Nick Clegg threatens to veto NHS reforms in bid to reassert himself

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Nick Clegg threatened to veto the Government's controversial health reforms yesterday as he warned David Cameron that the Liberal Democrats would adopt a more independent stance inside the Coalition.

After a drubbing in last Thursday's elections and the referendum on the voting system, Mr Clegg bowed to pressure from his party to reassert its separate identity from the Conservatives. The move also reflects the anger in Liberal Democrat circles that Mr Cameron allowed the No camp in the referendum battle to launch personal attacks on Mr Clegg for "broken promises" such as the rises in VAT and university tuition fees, which are government policies.

"Two people can play hardball," one Clegg ally told The Independent yesterday. "At some point there will be a story to tell about how we stopped the Tories privatising the NHS."

In an email to all Liberal Democrat members, Mr Clegg admitted he was "deeply disappointed" by a "bad set of results" last week. In a nod to his internal critics, he said: "I think it is clear that we need to do more to show people in the party and beyond what we are doing in Government and, perhaps more importantly, why.

After last week's referendum showed the public's limited appetite for constitutional reform, the Deputy Prime Minister has put health rather than an elected House of Lords at the top of his list of policy priorities. He wants to campaign on bread-and-butter issues such as the economy, education, welfare and health.

Yesterday, Mr Clegg declared that he would order his party's MPs and peers to vote down the NHS reforms unless there are "substantial, significant changes" to the proposals from the Health Secretary Andrew Lansley.

"As far as government legislation is concerned, no Bill is better than a bad one, and I want to get this right. Protecting the NHS, rather than undermining it, is now my No 1 priority," he told the BBC's Andrew Marr Show. He said GPs should not be forced to take on the role of commissioning services before they are ready, and that there should be no artificial deadlines. His warning throws into doubt the April 2013 target set by Mr Lansley.

Mr Clegg said: "I am not going to ask Liberal Democrat MPs and peers to proceed with legislation on something as precious and cherished – particularly for Liberal Democrats – as the NHS unless I personally am satisfied that what these changes do is an evolutionary change in the NHS and not a disruptive revolution.... What you will see in this legislation are clear guarantees that you are not going to have back-door privatisation of the NHS."

However, he promised not to destabilise the Coalition by indulging in what he called "tit-for-tat politics" with "ministers fighting like cats and dogs".

Mr Clegg's tough approach on the NHS creates a dilemma for Mr Cameron, who will hold his regular Monday meeting with his deputy in Downing Street today. The Prime Minister and the Health Secretary have both promised "substantive changes" to the NHS reforms but Mr Lansley may be reluctant to agree to a more voluntary approach towards GP commissioning that could undermine his plans.

Although Mr Cameron has ordered the Tories not to gloat about the council and referendum results, No 10 aides have warned him not to allow Mr Clegg to claim all the credit for watering down the health proposals. Private Tory polling suggests Mr Cameron is losing the public's trust on the NHS and that the party brand may not be "decontaminated" unless he regains it.

Meanwhile, Tory MPs will urge Mr Cameron at a private meeting on Wednesday not to give "sweeteners" to the Liberal Democrats to bolster Mr Clegg's position. Mark Pritchard, secretary of the 1922 Committee of Tory MPs, said: "It is not so much that the Lib Dems have nowhere else to go, but rather that the Lib Dems and their Conservative colleagues have so much to do – fixing the economy, getting people into jobs, keeping the nation safe and reforming public services to increase their efficiency and effectiveness."

While the Chancellor George Osborne accepted that the NHS blueprint would be amended, one Tory source suggested Mr Lansley would fight to prevent his Bill being filleted by the Liberal Democrats. "Some changes – yes. Fundamental changes to the reforms – no," he said.

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