John Pugh: Stop tinkering, and start again with NHS reform

Share
Related Topics

The Prime Minister is promising substantial and significant changes in the Health and Social Care Bill. But if yesterday's press reports are to be believed Professor Steve Field, the man appointed to pull together the Government's listening exercise, is likely find himself on the same page as many of the Bill's critics – particularly over unbridled competition within the NHS.

This could be embarrassing for Andrew Lansley, the Health Secretary, but it could also be an opportunity for him to show that the Government does listen. His oft quoted slogan "No decision about us without us" could be just the right principle for NHS reform and the way to win over the people who need to believe in and implement real reform.

Certainly, my parliamentary colleagues want radical surgery on the Bill, and like my Lib Dem colleague Norman Lamb, many Conservatives are exercised about a rapid roll-out of an untried scheme in a time of unprecedented financial restraint.

Accepting the growing evidence might be a helpful turning point for the relationship between Tories and Lib Dems, but wouldn't such change in the Bill mean having to start the parliamentary process all over again? And would there be a major loss of face attached to such a switch?

These are major concerns, but the concerns on the ground in the NHS are even greater, each with possible political consequences. With £20bn to be found in NHS savings as a result of Alistair Darling's last Budget; major hospitals heading for financial collapse under PFI deals; waiting lists rising; and the full lessons of Mid Staffs yet to emerge, there is justifiable concern that a chronic succession of bad health bulletins will dog the coalition. Neither coalition partner wants the next election based on why it wanted to completely restructure the NHS.

In recent weeks, my job has been to collate and condense Lib Dem and professional opinion on these controversial reforms. Issues such as the promotion of competition but not collaboration; the thin veneer of democratic accountability; and the competencies and composition of commissioning consortia feature universally in everyone's list of concerns.

However, we can now add to that: new anxieties about how medical training will be managed; how public health can function; and how regional clinical networks for illnesses such as strokes and cancer can survive with no regional or sub-regional bodies. The issue must be about about getting the future of the NHS right, getting professional opinion onside and winning over patient groups and health charities.

It is a genuinely open question if a radically amended Bill can actually do that and not end up as unworkable and bedecked with bolt-ons. Resubmission without recrimination could be an option.

Fundamentally, no one objects to the outline original aims of the Bill – more clinical engagement, accountability and less bureaucracy, even if we struggle and fall out over the mechanics of achieving it. Mr Lansley has reacted with some dignity to pressures that would destroy a lesser man. He needs, though, to show that he regards the NHS as being as precious as the nation does. He needs to stop tinkering with the existing Bill and start again. Some would say it would be a humiliation. I wouldn't. I'd say it was the act of a wise man.

John Pugh MP chairs the Liberal Democrat Parliamentary Policy Committee for Health and Social Care

React Now

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

Recruitment Genius: Warehouse Operations & Logistics Manager

£38000 - £42000 per annum: Recruitment Genius: One of the UK's best performing...

Recruitment Genius: GeoDatabase Specialist - Hazard Modelling

£35000 - £43000 per annum: Recruitment Genius: Our award-winning client is one...

Recruitment Genius: Compressed Air Pipework Installation Engineer

£15000 - £21000 per annum: Recruitment Genius: This leading provider of Atlas ...

Recruitment Genius: Operations Coordinator - Pallet Network

£18000 - £20000 per annum: Recruitment Genius: Opportunity to join established...

Day In a Page

Read Next
 

Letter from the Political Editor: With 100 days still to go how will Cameron, Miliband and Co. keep us all engaged?

Andrew Grice
A solar energy farm in France  

Nature Studies: For all the attractions of solar power, it shouldn’t blight the countryside

Michael McCarthy
Woman who was sent to three Nazi death camps describes how she escaped the gas chamber

Auschwitz liberation 70th anniversary

Woman sent to three Nazi death camps describes surviving gas chamber
DSK, Dodo the Pimp, and the Carlton Hotel

The inside track on France's trial of the year

Dominique Strauss-Kahn, Dodo the Pimp, and the Carlton Hotel:
As provocative now as they ever were

Sarah Kane season

Why her plays are as provocative now as when they were written
Murder of Japanese hostage has grim echoes of a killing in Iraq 11 years ago

Murder of Japanese hostage has grim echoes of another killing

Japanese mood was against what was seen as irresponsible trips to a vicious war zone
Syria crisis: Celebrities call on David Cameron to take more refugees as one young mother tells of torture by Assad regime

Celebrities call on David Cameron to take more Syrian refugees

One young mother tells of torture by Assad regime
The enemy within: People who hear voices in their heads are being encouraged to talk back – with promising results

The enemy within

People who hear voices in their heads are being encouraged to talk back
'In Auschwitz you got used to anything'

'In Auschwitz you got used to anything'

Survivors of the Nazi concentration camp remember its horror, 70 years on
Autumn/winter menswear 2015: The uniforms that make up modern life come to the fore

Autumn/winter menswear 2015

The uniforms that make up modern life come to the fore
'I'm gay, and plan to fight military homophobia'

'I'm gay, and plan to fight military homophobia'

Army general planning to come out
Iraq invasion 2003: The bloody warnings six wise men gave to Tony Blair as he prepared to launch poorly planned campaign

What the six wise men told Tony Blair

Months before the invasion of Iraq in 2003, experts sought to warn the PM about his plans. Here, four of them recall that day
25 years of The Independent on Sunday: The stories, the writers and the changes over the last quarter of a century

25 years of The Independent on Sunday

The stories, the writers and the changes over the last quarter of a century
Homeless Veterans appeal: 'Really caring is a dangerous emotion in this kind of work'

Homeless Veterans appeal

As head of The Soldiers' Charity, Martin Rutledge has to temper compassion with realism. He tells Chris Green how his Army career prepared him
Wu-Tang Clan and The Sexual Objects offer fans a chance to own the only copies of their latest albums

Smash hit go under the hammer

It's nice to pick up a new record once in a while, but the purchasers of two latest releases can go a step further - by buying the only copy
Geeks who rocked the world: Documentary looks back at origins of the computer-games industry

The geeks who rocked the world

A new documentary looks back at origins of the computer-games industry
Belle & Sebastian interview: Stuart Murdoch reveals how the band is taking a new direction

Belle & Sebastian is taking a new direction

Twenty years ago, Belle & Sebastian was a fey indie band from Glasgow. It still is – except today, as prime mover Stuart Murdoch admits, it has a global cult following, from Hollywood to South Korea