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Andy Burnham: These health reforms are an affront to democracy

There is no mandate to change the NHS

With all eyes on Europe, a constitutional mess closer to home is going largely ignored. Last week, the Government's Health and Social Care Bill, one of Whitehall's longest-running farces, hit a new low. Coalition peers trooped obediently through the lobbies on Wednesday to defy the Information Commissioner. He had ruled that the Department of Health should publish its risk register to help to inform their Lordships' consideration of the Bill and shed light on the risks of reorganising the NHS at this time of unprecedented financial pressure.

Instead, Tory and Lib Dem peers backed the Government's fight to keep it secret, thereby denying the wider public the chance to learn about the risks its government is running with the NHS. Outrageous – but entirely in keeping with the way the coalition has handled this most important of Bills.

The Government's reorganisation of the NHS is turning out to be one of the biggest crimes against democrait was in neither the Conservative nor the Lib Dem manifesto. In fact, voters were promised the opposite. In Opposition, David Cameron liked to be photographed alongside doctors and nurses promising "no top-down reorganisation of the NHS". It was all part of the Tory detoxification strategy. The subliminal message wasn't too hard to decode: "I'm a different kind of Tory: I love the NHS as it is and don't want to privatise it." But that is precisely what he is doing. The King's Fund recently compared Cameron's NHS reorganisation with the utility privatisations of the 1980s when Andrew Lansley was one of Norman Tebbit's civil servants. Just as we have seen with green issues or his claims to care about poverty, David Cameron has broken every promise he made in his "rebranding" project before the election. The Tories are now re-toxified.

Secondly, the precise detail of this reorganisation is being determined in the unelected House with MPs sidelined. No single organisation matters more to our constituents, and yet MPs look on powerless as huge questions such as the competition regime for the NHS are thrashed out in the Lords.

The third reason why the NHS reorganisation is an affront to democracy is also the most scandalous. Ministers and senior civil servants don't actually care what MPs and peers think: they're just getting on and doing it anyway. The arrogance is breathtaking, but also dangerous.

The disintegration of primary care trusts across England has created drift just when the NHS needed grip. NHS London's risk register warns that the loss of experienced staff in PCTs creates a danger that they are failing to fulfil important statutory responsibilities, such as child safeguarding. Chillingly, it predicts that the consequences of this could be "preventable harm to children".

The Government is running huge risks by reorganising the NHS at this time of financial stress, but to acknowledge that publicly would see the evaporation of the Bill's pitiful levels of support. The coalition's main argument in support of its Bill seems to be "things have already gone too far and it would be dangerous to turn back".

But that's not true. If the Bill fell tomorrow, emerging clinical commissioning teams would simply be put in charge using the existing legal structures. It would save a lot of money and disruption. Britain's right wing may have launched a coup against the NHS but it can be stopped. In recent weeks, the BMA has changed its position to one of outright opposition to the Bill. If nurses, midwives, and others were to join them, there is just a chance that it would alert more people to what's happening and the scandal of a Government ripping apart the country's best-loved institution without the consent of its people or Parliament.

Andy Burnham is the opposition spokesman on Health