Last-minute talks seek to stave off Lords rebellion on health reforms

Health Secretary Andrew Lansley faces criticism within Tory ranks (PA)

The Government was conducting final talks with rebel peers in the House of Lords last night in an attempt to head off a series of rebellions that could still derail its Health and Social Care Bill.

Labour will table a series of amendments today which it hopes will win support from Liberal Democrats, who have concerns about the amount of competition the Bill will impose on the NHS. Amid signs that Downing Street officials were distancing David Cameron from his Health Secretary, sources suggested that Andrew Lansley, right, had been lamentable in trying to explain the purpose of his reforms. They fear that even if the Bill is passed in the Lords, where it returns today, the reforms will be blamed for all future problems in the NHS.

"Everything that goes wrong now in the NHS will be blamed on this Bill and there is nothing we can do to stop it," said one government source. Another Downing Street source was even quoted as saying the Health Secretary had failed so badly to explain the purpose of his reforms that he should be "taken out and shot".

The suggestion that Mr Lansley might be forced to resign was roundly denied by Downing Street, which said that Mr Cameron and Nick Clegg had met Mr Lansley yesterday and they had agreed to "press on".

In a further sign of the opposition to the Bill from within the medical profession, more than 90 per cent of readers of the British Medical Journal said they believed it should be withdrawn.

Government sources said last night they believed the 137 amendments to the Bill laid out by Mr Lansley's department last week should be enough to avoid substantial defeats in the Lords.

They said they believed Liberal Democrat rebels were now broadly supportive, but last-minute talks were still going on around the areas of competition and ensuring GPs were not commissioning services from themselves.

Labour believes one of its best hopes of a rebellion is over plans to allow hospitals to earn up to 49 per cent of their income from private patients. They will table an amendment restricting this to 5 per cent today.

But the Government's position was not helped when the director of the think-tank the Kings Fund wrote in the BMJ that the plan to put doctors in charge of commissioning was "doomed to fail" if they were not given management support.