For those who have forgotten the original Health & Social Care Bill was signed by Lib Dem Ministers Clegg, Alexander, Cable, and Burstow.  At that time the Bill contained competition on price and a duty on an economic regulator to promote competition.  During examination by the Commons Paul Burstow voted with the government on every occasion and ensured every line of the Bill was defended. LibDem MPs showed with their votes they were happy with moving our NHS into a regulated market with price competition.

The failure of the Coalition to deal with any of the key points raised during the Committee stage led to the Pause. A great deal of attention was focused onto the Bill and slowly but remorselessly opposition built up and we had to have a pause.  The LibDems claimed the pause was a great success and that their Red Lines had been dealt with by the amended Bill.

During examination of the revised Bill in the Lords the LibDem peers talked a great deal but consistently voted to support the government at every opportunity.  They claimed, as they have claimed throughout, that somehow they had influence behind the scenes in changing the Bill – but the Bill did not change.

Now at the latest of stages the LibDems once again face external pressure.  Just about everyone has now come out against the Bill even after the LibDems claimed the Pause and the Future Forum had made it acceptable.  Every Royal College that has consulted its membership is now against.  It has no support left; even the evangelical GP Commissioners are expressing doubts. And looming nearer is the LibDem conference where a few independent minded LibDems might make trouble.

So yet again we have a laughable set of claims made to disguise the fact that actually the LibDems are as much architects of the destruction of our NHS as Cameron and his free market support group.

According the BBC the greatest achievement the LibDems will claim (they haven’t done anything yet) was to remove the provision in the Bill for the Competition Commission to carry out a review in 2019!!  That about sums them up. The NHS has problems now!

They claim that the Bill is not the one that was around last March – which is true.  But almost every amendment has been made by the government – none by them. The core of the Bill which is about competition and markets has not been changed nor have the daft parts around a failure regime or the role of the major quangos or the hugely increased scale of bureaucracy this Bill brings in. LibDems are no more able to explain why we need this Bill than their Tory partners.

They make claims about the effect of their role in scrutiny which is belied by a quick look at how they voted.  They mention the changes made after the Lords Constitutional Committee reported on defects in the Bill but they did not bring this about.  Only the Labour threat to force a vote instead of allowing fudge by the Minister got this blockage unlocked.

To muddy the waters they have to deflect attention from their own abysmal conduct so they throw in the accusation “that 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”.So the current Bill that is designed to bring in a regulated market is better than a publicly managed system as regards preventing unnecessary competition?  You could not make it up – although they do.  Even so, even if it were true – you do not need the Bill to stop this anyway.  In fact it had already been stopped before the election.  They claim they got the Bill changed but there are no amendments from them which were passed to do this.

To those who have read the various expert legal views on the Bill the next passage is simply laughable.  “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.”

The Bill simply does not do what they claim it does – and probably they know it – they are hoping their activists fail to ask detailed questions.

But they verge on the outright dishonest in their claims.  They say that proposed changes were led by them – ignoring the fact that exactly the same amendments were originally put forward by Labour.  They forget to mention that these are proposed amendments – they have not been accepted or voted on.  Although Labour consistently worked with the LibDems offering them access to support and expertise the LibDems like to pretend this was their own initiate – it is simply dishonest.

Descending into farce is their defence of a change to the Private Patient Income Cap which will allow Foundation Trusts to get up to 49% of their income from private patients.  They claim this as a safeguard.  But it is the Bill they support which removes the current strict cap on private patients at a much lower level!!

They also claim the Bill somehow brings in a defence against the process of marketisation and greater use of the private for profit sector when the coalition government has made it abundantly clear at every opportunity that this is the whole point of the Bill. Having briefed the media that the crucial part of the Bill dealing with competition needed to be removed they now support it.

So we will have the Bill as it stands, with a few further cosmetic changes which the government has agreed are not significant.  The LibDems then claim that this “delivers on the issues that Liberal Democrats have campaigned on for years”. Well if LibDem policy was for a regulated market for healthcare, dominated by unelected and unaccountable quangos – which is opposed by those who work in the NHS, by the professional bodies and by a vast majority of the public – then so be it.

These people are dishonest – their fear of their own members is only marginally less than their fear of their coalition partners. They supported the Bill when it was produced and they support it now.  If they think this Bill moves the NHS forward then they are truly in denial.

If they really want to save our NHS then they have to use their votes – and stop being dishonest.

Irwin Brown .

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