

The King’s Fund thinktank reports that Monitor – the new health service regulator – could fail unless the NHS bill passing through the upper house is amended.

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

NHS bill clause put on hold to stave off revolt by Liberal Democrat peers | Politics | The Guardian

Vote over key issue of political control over NHS will not be resolved until January at earliest to avoid a Lords rebellion

The government has “paused” a key part of its NHS bill to stave off an embarrassing rebellion from key Liberal Democrats in the House of Lords – a move that ensures peers will now debate the controversial legislation until Christmas.

At the heart of the debate is the government’s plan to hand over its “constitutional responsibility” to provide NHS services to a quango. But a number of Lib Dem peers, led by Lady Williams, had insisted the health secretary should be responsible for the provision of health services.

The powerful Lords constitutional committee, on which sits some of the political world’s most prominent legal minds, warned last month about the “extent to which the chain of constitutional responsibility as regard to the NHS [will be] severed”. However both Williams and former Tory lord chancellor James Mackay, who had tabled a fresh amendment seeking to accommodate Lib Dem and Tory visions, agreed to drop their proposals once the government announced it would have a further “period of reflection”.

Earl Howe, the health minister, told the peers to “use the time between now and report stage to reflect further on this matter in the spirit of co-operation”. This means the issue about political control of the NHS will not be resolved by a vote until January at the earliest. It could also see the constitution committee and other lawyers re-examine the issue again, ahead of the bill’s scrutiny at report stage next month.

Such a timetable means that the bill will last in the upper house for much longer than expected as the government is unable to “guillotine” the bill through – causing concerns that it may not be ready by April, at the end of the parliamentary session. Last night sources close to Lansley admitted it “would be a close run thing” but expected the NHS bill to be law in March.

Labour, who had managed to get more than 150 peers out on to the red leather benches, claimed it was “a mess of Andrew Lansley’s own making”. The shadow health spokesman, Andy Burnham, said: “Last week the government indicated they were ready to make concessions and accept the amendment. Today they have been forced to withdraw it for fear of losing the vote. After 10 months of debate on the health bill, it is an indictment that the government does not know what it thinks on a question as basic as the responsibilities of the secretary of state. It is yet more evidence that this Tory-led government has failed to establish a consensus on this bill. They should drop the bill and focus on the financial challenges facing our NHS.”

It is unlikely that the Lib Dem rebels will back down. Williams’s amendment had insisted the “duty to provide” NHS services rests with the health secretary. She told the house that “I in no way resile from the amendment … because we do believe it’s important to have an absolutely solid basis on which the whole of the house will understand about exactly what are the accountabilities and responsibilities of the secretary of state.”
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Health policy, leadership, events, information – The King’s Fund

Monitor’s new role may be too wide and complex and could lack independence from ministerial interference, warns a King’s Fund thinktank report

The government’s new health service regulator “may fail” unless the controversial NHS bill passing through the upper house is amended, the King’s Fund has warned.

In a report examining Andrew Lansley’s proposals for Monitor, the NHS regulator, the health thinktank says the health bill expands the regulator’s role from overseeing NHS foundation trusts with a set of “wide-ranging new powers” that will allow economic supervision of the entire health sector.

Under the health secretary’s plans, Monitor will become responsible for setting prices for NHS-funded services, ensuring competition works in the health service and maintaining essential services if hospitals go bust. The new body will have 500 staff and a budget of £82m a year.

But with increased size comes increasing complexity and potential confusion, says the King’s Fund. It warns that “the large number of objectives Monitor has been set may cause confusion and risks diluting the focus of its work”.

The report also warns of a possible clash between other bodies that will seek to exercise control over doctors and hospitals: “A lack of clarity about how it will work alongside other key health bodies, including the NHS Commissioning Board and Care Quality Commission, risks creating tension and unresolved disputes.”
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