Rt Hon Nick Clegg MP
Deputy Prime Minister
1st November 2011
Tomorrow the House of Lords returns to the crucial issue of the Secretary of State's responsibilities in respect of the National Health Service.
The Government has already indicated that it is prepared to accept changes in this area. I understand the Minister intends to accept the amendment in the name of Lord Mackay of Clashfern. We do not believe that this goes far enough, either to meet our concerns or those expressed by leading Liberal Democrats. Indeed, by providing a narrow definition of the circumstances in which the Secretary of State can intervene, it represents a major diminution in the democratic accountability of the NHS and undermines provision of a comprehensive service.
Even with the Mackay amendment, the Bill still hands huge power and control over health services to an unelected board of the largest quango the UK has ever seen. Patients and their elected representatives would have limited ability to challenge commissioning decisions. By limiting the Secretary of State's ability to set national standards, and only allowing complaints to be heard by an unelected quango, the Bill opens the door to an unfair postcode lottery.
We are encouraged, though, by the common ground that appears to exist between our two parties on this matter. As you will know, the first amendment in the names of Liberal Democrat peer Baroness Williams, Labour’s Baroness Thornton, the chair of the Lords constitution committee Baroness Jay and crossbencher Lord Patel restores the Secretary of State's responsibilities in line with the 2006 Act and a straight line to 1946. This amendment fulfils the policy set out in the motion agreed at Liberal Democrat 2011 Spring Conference calling for amendments to the Health Bill to secure "more democratically accountable commissioning".
Given the Government's decision to give ground, this issue is now clearly in your hands. The purpose of my letter is two-fold: firstly, to assure you of Labour's full support for the Williams, Thornton, Jay and Patel amendment; secondly, to ask for your assurance that Liberal Democrats will not accept the Lord Mackay amendment and that you will stand firm with us behind the Williams / Thornton amendment.
Tomorrow, by pressing this matter to a vote, we can work together to secure a democratically accountable NHS. Anything less would be to sell short the many millions of people who still have huge concerns about this Bill.
RT HON ANDY BURNHAM MP