Coalition to clash again over return of NHS Bill

The longest NHS Bill in history returns to the Commons tomorrow amid rising anger over its provisions to increase competiton and the role of the private sector.

More than 1,000 amendments have been made by the Government since a summer "listening exercise", but it still faces the prospect of a Liberal Democrat revolt.

Opposition to the Health and Social Care Bill in the Lords will be championed by Baroness Williams, who warned yesterday that Lib Dems still had "huge concerns" over the planned reforms. She said there was legal doubt over whether it would require the Health Secretary to deliver a "comprehensive health service for the people of England, free at the point of need".

She questioned why ministers had become "bewitched" by the market system run in the US, when the NHS was "among the most efficient, least expensive and fairest anywhere in the world".

Her intervention came as it emerged that the Department of Health had discussed handing management of up to 20 failing hospitals to private companies overseas. Emails released in response to a Freedom of Information request showed management consultants McKinsey had acted as broker between the department and foreign firms for contracts worth millions of pounds.

The department said it was not unusual to hold talks with external organisations and that NHS staff and assets would always remain wholly owned by the NHS. The disclosure fuelled protests from unions campaigning against the reforms. Christina McAnea, Unison's head of health, accused the Lib Dems of colluding with the Tories to "break up and privatise the NHS".

The Health Secretary Andrew Lansley said: "Claims that we aim to privatise the NHS amount to nothing more than ludicrous scaremongering. The reality is that we're giving more power and choice to patients . We will not allow these lies to block the progress we want to achieve for patients."

The management expert Sir Geoffrey Robinson will warn on BBC1's Panorama tonight that the reforms could spell the end of the NHS unless they created a management structure able to take difficult decisions on hospital closures. "The stakes here are huge, the very existence of the NHS could depend on getting this right," he said.