Ministers disappointed at BMA vote, while opposition grows and MPs warn of a potential service collapse
No 10 responded to the British Medical Association vote on NHS reforms by describing the general meeting as unrepresentative of the BMA membership, adding it was disappointed it had decided to oppose reforms it had previously supported.
Andrew Lansley, the health secretary, has insisted he will only be making minor changes to the language of the health and social care bill in response to the Liberal Democrat decision to oppose it. A discussion is now under way inside the coalition on how to respond, with some influential cabinet figures arguing Lansley has to recast a bill that is losing support daily.
Labour is to stage a debate on health on Wednesday with a motion broadly designed to mirror the Liberal Democrats' objections to the bill, which were passed in a weekend motion at its conference in Sheffield. Liberal Democrat MPs met on Tuesday to decide how to vote in the Commons debate, but are not expected to vote with Labour.
John Pugh, the Liberal Democrat backbench MP on the health and social care bill, has raised objections to a centrepiece of the bill: the introduction of a new economic regulator, Monitor, charged with promoting competition in the NHS for publicly funded services.
During a line-by-line debate on the bill, he said he feared there was a danger of "service collapse" if there was too much competition, with the net effect that local hospitals would no longer provide specialist services that a competitor would not provide.
Pugh said "Monitor will have the capacity to fundamentally change health services without people having much of a say in it". He said its decisions would be irrevocable.
Pugh argued it would be better for the health and wellbeing boards, accountable to councils, to undertake this regulatory role and put greater emphasis on collaboration. He challenged ministers to show him an instance of a successful economic health regulator anywhere in the world working in the way proposed in the health bill.
Patients are not consumers, he said, a point reiterated by Liz Kendall, the shadow health bill minister: "Monitor's role will be comparable to that of the regulators who opened up the gas, electricity and telecommunications markets. Relying on markets and competition to drive up quality from the patient's perspective is therefore very different in healthcare compared to the telcoms or utilities industries."
Kevin Barron, former chairman of the health select committee, said he objected to Monitor having powers to transfer major decisions to the Competition Commission.
Source: http://www.guardian.co.uk/society/2011/mar/15/nhs-reform-bill-opposition-andrew-lansley
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