NHS Reform Bill - Why we Must Discuss our Concerns in the Lords

So the Liberal Democrats have fallen in line behind their Tory masters over the Health and Social Care Bill. Both last night in the House of Lords and in a letter in today's Guardian, they declare that "the time for declaratory statements is past." Well, they can speak for themselves. Plenty of people in the country at large are still disturbed by what the Tory Health Bill will mean for them and want to hear those concerns expressed. There's still a chance to do so in the House of Lords as we examine clause by clause of this massive bill.

So the Liberal Democrats have fallen in line behind their Tory masters over the Health and Social Care Bill. Both last night in the House of Lords and in a letter in today's Guardian, they declare that "the time for declaratory statements is past."

Well, they can speak for themselves. Plenty of people in the country at large are still disturbed by what the Tory Health Bill will mean for them and want to hear those concerns expressed.

There's still a chance to do so in the House of Lords as we examine clause by clause of this massive bill. It will remain for the Labour peers to make clear what many of us think about the move towards market values that is sneaking into the much-loved NHS.

Yesterday was the first committee day of the Bill in the House. Like many things in this place, the names don't tell the whole truth.

"Committee" would normally suggest an enclave of experts coming together over a concentrated period of time to pool their knowledge and come to conclusions. In the House of Lords things are different. "Committee of the full house" is its full title, and so we can all turn up and offer our contributions.

Labour began with a daring and unusual idea. It proposed as amendment 1 a pre-amble to the bill, which would set out clearly at the very beginning - overarching all that was to come - exactly what defined the principles of the Health Service in England.

The language was carefully, even wittily, chosen.

Baroness Thornton who formulated it used quotations taken from the actual constitution of the NHS itself from a Lib Dem resolution passed at their spring conference, and from the many pledges made by the prime Minister himself.

Surely it would be hard to vote against something which had been so thoroughly sourced. Alas, it was not to be. When it came to the vote, the amendment setting out the principles was lost by some 40 votes. Not many in a chamber of over 400 peers. But the Lib Dems stuck with their Tory allies, and so the vote was lost.

And so we go on, engaging in a fastidious scrutiny of clause after clause of the bill, with amendments piling in to stop its more ruinous consequences for the NHS.

Lords and Ladies who are members of the House come and go at whim, coming into the Chamber when an issue that concerns them is being discussed, then off to their offices, meetings etc when they are not engaged. That's why the place looks so empty on the television. For this bill however, more and more peers are turning up and staying to listen.

One big issue yesterday was the matter of education and training of those who would serve in the health service. Strangely enough the bill had passed the Commons with no mention of such training. It's hard to believe that could be so, that it hadn't occurred to the major legislative Chamber to include education and training within the Bill's range.

It shows just how valuable the professional expertise of the House of Lords is. Here were doctors, consultants, surgeons and psychiatrists, all having their say and exchanging views and opinions across the chamber with the sole object of making the bill better.

Party politics didn't come into it as Lord (Robert) Winston, Lord Mawhinney, Baroness Emerton and the Earl Listowel exchanged ideas and suggestions. The government minister, the Earl Howe listened thoughtfully to it all. I feel the Bill will ultimately be better, thanks to them.

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