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NHS bill: Peers fear health secretary role 'ambiguity' NHS bill: Lib Dem peers signal end to rebellion
(about 14 hours later)
Peers debating the controversial health bill have raised concerns about the ambiguity of the role of the health secretary under the NHS reforms. Lib Dem peers are to end their rebellion over the NHS bill for England after the government signalled it would meet one of their key demands.
Lib Dem peer Baroness Shirley Williams said a major health emergency in the country was an example of when the secretary of state's role was unclear. href="http://www.guardian.co.uk/society/2011/oct/25/libdems-draw-line-on-nhs?newsfeed=true" >In a letter to the Guardian 32 Lib Dem peers said: "The time for declaratory statements is past."
A Conservative peer is tabling an amendment which would explicitly state the role's responsibilities. The government signalled it would accept a Tory peer's amendment stating the health secretary "retains ultimate responsibility" for NHS services.
A government source said whips would "look favourably" on the amendment. Its plans to restructure the NHS in England have proved controversial.
Lord Mackay's amendment states the health secretary retains ultimate responsibility to parliament for the provision of the health service in England. Government sources said they would "look favourably" on the amendment, from Conservative former lord chancellor Lord Mackay, but the Lords adjourned on Monday night before the government had a chance to accept it. It is now expected to be voted on next Monday.
The debate was adjourned before a vote on the amendment could take place, but will resume next week. Ambiguities
The Health and Social Care Bill - currently at committee stage in the House of Lords - would increase competition and put GP-led groups in control of buying care in their areas. The peer said his amendment "makes it absolutely plain in language we can all understand that the ultimate responsibility to Parliament will rest with the Secretary of State".
Ministers say the changes are vital to help the NHS in England cope with the demands of an ageing population, the costs of new drugs and treatments and the impact of lifestyle factors, such as obesity. Concerns had been rised by Lib Dem peers that there were ambiguities about the secretary of state's role in the Health and Social Care Bill.
They say the bill, which has already been substantially altered following criticism from NHS staff, opposition and some Liberal Democrat MPs, now has wide support. But leading medical professionals have warned that the proposals are still unpopular. Baroness Williams had argued that it would mean the health secretary was no longer legally and constitutionally responsible for providing a comprehensive health service in England.
Speaking in the House of Lords, shadow health minister Baroness Thornton said the bill still failed to reassure people and NHS staff, and a defining set of principles was required. On Monday she said it was crucial that accountability for £120bn of taxpayers' money spent on the NHS and other health services was retained directly through Parliament.
"Only clarity around the principles will get them to take NHS staff with them," she added. But in a letter to the Guardian on Tuesday, Baroness Williams and 31 other Lib Dem peers wrote: "The time for declaratory statements is past. Patients who care passionately about the NHS and staff who want to give it the best possible service, need certainty about the future of the health service. Any politician who plays party political games with the NHS would be open to justified public criticism."
Baroness Williams said it was crucial that accountability for £120bn of taxpayers' money spent on the NHS and other health services was retained directly through Parliament. The government's plans for the NHS in England involve giving GPs and other clinicians much more responsibility for spending the budget, while greater competition with the private sector will be encouraged and have proved to be .
"That means that we have to make it clear that the channel passes through the secretary of state," she said. Ministers say their plans are needed to help the NHS cope with the demands of an ageing population, the costs of new drugs and treatments and the impact of lifestyle factors, such as obesity.
They say the bill, which has already been substantially altered following criticism from NHS staff, opposition and some Liberal Democrat MPs, now has wide support.
But some leading medical professionals have warned that the proposals are still unpopular.
Speaking in the House of Lords on Monday, shadow health minister Baroness Thornton said the bill still failed to reassure people and NHS staff, and a defining set of principles was required.
"Only clarity around the principles will get them to take NHS staff with them," she said.
Former SDP leader Lord Owen called it a "disastrous" bill, which would "unutterably change the principles of of the NHS".Former SDP leader Lord Owen called it a "disastrous" bill, which would "unutterably change the principles of of the NHS".
"I have lost any hope of convincing the government or the Liberal Democrat benches about the substance of the bill. This is going to go through - it's unfortunate but that's the reality," he added."I have lost any hope of convincing the government or the Liberal Democrat benches about the substance of the bill. This is going to go through - it's unfortunate but that's the reality," he added.
"People do forget the market value of having a very substantial national health service. I think this has been fragmented with wilful disregard. Concessions
"I cannot understand how the Treasury has accepted the disbandment of the procurement policies of the NHS which have ensured far more value for money than in any other health service around the world."
Later, crossbench peer Lord Walton of Detchant, a former president of the British Medical Association, said the bill should make clear that the NHS should "provide education and training for its workers".Later, crossbench peer Lord Walton of Detchant, a former president of the British Medical Association, said the bill should make clear that the NHS should "provide education and training for its workers".
Several peers, including the health minister Lord Howe, have put down amendments on the issue.Several peers, including the health minister Lord Howe, have put down amendments on the issue.
Lord Howe's amendment, which is expected to be accepted, specifies that the health secretary should ensure there is an "effective system for the planning and delivery of education and training".Lord Howe's amendment, which is expected to be accepted, specifies that the health secretary should ensure there is an "effective system for the planning and delivery of education and training".
Earlier this month, the House of Lords rejected a proposed amendment that would have referred parts of the bill to a special select committee.Earlier this month, the House of Lords rejected a proposed amendment that would have referred parts of the bill to a special select committee.
The reforms have been one of the most controversial areas of government policy over the past year and had to be put on hold in the spring amid mounting criticisms from the medical profession, academics and MPs.The reforms have been one of the most controversial areas of government policy over the past year and had to be put on hold in the spring amid mounting criticisms from the medical profession, academics and MPs.
It led to ministers making a number of concessions, including giving health professionals other than GPs more power over how NHS funds are spent as well as watering down the role of competition.It led to ministers making a number of concessions, including giving health professionals other than GPs more power over how NHS funds are spent as well as watering down the role of competition.