Andrew Lansley’s controversial NHS reforms finally cleared their last major hurdle last night as Labour failed in a last-minute attempt to delay the plans.
David Cameron and his senior ministers banged the Cabinet table yesterday after hearing that the shake-up had completed its tortuous passage through the Lords. The Health Secretary’s overhaul of the health service will now be given Royal Assent and passed into law before Easter.
Andy Burnham, the Shadow Health Secretary, said that a Labour government would repeal the reorganisation “at the first opportunity” after his party’s failure to delay the plan.
A Labour motion had called for the Health and Social Care Bill not to be passed until the Government had agreed to reveal a secret assessment of the risks posed by the legislation. It was defeated by 82 votes.
A ruling by the Information Commissioner that the so-called risk register should be disclosed under Freedom of Information laws was supported by a tribunal last week. But the Government has said that it will only decide whether or not to comply once the tribunal has published its reasoning.
Advertisement
Nick Clegg, the Deputy Prime Minister, warned yesterday that handing over the document would stop civil servants giving “frank and fearless” advice about policies. Ministers ultimately have the power to veto the release of assessments.
In an emergency debate that marked Labour’s last chance to derail the reforms, Mr Burnham said that MPs and peers had been forced to take a “gamble” on sweeping changes to the health service without knowing the risks.
“People outside will struggle to understand how members of this House could make such momentous decisions without having carefully considered all of the facts and all of the evidence,” he said. “But the truth is, members will go through the lobbies tonight without knowing the full implications of what it means for the NHS in their constituencies.”
Some Liberal Democrats turned on the decision not to publish the register and argued that dropping the Bill could still be the best option. However, none voted against the Government.
The passing of the health Bill into law will come as a huge relief to Mr Clegg and Mr Cameron, who have spent significant political capital on the reforms. Downing Street has been furious at Mr Lansley’s failure to sell the reforms or win the support of health service professionals.
Advertisement
Speaking in the Commons last night, the Health Secretary, who could yet lose his job in a Cabinet reshuffle later this year, remained defiant. He accused Labour of “political opportunism” in opposing the Bill and said that publishing the opinions expressed in the risk register would destroy the “safe space” for civil servants to give frank advice.
“They do not represent a balanced view, they are not a prediction of the future,” he said. “They set out a worst-case scenario to challenge decision making. Publication of the risk register would prejudice the frankness and integrity of the decision-making processes of government and the Government is opposed to their publication.”
Liz Kendall, the Shadow Health Minister, said that there had been 1,000 government amendments to the “disastrous” Bill, and 374 changes in the Lords. “It is unacceptable that elected members in this House have been give so little time to debate these amendments.”
Uncertainty remains among those working in the health service. Mike Farrar, chief executive of the NHS Confederation, said that the passing of the Bill would be “the beginning, not the end”. He added: “NHS leaders have to make sense of the hand they have been dealt. Let there be no doubt that this will be among the toughest projects the NHS has taken on. We have to find our way through the considerable confusion and complexity that has been handed to us as we build and stress-test the new NHS system.”