Lords debating NHS shake-up bill

He was opening a marathon debate on the Health and Social Care Bill in the House of Lords, which is set to culminate in votes on Wednesday.
The bill will increase competition and give clinicians control of budgets.
The bill has already been substantially altered following criticism from NHS staff and Liberal Democrat MPs, with many peers seeking further changes.
Labour peers are expected to table an amendment calling for it to be dropped altogether, while Lib Dems and some crossbenchers - non-aligned - have vowed to push for further changes.
The government says the changes are vital to help the NHS cope with the demands of an ageing population, the costs of new drugs and treatments and the impact of lifestyle factors, such as obesity.
On Sunday, hundreds of protesters gathered on Westminster Bridge in central London to urge peers to "block the bill".
And last week almost 400 health professionals and academics wrote to peers asking them to vote against the bill, arguing it would do "irreparable harm to the NHS, to individual patients, and to society as a whole".
Select committee The Health and Social Care Bill has been described as the biggest shake-up of the NHS since its creation.
The original plans proved so controversial that the government took the unprecedented step of halting the legislation while it carried out a "listening exercise" with critics - and subsequently altered the bill considerably.

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Health and Social Care Bill

• Jan 2011: Commons First and Second readings. Approved with no rebellions
• Feb - Mar: Commons committee stage, various amendments accepted on competition
• 4 April: Bill "paused" following widespread criticism
• April - June: "Listening exercise" conducted by NHS Future Forum
• June - July: Bill sent back to Commons committee stage. MPs approve further amendments prompted by listening exercise
• 6 - 7 Sep: Commons report stage and Third Reading - approved with four Lib Dem rebels
• Sep: Bill arrives in the Lords
• Christmas? Ministers would like the bill to get royal assent by then but even without further delays, there are still several stages to go through
• April 2013? Further delays notwithstanding, NHS commissioning groups due to take charge of budgets then

Ministers now say it does have support from the medical profession, but groups such as the Royal College of Nursing and Royal College of GPs have continued to express concern.

Almost 100 peers have requested the chance to speak during the Lords second reading debate on Tuesday and Wednesday. Peers are set to vote on the bill on Wednesday.
Among them, two crossbench peers - Lords Owen and Hennessey - have tabled an amendment calling for part of the bill to be sent to a special select committee - which allows witnesses to give evidence - for further scrutiny.
They say the bill raises serious constitutional issues, particularly aspects relating to the role of the health secretary in overseeing the NHS and the role of a new body, Monitor, in promoting competition within it.
Baroness Thornton, who leads for Labour on health in the Lords, told the BBC last week that peers from her party would be supporting the Owen-Hennessey amendment.
But Labour's shadow health secretary, Andy Burnham, said at the weekend they planned to go further and table an amendment calling for it to be scrapped altogether.
He said he had written to Health Secretary Andrew Lansley offering to work with him to "constructively reform NHS commissioning" if he agreed to drop the bill.
'Autonomy clause' The Lib Dems have consistently argued that the bill be watered down, and their leader - and deputy prime minister - Nick Clegg has said the changes already made will make the health service "stronger and more sustainable".

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“Start Quote

The fact that there is still widespread opposition among the profession is certainly a headache for ministers”

End Quote Nick Triggle Health correspondent, BBC News

• NHS shake-up: The sticking points

However, the Lib Dems' Lords health spokeswoman Baroness Williams told the party's conference last month she wanted to see further changes to it, particularly regarding the role of the secretary of state.

Lib Dem health minister Paul Burstow told the conference he was keen to make further changes "if they are needed" to "put beyond doubt" the party's commitment to safeguarding the NHS.
During a session of prime minister's questions in September, Mr Cameron insisted that "the Royal College of GPs, the physicians, the nurses, people working in the health service" were now "supporting the changes we're making" to the NHS.
But following his comments the RCGP and RCN issued statements saying they still had "very serious concerns" about the plans.

taken from http://www.bbc.co.uk/news/uk-politics-15244060