Lib Dems agree to disagree on health reform Bill

NICK CLEGG stood in front of Liberal Democrats in Gateshead, northern England, on Saturday afternoon – without a tie and displaying a growing paunch despite early morning gym-work – and mused on the lessons learned in nearly two years of power.

“You can’t spring a solution on people until you have spent a lot of time explaining what the problem is,” said the deputy prime minister, referring to the need to reform the National Health Service (NHS) in England.

Clegg then, in the eyes of those who are against him on the issue, spent the rest of the weekend ignoring the lesson allegedly learned.

On Friday, ever-fractious Lib Dems decided not to call for the reforms under the Health and Social Care Bill to be abandoned.

Having thus effectively surrendered, delegates yesterday morning, following an hour of passionate debate, took some solace in partially rejecting a leadership-sponsored motion for peers to support the Bill’s third passage through the Lords.

The reforms – which involve putting £60 billion worth of NHS cash under the immediate control of GPs – have proven impossible to explain, and there are fears that they will lead to the creation of American-styled “middle-men” in search of profit.

The issue dominated the Gateshead gathering. Clegg desperately feared delegates would reject the Bill, destroying his pledge to prime minister David Cameron that the Liberal Democrats would demand no new concessions.

Even now, many in his ranks do not want concessions: they want the legislation abandoned. Party managers successfully headed that off. Instead, a motion in the name of Shirley Williams was heard, calling for support for the changes the Lib Dems have already forced to the legislation.

Eighty-four-year-old Williams, daughter of Testament of Youthauthor, Vera Brittain, is the party's conscience – a Garret Fitzgerald-style figure, as it were, except that Williams remains a hands-on player in the political trenches decades after she held political office.

Few in the party could imagine standing against her. However, the decision of party managers to label the motion the “Shirley Williams motion” irked, particularly after it emerged that she had not written it. In fact, she had only seen it minutes before it was tabled.

During a fringe meeting on Saturday, she grumpily complained that the encounter allowed her the opportunity of time with chief secretary to the treasury Danny Alexander, since she had “no chance” of getting such an opportunity with him anywhere else at the conference.

Clearly not enjoying her time as Clegg’s human shield, Williams – who led the Liberal Democrats’ efforts to rewrite much of secretary of state for health Andrew Lansley’s plans – testily declared: “This debate is not about me. It is absurd that it has become about one person.”

The legislation has been a political oddity from the start. It was not part of the coalition agreement. The first draft was the personal creation of Lansley, who had years to mull it over during an undisturbed term as the Conservatives’ lead on health issues.

Lansley’s relationship with Cameron is curious, since he was the younger man’s boss in the Conservatives’ research office after Cameron arrived to make his way in politics. The change in the dynamic between the two since has not reflected Cameron’s meteoric rise.

Unwilling to block his former superior, Cameron let him get on with his planning – even if he now rues the decision since it has the potential to toxify the Conservative brand and undo much, or all of his work since he took over in 2005.

The Liberal Democrats’ behaviour, meanwhile, is even more striking. They had not agreed to the plan in the coalition agreement. Yet they, not the Conservatives, have become the target for the anger of the public and vested interests.

Williams herself admitted yesterday that the party still had not understood the legislation when they pushed for a pause in its Commons passage a year ago – months after it had begun its parliamentary journey.

Much of the press had “peddled lies” about the legislation, she said, adding that significant concessions had been won.“We mustn’t continually undercut what we have achieved (in the Lords),” she said.

In the end, delegates voted by 314 to 270 to delete a reference that would have called on Liberal Democrat peers to support the third reading of the Bill in the Lords this week “provided further concessions were met”.

Birmingham delegate Ann Morrison, to applause, said the rank-and-file would not be in this position if the leadership had not accepted “rubbish like this . . . seeing the light of day”.

“We support the coalition agreement, and we expect the people in government to keep it. We’re not being petulant. You should never turn support for a bad Bill into a political testosterone test,” she said.

Nervous to the point of tears, Rachel Coleman-Finch took the stand: “We’re screwed if we pass it and we are screwed if we don’t,” she said. “The merits are not clear, the politics are poisonous and people I trust are divided.”

Surprisingly, many Liberal Democrats believe the reforms – which are opposed by nearly every medical organisation imaginable, as well as by GPs, can be portrayed as “Conservative legislation” and that they can avoid retribution.

“It is not a Liberal Democrat health Bill, but it is a better Bill because of the Liberal Democrats,” Clegg told his people. However, even if this is true, junior coalition parties have rarely been thanked for stopping things from being worse.