Actually (cynical me) I don’t think the DH response is inconsistent with what Clegg wants.

The controversial health regulator Monitor will not “push competition”. Its main duty will be to protect the needs of patients.

We have already had a change to stop price competition. It was a minor change to the bill, a rewording, although a big change in the meaning of the bill. I suspect that even if Clegg gets a pledge to replace “competition” with “collaboration” it wont take too much time.

The membership of the GP-led consortiums, which lie at the heart of the reforms, will be opened up and no doctors will be forced to join. Lansley had hoped to hand around 65% of the NHS budget to the new consortiums, which are designed to hand commissioning powers to GPs.

This is a pointless pledge. Already 90% of the population is covered by a “Pathfinder”. Has Clegg said that Pathfinders can now change their minds? No. My guess is that those remaining GPs will find that they will be assigned a “partner” consortia who would do the commissioning for them. It won’t take too long before those GPs decide that they really do want to do commissioning. PCTs are dead, you cannot bring them back. Frankly I do not understand why no one is making a fuss about Lansley implementing a policy before Parliament has actually approved it.

The NHS will continue to have a mix of providers but there will not be a “competition-driven dog-eat-dog market” in which the NHS is “flogged off to the highest bidder”. Clegg said there would be no privatisation of the NHS.

There was no privatisation clause in the Bill. In my opinion, Any Qualified Provider will only be small scale – say midwifery or podiatry – the reason is that the DH say it will be the choice of commissioners which services are affected by AQP. The DH also says that under AQP there will be no volume contracts. Since volume contracts are the most effective way to keep costs low, and since GP commissioners will see big cuts in the money for treatments, my guess is that GPs will not use AQP for the services on which they spend the majority of their money.

The privatisation aspect will come from people choosing to use private care. Over the last decade the proportion of total healthcare spend on private care has stayed about the same at 18%, this is even though the NHS now is a significant purchaser of private care (23% of the market is funded by the NHS). This shows a shift over the last decade of private patients moving to NHS care. With the big cuts that are coming into the NHS at the moment, there will be less money for the NHS to spend. This is leading to longer waiting lists or even outright denial of treatment (cf “Croydon List”). Many more people are choosing private treatment.

Clegg is being a politician for promising to prevent something from happening that was never going to happen. he may as well have promised that “no patient will be forced to wear a tutu during their treatment”.

There will be “no sudden, top-down opening up of all NHS services to any qualified provider”.

As I described above, this was never the intention. Clegg clearly has not read the policy document on AQP. He may well have promised “patients will not be forced to sing the national anthem before treatment”.

Health and social care budgets will be brought closer together.

Now this is where the real meat is. It is a huge political issue because the social care budget is a jealously guarded domain of local authorities. They won’t want to lose that. Devolving more NHS money to LAs will be unpopular with the Treasury, who do not trust LAs to spend the money well, and it will be unpopular with patients because it is heralding a postcode lottery.

I would like to see social care and NHS integrated, but I would take the money off local authorities. It would be interesting to see how this pledge will pan out. (My opinion? Not much will be done.)

Sorry, forgot the conclusion:

Actually (cynical me) I don’t think the DH response is inconsistent with what Clegg wants. The reason is that the changes are not as huge as you say.

A bigger issue is whether Dr Evan Harris will accept Clegg’s offer because his list of demands will rip the heart out of the Bill.

Where are Dr EH’s demands listed?

Don’t trust Clegg an inch. He is playing for time. He will not say no to Cameron. He will obey his master.

For crying out loud Sally. We know you don’t trust Clegg. You insist on reminding us with every single post. From now on we will take it as read that you don’t like Clegg or the Liberal Democrats.

Do you have any insight on what Clegg is actually thinking, rather than just stating that “he’ll do what he’s told”, perhaps you could consider whether or not you think that Clegg or Lansley is the more vulnerable of the two. Clegg is vulnerable, sure, within the Liberal Democrats, but blocking the bill will likely shore up his support within the party. The Tories will hate it if Clegg forces Lansley out on principle. However, if you talk to Tories individually, they realise that ‘privatising the NHS’ is still kryptonite, especially in their more marginal constituencies. Therefore I think Clegg has at least a decent shot at winning against Lansley.

So, any analysis from your end Sally? or just more ad-hominem crap?

Whatever else, it looks as though Clegg has ambushed Paul Burstow MP, the LibDem minister of state in the Department of Health who has been very, very quiet during the public debate over the proposed reforms to the NHS, not least in his own Sutton constituency where the local hospital, the Epsom and St Helier University Hospitals Trust has learned that it is facing a deficit of £38 millions this year:

“Campaigners have criticised plans by an NHS trust that could see the loss of 115 posts including doctors. Epsom and St Helier, which has hospitals in Surrey and London, has started a 90-day consultation with staff about the proposals. . . The trust said it wanted to save £18.7m by March 2012 but it would still be left with a £19.3m deficit at the end of the financial year. Clinical posts affected were 26 doctors, which the trust said represented 4% of the medical workforce.”
http://www.bbc.co.uk/news/uk-england-13502469

At least Mr Burstow could be expected to comment on this in today’s news : “Doctors repeat call for NHS reforms to be scrapped”
http://www.telegraph.co.uk/health/healthnews/8536450/Doctors-repeat-call-for-NHS-reforms-to-be-scrapped.html

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#3 Sunny, the list of 23 demands is here:

http://socialliberal.net/sign-the-statement/essential-amendments/

#5. Ed

Sally is right. Clegg is not offering much, yet he is hailing himself as the saviour of the NHS. The fact is, he cannot explain how a thoroughly bad Bill (both in policy and by being appalling ill-drafted) can have made its way to the Report stage (two votes in the House and then two months of Committee stage). The reason is that Lib Dems have supported it all the way with many of them not having a clue about what was in the Bill (Andrew George is about the only exception).

The fact that the Bill has got this far shows that Lib Dems cannot do coalition. They are incapable of moderating the Tories. They simply do not understand what a coalition means. They actually voted for a bill that went against the Coalition Agreement! The problem, I’m afraid, is that the Lib Dems are permanently in opposition to Labour. They simply cannot get out of that mode. This means that in the future they could never be in coalition with Labour. However, they’ll never be in coalition again anyway, considering how few MPs they will get at the next election.

This is nothing more than playing for time and doesn’t change anything significantly.

@Richard Blogger,

You are right about the bill, the Lib Dems have clearly not been scrutinising the bill properly. In fact, in a more general sense, the reality of coalition government requires MPs to actually pay attention to the legislative part of their job description. Far too many MPs throughout the house don’t bother to actually scrutinise legislation and merely vote according to the whip. And I agree, that we cannot be sure about how successful Clegg will be. But I stand by my criticism of Sally for her failure to include any real insight in her post.

I put my insight in my second post, but the powers that own this site have taken it down. It does not matter if you get rid of Lansley. He will be replaced by another tory robot spouting the same policies.

The tory party wants to privatise the NHS, but they have not got the guts to admit it. So they use the Lie Dems as a human shield to cover their plans. So far you have helped them every inch of the way because you are naive.

Your leader talks about “grown up politics” and the tories just laugh behind your back. Prove you are not an Italian tank which can only go backwards and stand and fight. If you do not then you are finished as a party of any credibility.