NHS bill: Nick Clegg outlines changes aimed at Lib Dems

The bill aims to give GPs control of much of the NHS budget

Nick Clegg has set out changes to the NHS reforms which he says should mean the bill can be passed into law.

In a letter co-signed by Lib Dem peer Baroness Williams, the deputy prime minister sets out amendments he wants to see which would limit competition and the role of the private sector.

Downing Street said they were "not significant amendments - they are areas where reassurance is required".

Labour called it a "face-saving exercise" for Nick Clegg and his party.

The letter was sent to all Lib Dem peers and MPs as the House of Lords debated a fresh series of amendments to the government'sHealth and Social Care Bill for England.

Two of these - submitted by Labour's Lord Warner and Lord Hunt of King's Heath - were defeated by the government on Monday night.

They related to the role of groups of GPs in commissioning services and the "integration of services" under an altered NHS.

But ministers accepted amendments on registers of interest, aimed at preventing conflicts of interest among GPs providing and commissioning services.

Health Secretary Andrew Lansley will give MPs statement on the progress of the bill at 1530 GMT, following an urgent question from his Labour shadow, Andy Burnham.

'Precious'

Mr Clegg and Baroness Williams's proposed changes are unlikely to be debated by peers until late this week or early next week.

The Lib Dem leader and Baroness Williams - a key figure in Lib Dem efforts to reshape the NHS reforms - said competition and diversity in the NHS must be in the "interests of patients and not profits".

"Given how precious the NHS is, we want to rule out beyond doubt any threat of a US-style market in the NHS," they wrote.

"That is why we want to see changes made to this bill that have been put forward by our Liberal Democrat team in the House of Lords to make sure that the NHS can never be treated like the gas, electricity, or water industry."

Mr Clegg said he supported five "final" changes to the bill which aims to give GPs control of much of the NHS budget and would open up the health service to greater competition from the private and voluntary sector.

These are:

• Reducing the remit of the Competition Commission

• Watchdog Monitor to require Foundation Trusts to put patients' interests first

• Insulating the NHS from the full force of competition law to prevent private takeovers of hospitals

• Members of new care commissioning groups to have to declare financial interests

• Foundation Trusts required to get permission from their governors before carrying out extra private work.

Lib Dem concerns about the government's plans helped lead to a pause in the health bill's progress last year and many amendments.

Mr Clegg said activists had begun the process of altering the bill when raising objections at their 2011 Spring conference, adding that "once these final changes have been agreed, we believe conference can be reassured that it has finished the job it started last March and the bill should be allowed to proceed".

He told the BBC he wanted to make it "crystal clear that competition is the servant of the NHS, never its master". He said he had discussed his letter with the prime minister before sending it and was confident that the suggested changes would now get through the Lords and the Commons.

Conservative MP Stephen Dorrell, chairman of the Commons health select committee, said the proposals were "uncontroversial" and had been "part of the policy mix" for some time, suggesting they were a "response" to internal Lib Dem concerns.

Downing Street said the prime minister did not think the bill needed further amendments, but was happy to provide "reassurance and clarity" on the issues.

Health minister Simon Burns told the BBC it was right that the Lords had a "full discussion" about the bill but "the government and cabinet as a whole" fully supported it.

"What is being proposed is the best opportunity for the NHS to continue to be able to evolve to meet the challenges of an ageing population, a huge increase in the drugs bill and advances in medical science which means patients are being treated more effectively and those with long-term conditions looked after better," he said.

For Labour, shadow health secretary Andy Burnham said Mr Clegg's letter was "stage-managed" and "part of a face-saving exercise for Nick Clegg and the Liberal Democrats. It is a panic move in advance of the spring conference and will convince nobody".

Meanwhile more of the medical Royal Colleges have been reassessing their position.

The Royal College of Physicians - hospital doctors - met on Monday afternoon and has agreed to survey its membership about the bill.

Last week the Royal College of Paediatrics, which also attended last week's No 10 summit, withdrew its support.

The Royal College of Surgeons and the Royal College of Obstetricians are both now due to hold extraordinary meetings next month to consider their position on the bill.

The bill returns to the Lords on Wednesday.