David Cameron’s fondness for U-turns has emboldened the opponents of his health reforms. In an article for today’s Times (£), the Lib Dem grandee Shirley Williams declares her opposition to an “untried and disruptive reorganisation”.
Like others, she warns that the reforms are likely to cost more than the government suggests, that the private sector “will skim off profitable routine operations” and that there is no mechanism to hold GPs’ consortiums to account. What’s more, she implies that Lib Dem MPs have both a duty and a right to rebel.
Pointing out that the coalition agreement promised “to stop top-down reorganisations of the NHS”, she declares: “As a Liberal Democrat parliamentarian, I am under no obligation to support policies outside the agreement.”
It’s notable that Williams is the second of the three surviving founders of the Social Democratic Party to oppose the coalition’s plans for the NHS. In a recent article for the NS, David Owen, the former leader of the SDP, wrote:
There is growing anxiety within the coalition that [the Health Secretary, Andrew] Lansley’s reforms will prompt the public to hold the government responsible for anything and everything that goes wrong in the NHS. No wonder David Cameron is worried. And no wonder Liberal Democrats, deeply committed to the NHS and historically sceptical even of an internal market, are beginning to question what they are being asked to support. If the Liberal Democrats cannot call a halt to or, at the very least, slow down, these ill-conceived health reforms they will no longer be able to claim to be the heirs of Beveridge.
Those Lib Dem MPs who defected from Labour to the SDP in 1981-82, including Bob Russell, Mike Hancock and one Vince Cable, will find it hard to resist such appeals. When Cable denounced the coalition’s “Maoist revolution”, it was notable that he cited the government’s health reforms above all else.
The NHS is likely to provide one of the flashpoints at next month’s Lib Dem spring conference in Sheffield (11-13 March). A motion calling on the party to rethink the reforms has not been tabled formally for debate after the Lib Dem health minister Paul Burstow complained of its “inaccuracies”. But expect rebels to attempt to amend a motion supporting the reforms, including the words, “Conference welcomes the vision for the NHS set out in the government’s white paper”.
It now seems increasingly unlikely that the coalition’s reforms will be implemented in full.