This afternoon, the House of Lords votes on whether to allow the Health and Social Care Bill to continue its passage into law. Whatever happens, it is very unlikely that this vote will mark the end of the campaign to protect the NHS.
But it is definitely an important milestone. It could turn out to be the day we finally start to secure substantial changes we need to stop Andrew Lansley fatally undermining our health service.
The House of Lords will have the option of voting for at least two key amendments. Lord Rea has tabled an amendment which would basically kill the Bill stone dead, denying it a second reading. Another amendment brought forward by Lords Owen and Hennessy would place the bill under much closer scrutiny and open up the possibility of bigger changes, by setting up a Select Committee to investigate its implications and recommend amendments.
Many of us probably sympathise with former GP Lord Rea's view that this legislation imposes precisely the kind of "top-down reorganisation" of the NHS which the coalition parties had explicitly ruled out, and that therefore the Lords have grounds for throwing it out altogether.
But it looks like the Owen-Hennessy amendment has more chance of success. This would not block the bill, but it would put under the microscope the government's plan to water down their responsibilities towards - and accountability for - our health service. That would be a big breakthrough for our campaign, and it's certainly something which the government is desperate to avoid.
In the 12 hours since the Owen-Hennessy amendment was finalised, over 100,000 38 Degrees members signed a petition in support of it.
It's still growing, you can check the exact number (and add your own name, if you like) here. It's a remarkable and unprecedented show of public support for an amendment tabled in the House of Lords at second reading. It is already being talked about in the chamber, and we will be delivering a copy to a cross bench group of peers just before the voting starts.
It's not that surprising that 38 Degrees members are so keen to support putting Lansley's NHS plan under more scrutiny. We know that the more scrutiny these plans are put under, the more worrying they turn out to be. We have been working together to put this Bill under the microscope for some time.
Thousands of us donated to hire independent legal teams to go through the Bill prior to its third reading in the House of Commons. Our lawyers set out the implications of scrapping the Secretary of State's "duty to provide" health services, identified a "hands off clause" which would severely curtail the Secretary of State's ability to influence the delivery of NHS care, and explained how the changes would increase the likelihood of the NHS being subject to EU competition law.
These are serious concerns, backed by serious expertise. They were almost immediately picked up by Lib Dem peer Shirley Williams. And they were subsequently echoed by an influential Lords committee, the Constitution Committee, who warned that Lansley's plans "may risk diluting the Government's constitutional responsibilities with regard to the NHS ".
Yet when 38 Degrees members asked their MPs to address these issues whilst the bill was being debated in the Commons, an alarming number of MPs on the government benches totally failed to engage. Many responded to their voters' concerns by parroting the evasions offered by Andrew Lansley during the House of Commons debate. Serious concerns about the implications of the legislation were dismissed as as "propaganda" - despite that "propaganda" having been signed off by an independent legal team.
The cynical response to 38 Degrees members' legal opinions, and the repeated claims that the entire medical profession support Andrew Lansley's plan, are just two of the more prominent examples of the evasion, obfuscation and downright dishonesty which the government deployed to help whip this legislation through Commons. So it's no wonder so many lords are concerned that the plans have not been properly scrutinised. And it's no wonder that 38 Degrees members, along with so many other groups and individuals concerned about the future of our health service, are doing all we can to show our support for those lords who want to put this bill under the microscope.
How this afternoon's votes will go looks too close to call. Members of the House of Lords are certainly feeling the public pressure. Thousands of us have sent them personal letters, numerous groups of health professionals have made their own submissions, and the petition in favour of the Owen-Hennessy amendment is growing by the minute. As many 38 Degrees members have pointed out in their letters to Lords and Baronesses, the general public never had a chance to vote on these NHS changes. The proposals weren't in anyone's manifesto, and they didn't feature in any party political broadcast.
Members of the House of Lords do now have a chance to vote on them. Let's do all we can to persuade them to vote the right way.
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