Shirley Williams: Lib Dems should take credit for thwarting Lansley

The complex, extensive and sometimes almost incomprehensible blueprint attracted remarkably little public attention until well into this year

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Liberal Democrats, from our party's grassroots to its leadership, can be proud of the influence we have exerted to change the Government's NHS plans. It is clear now that the proposals that will be taken forward are dramatically different to those originally proposed.

The implications of Andrew Lansley's massive health proposals, setting England's health system on the path to a market in health care rather than a public service, were very slow to sink in. The complex, extensive and sometimes almost incomprehensible blueprint attracted remarkably little public attention until well into this year.

A handful of committed doctors, nurses and administrators got together to challenge this complacency at the Liberal Democrats' spring conference in Sheffield. In the next three months of intensive debate and deliberation, there was a remarkable meeting of minds, one that embraced the leading medical organisations representing GPs, nurses and patients, as well as the leading think-tanks such as the Nuffield Foundation and the King's Fund.

What are the essential elements of the changes we want to see?

The Secretary of State for Health should remain responsible for administering a universal health service free at the point of need. The commissioning of health care should be done by GPs, together with doctors responsible for hospital care and specialised treatment, representatives of other medical professions such as nursing and physiotherapy, and independent members representing the community that is being served.

As far as practicable, the boundaries of clinical consortiums should reflect geographical communities. Furthermore these consortiums must meet in public, be accountable for their actions, and maintain the highest public standards by ensuring their members declare any financial interest they might have in the decisions being taken.

Monitor, the body responsible for the surveillance of foundation hospitals, should ensure that new providers, which could come from the private sector, put integration and partnership first among their priorities, should compete only on quality, not price, and should not be able to "cherry-pick" easy and profitable cases.

Liberal Democrats can comfort themselves with the realisation that one of England's most trusted and best loved public services will now survive as the framework for our health care; the Prime Minister will be able to say with confidence that the NHS is safe in the Coalition's hands.

Baroness Williams of Crosby served as Leader of the Liberal Democrats in the House of Lords, 2001-2004

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