Nick Clegg and Baroness Williams' letter on NHS reform

Dear Chris,

As you know, the Liberal Democrats fought for significant changes to the Government's original Health & Social Care Bill. We've succeeded in making a real difference. Thanks to those efforts, and if we are able to win amendments on competition and Foundation Trusts, the bill now going before the House of Lords should be allowed to be completed.

Today we have written to all of our colleagues in the Commons and Lords. You can read the letter here (see below.)

Later this week the House of Lords will debate Liberal Democrat amendments to ensure we rule out any threat of a US-style market in the NHS.

If these amendments pass we are confident that competition and diversity in the NHS will always be done in the interests of patients, not profits.

Next month we will return to where this process all began a year ago when we meet at our party's Spring Conference.  If we secure these necessary changes Conference can be reassured that it has finished the job it started last March and the Bill should be allowed to proceed.

With your support we can build a stronger and better NHS ready to put patients at the centre, working with local communities, and responding to the financial challenges of an ageing population.
Best wishes,

Nick Clegg MP
Leader of the Liberal Democrats and Deputy Prime Minister

Baroness Shirley Williams of Crosby

Dear Colleague,

The Health Bill currently in the House of Lords is now undoubtedly a better Bill because of the Liberal Democrats. A number of people deserve credit for improving this Bill. Firstly, and most important, are our Party members who made it clear at our conference in Sheffield in March last year that we would not accept a Bill that puts profits before patients. We secured a “pause” in the legislation, which led to a number of substantial changes to the Bill, for instance that competition could only be on quality and not on price. Since the “pause”, there have been further changes, which owe a great deal to the hard work of our Health Minister, Paul Burstow and our parliamentary health committee led by co-chairs, John Pugh and John Alderdice. Second, our Liberal Democrat peers in the House of Lords, led superbly by Judith Jolly, have done an outstanding job scrutinising the Bill line by line.

With the help of the House of Lords Constitution Committee, several eminent Conservative peers, Labour’s Lords team led by Baroness Thornton and Lord Hunt, and a determined group of cross-benchers, many members of the medical professions, an all-party consensus has now ensured that the Secretary of State will remain responsible and accountable for a comprehensive health service financed by taxpayers, accessible to all and free at the point of need.

This should guarantee the future of the NHS, one of Britain’s greatest social achievements. In addition, led by Phil Willis and others, arrangements have been put in place to make the UK a world leader in medical research, to raise the status and protect the independence of the Public Health service, and to ensure that all profits from the treatment of private patients in Foundation Trust hospitals must benefit the NHS.

The Bill has now undergone more than 200 hours of scrutiny and had more than 1,000 amendments made to it, amendments that have put patients and the people who know them best at the very heart of the legislation. This is not the Bill that we debated as a party last March. Crucially, some elements of Labour’s 2006 Health Act, which opened up the possibility of a US-style market in the NHS, have been radically changed, such as the gold plated contracts for the private sector, which allowed a Labour Government to pay private providers a total of £250million for operations that weren’t even performed. We can also take pride in the fact that it was the Liberal Democrats who changed this Bill to ensure that no government will once again be able to favour the private sector over the public sector like the last Labour government.

The Bill also now has in place safeguards to stop private providers “cherry picking” profitable, easy cases from the NHS, and we have made sure that private providers can only offer their services where patients say they want them. We are also clear that no one should be allowed to spend public money without telling us how they are going to use it. That is why we have insisted that decisions about patient services and taxpayers’ money must be made in an open, transparent and accountable way.

We now have a Bill that delivers on the issues that Liberal Democrats have campaigned on for years. For the first time, there will be real democratic accountability in the NHS through new Health and Wellbeing Boards that will give councils a real role in shaping local health services. Public health will finally be returned to its rightful place in local government. Integration between health and social care will become the norm rather than the exception.

However, given how precious the NHS is, we want to rule out beyond doubt any threat of a US-style market in the NHS. That is why we want to see changes made to this Bill that have been put forward by our Liberal Democrat team in the House of Lords to make sure that the NHS can never be treated like the gas, electricity, or water industry. First, we propose removing the reviews by the Competition Commission from the Bill to make sure that the NHS is never treated like a private industry. Second, we want to keep the independent regulator of Foundation Trusts, Monitor, to make sure hospitals always serve NHS patients first and foremost. Third, we will introduce measures to protect the NHS from any threat of takeover from US -style healthcare providers by insulating the NHS from the full force of competition law. We will also insist that anyone involved with a commissioning group is required to declare their own financial interests so that the integrity of the clinical commissioning groups is maintained. Finally, we will put in place additional safeguards to the private income cap to make sure that Foundation Trusts cannot focus on private profits before patients. These changes are needed, not just because of this Bill, but also to plug the holes left by Labour’s 2006 Health Act that allowed private providers to make profits at the NHS’ and taxpayers' expense. It was that Act that started the process of the marketisation of the NHS by allowing private providers to be paid on average 11% more than the NHS. These changes will ensure that competition and diversity in the NHS will always be done in the interests of patients and not profits.

Next month we will return to where this process all began a year ago when we meet at our party’s Spring conference. Once these final changes have been agreed, we believe conference can be reassured that it has finished the job it started last March and the Bill should be allowed to proceed. We believe these changes will appeal to those in the House of Lords and the House of Commons who share our commitment to the NHS, and believe it can now embark on the reforms that matter: putting patients at the centre, working with local communities, and responding to the financial challenges of an ageing population.

That will demand a united effort not only from the NHS but from all of us who cherish it. Then the essential work will begin to ensure that the necessary changes are introduced as smoothly as possible in full collaboration with everyone who works in the NHS. The real test will be to demonstrate tangible benefits to patients. After all, in the end, it is the interests of patients, which should count most of all.

Best wishes


Nick Clegg
Baroness Shirley Williams

Fat Tax II - Take away's to get stealth tax?

There have been discussions about bringing a Fat tax into the UK that would see food of a certain calorie level taxed in an attempt to combat obesity in the UK.

Now a new measure is being suggested and backed by Chatham and Aylesford MP Tracey Crouch.

In Last week's KM [21-10-11 Medway Messenger article "Takeaway tax touted by MP in fight against Fat" by Alan McGuinness] it was reported that levels of obesity in Medway were such that 30% if adults were obese and more than 20% of children were overweight. Quite a shocking statistic. To fund education into better diet and litter picking generated by takeaways such as Baran's Kebab and Fish bar of Sturdee Avenue or McDonald's (who organise their own litter patrols within a certain radius of the restaurants.) a one off tax will be levied to any new take away before it opens its doors.

It is very interesting, it should be explored. Miss Crouch stated. We have to remember that these people pay business rates.
We are trying to encourage businesses to open but we just have to look at all these different issues and see what the pros and cons are.

Starting up a catering outset is always expensive, ovens, fryers, freezers etc as well as starting stock, menus and opening publicity can near enough bankrupt anyone. Then to have a one off £1000 tax on top of that might cripple someone. As she says these businesses do pay business rates and we are trying to encourage business to grow and for entrepreneurs to start up companies, do we really want to cripple them with more tax?
Companies like Burger King, KFC and McDonald's will be able to absorb the cost without a problem but a smaller business won't be able to.

Other options, currently carried out by Medway Council, include siting such places away from schools where Children can have easier access and temptation. Ones like the Baran's fish bar in Sturdee, situated between four schools, would end up with severe planning problems.

Littering isn't really the responsibility of the companies, it is the individual consumer who then litters. If anything greater education in schools or from parents should combat this and the unhealthy eating. I've seen kids walking past my house and just dropping their fish wrappers in my garden, and adults too. Also what of confectionery companies who also produce such waste, should they also be charged?
Does Subway count as a take away, it's food isn't high calorie but it does produce litter?

I agree with the principle though but it does need more research.

Thankfully for me, Miss Crouch agrees that consumers shouldn't be levelled with such a fee. Though the pro of that is that the consumer who does over eat does pay for their eventual health care the con being someone who indulges occasionally gets hit with it.

In Friday 28th October's KM the following comments were posted by readers:

I don't see how going after the income of takeaway outlets is fair when perhaps the fatties should be targeted themselves - Dr D

I can see his point but...

I don't see what a stealth-tax such as this would achieve. Clearly a poorly thought-out idea. -Jon

Food for thought.

NHS reform; Nick draws the battle lines.

As the NHS reform proposals make their way into parliament this week after prolonged a “listening exercise” sparked by the Lib Dem spring conference, concerns reach boiling point.

Dr Evan Harris has said the reforms were “Poor in all aspects.”

Andrew George MP, Lib Dem member of the parliamentary Health committee has already vowed to vote against it as it is “driven more by private profit than by concern about patient care.”

Baroness Shirley Williams has indicated that there will be opposition in the Lords and that the “battle was far from over”

Against these pillars of Liberalism Nick could only muster;

“Let me be clear: There is nothing, nothing, nothing, nothing – in any of this Government’s plans which in any way threatens the basic principles of the NHS.”

Andrew Lansley has also promised that the bill seeks to improve and maintain the comprehensive service;  “The NHS is not going to be broken, it is not going to be privatised…”

The Evening Standard has predicted a back bench revolt and indeed another grilling for the entrenched Deputy Prime Minister by angered grass roots party members at this Autumn’s Conference- Well those who passed the stringent security checks!

Whatever happens though Nick has vowed :-

“The package will not now be reopened – About that I am clear.”

Covert Whipping and Nadine Dorries.

I Must admit I am a little late to the comings and goings of this debate but as I understand it – and do correct me if I’m wrong…

Ms Dorries wants to put an amendment to the Health bill regarding abortion.

The amendment is a long the lines of making all independent information, advice and counselling services completely to the NHS. Any private body that supplies advice must not be able to supply the termination.

On the face o f it this is a reasonable measure, it’ll give women more choice and could remove any essence of pressure to receive a termination.

However as Lord Steel pointed out, existing legislation already caters to that as patients have to talk to two doctors before being passed on to the clinic.

As a further back up the Department of Health can close any clinics that receive complaints.

Also another fear is that Religious groups and charities may pressure women into keeping the baby.

The amendment has attracted a lot of attention and mixed reception. Liberals feel that it should be up to the patient to decide what is best for her body without pressure from either clinics or religious groups.

Others, like Doctor Liam Fox, believe there are “Too many abortions” these days  and measures need to be taken. Then there is the pro life debate that I shan’t get into here. Lets just say the debate is very heated.

Now Ms Dorries has launched a rebuke as a letter was sent to MPs urging them not to vote for the amendment that was sent by Health minister Anne Milton. The move is unprecedented according to Ms Dorries and will probably have the affect of convincing some Conservatives who were wavering to vote for her amendment now.

The Prime Minister, although sympathetic to her cause has said that he will not support it.

Who is to blame for this lack of support from Mr Cameron?

Well it has to be Nick Clegg!

Ms Dorries blames Nick and claims he has black mailed the Tory leadership by saying that his MPs won’t vote for the Health bill if the amendment went through.

Nick Clegg has put pressure on the prime minister, the prime minister is putting pressure on MPs

However the BBC reports that sources near to Nick Clegg say that although there have been conversations about it there have been no demands. Indeed this won’t be a party political issue and is down to all MPs to vote by their conscience – indeed if it even comes up, after all there are 1100 amendments and speaker Bercow may not even call it.

This is a very divisive issue and one that is down to the individual and the MPs to decide without pressure from anyone however it also shows that the strains within the coalition between Liberals and Conservatives, for some of the more right wing orientated feel any wavering or “coolness” must be down to our presence in government. As Nick once said;

“The right just horrified at having Liberal Democrats in power.”