The Health and Social Care Bill has cleared another political hurdle: the House of Lords has voted not to refer it to a select committee and not to block the Bill outright.
The Health Bill will now proceed to a normal House of Lords committee stage.
The amendment calling for referral to a select committee, which would allow witnesses to give evidence, was tabled by cross-bench peers Lords Owen and Hennessy. They argued that aspect of the Bill raised serious constitutional issues – specifically in relation to the roles of the Health Secretary and the regulator, Monitor.
According to Lord Owen, a select committee was necessary to examine “the complexity of this new relationship” between patients, clinicians and the DH. He insisted that the select committee would not prevent the Bill completing its trajectory on schedule.
However, Health Minister Lord Howe denied that the market reforms threatened the integrity of the NHS, and claimed that any delay “could well prove fatal” to the necessary timing – as the changes are already under way.
The Lords voted 330 to 262 against the amendment. They also voted 354 to 220 against an amendment put forward by Labour peer Lord Rea to block the Bill on the grounds that it ran contrary to both Conservative and Liberal Democrat manifesto commitments.
Recently-appointed Shadow Health Secretary Andy Burnham said Labour would continue to oppose the Bill: “It will be debated now over a number of weeks, even months, in the House of Lords – line by line, clause by clause – and Labour will be wanting changes to this bill, substantial and drastic changes to it, so this is far from over.”
The BMA had written to every peer urging them to block the Health Bill as “dangerous”. PM David Cameron responded by claiming the Bill had the broad support of the medical profession, while Health Secretary Andrew Lansley claimed the critics were “politically motivated”. The BMA has rejected both claims.
Following the House of Lords vote, Dr Hamish Meldrum, Chairman of the BMA Council, commented: “The BMA continues to have many areas of concern, including the need for assurance that increasing patients’ choice of provider for specific elements of their care won’t be given priority over the development of integrated services and fair access. We also need to see an explicit provision that the Secretary of State will retain ultimate responsibility for the provision of comprehensive health services.”
Critics of the Health Bill claim that whereas the first version made privatisation of the NHS an overt political aim, the second version retains it as a covert goal and intended consequence of the legislation.
The Government aims for the Health and Social Care Bill to become law by April 2012, a year before the new Clinical Commissioning Groups are due to take charge of NHS budgets.