Under the knife: NHS reforms face further dilutions in the Lords

Lords truce breaks out over NHS reform

Lords truce breaks out over NHS reform

By Alex Stevenson

Rebel peers have agreed to defer their clash with ministers over the coalition's NHS reforms until close to Christmas.

Shirley William, James Mackay and others dropped their amendments challenging the coalition's bid to transfer "constitutional responsibility" for the NHS to an unelected body.

A number of Lib Dem peers are insisting the health secretary should be ultimately responsible for the provision of NHS services.

But this afternoon they accepted health minister Richard Howe's request that "the best course [for the Lords] would be for none of the amendments in this group to be moved today and instead for us to use the time between now and report state to reflect further on these matters in a spirit of cooperation".

Baroness Williams' amendment had insisted the "duty to provide" NHS services rests with the health secretary.

"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," she told peers.

But Baroness Williams said she valued agreement, adding: "The greatest prize this House could give to the future of health services in England would be by reaching a broad political consensus on the issue so that the NHS and other health services would find they a solid block of acceptance and consensus that would carry us over many of the ups and downs we're bound to face over the coming few years."

Shadow health minister Glenys Thornton said she backed the move to withdraw the amendments because it would give legal and medical experts a chance to have another go at this particular issue, so that towards Christmas we may find we have found a solution that suits us all".

Earlier, shadow health secretary Andy Burnham had appealed to Liberal Democrats to stand by their convictions in a letter to deputy prime minister Nick Clegg and prevent Andrew Lansley's plans to turn the NHS into "the biggest quango in the world".

"Liberal Democrats must today find the courage of their convictions and stand with us to defeat the Tory plans," Mr Burnham wrote.

"If they accept the watered-down compromise, they will be selling the NHS short and signing up to a massive diminution of democratic accountability in the NHS."

The health and social care bill's traumatic progress through parliament has already seen it stripped of much of its pro-competition thrust.

The British Medical Association continues to oppose the bill in its current form, while the secretary of state issue has attracted criticism from the Lords' constitution committee.

"We are concerned that the bill, if enacted in its current form, may risk diluting the government's constitutional responsibilities with regard to the NHS," it warned.

"Moreover, it is not self-evident that the proposed changes are a necessary component of the government's reform package.

"Given the uncertainty as to the interpretation of the provisions proposed in the bill, could not the relevant wording contained in the 2006 NHS Act be retained?"

The Lords' constitution committee and other lawyers could look at the issue again, ahead of the bill's scrutiny at report stage next month.