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Baroness Thornton

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A "First Amendment" for the NHS

Posted: 26/10/11 01:00

Today, the Health and Social Care Bill continued its tortuous passage through Parliament, with its first day of Committee on the floor of the Lords. To kick things off, Labour's front bench tabled an amendment on 'the Principles of the NHS'.

Our "First Amendment" set a framework for the Health Bill to follow, with a debate on the principles that should underpin the health service in England. It stressed the rights and pledges, values and principles as outlined in the NHS Constitution.

Our amendment also placed the protection and promotion of patient care above any structural or financial reorganisation of the service. Furthermore, it called for transparency and openness in decision-making, especially on funding, in order to ground proper accountability at the heart of our NHS.

The government says they agree with all of this, but its Health Bill fails to reassure people that it will deliver on these principles, and the resulting confusion and lack of trust will be the substantive matter of the 450 plus amendments already tabled for future debate.

The need for a defining set of principles for the NHS arises out of the government's failure to provide any reasonable explanation of what the Health Bill is actually for. Ministers tell us it has to be a different NHS, so Labour is seeking to place some definition on what all sides can agree about and to place those principles at the front of the Bill.

Of course our amendment is a statement of intent for the Bill, coming as it does before Clause 1. But it is also a perfect cross-party marriage in its crafting, as it includes something old, something new and yes, something borrowed and blue.

The 'old' - though not very old - is the NHS Constitution, devised, designed and brought about by the last Labour government.

The 'borrowed' is from the LibDem spring conference resolution, when some of their membership voiced concerns, long made by Labour, that the Health Bill was paving the way to set the NHS up as a utility-style market.

The 'blue' is the Coalition Agreement, with echoes of David Cameron himself, and the commitment to no more top down reorganisations. And the 'new' is from the Future Forum - that body of experts established to protect the government against its own legislation, and which quite rightly brought the probity of the Nolan principles into play.

Given how unpopular its Health Bill is among health professionals, patient groups and NHS staff, the government still has some way to go in persuading people of its aims, let alone its plans. In that context, our "First Amendment" on the principles of the NHS should be seen as helpful.