The letter from the leader of the Liberal Democrats and Baroness Williams has made quite an impact this afternoon. The key paragraph to see which “changes” they call for is below.
‘First, we propose removing the reviews by the Competition Commission from the Bill to make sure that the NHS is never treated like a private industry. Second, we want to keep the independent regulator of Foundation Trusts, Monitor, to make sure hospitals always serve NHS patients first and foremost. Third, we will introduce measures to protect the NHS from any threat of takeover from US -style healthcare providers by insulating the NHS from the full force of competition law.’
You can find the full letter at PoliticsHome here. This will not go down well with Conservatives, who simply wish that the Bill was placed on the statute book as quickly as possible. They get very nervous at any hint of further delay. And further politiking from Lib Dems will also be viewed negatively. However, Nick Clegg also has his eye on the looming spring conference in Newcastle and the local elections in May. He wants to do everything he can to avoid further heavy hits at a local level. So what do Lib Dems think?
Chris Nicholson, chief executive of the CentreForum think tank, tells me that: "Nick and Shirley's letter treads a delicate path between emasculating the competition aspects of the bill, which would be a bad idea, and putting in enough safeguards to provide reassurance. I think it does that successfully. I think there are still problems with the bill with confused accountability and putting too much power in the hands of GP commissioning consortia. But this letter should address the main concern that Liberal Democrat activists have expressed."
One party insider told me that the significant movement was Shirley Williams's change in position on competition in the NHS. Instead of being completely hostile, Williams has been convinced by the Lib Dem leadership that the competition rules, Part 3 of the Health and Social Care Bill have to be “tidied up”. With the deity-like status enjoyed by Williams in the party, he points out her joint authorship of the letter will add huge credence to Nick Clegg’s position. This is true but it doesn’t answer the question as to what happens if these changes are not accepted?
We will shortly see what impact their proposed changes to the competition aspects on the Bill's tortuous progress. The Liberal Democrats I’ve spoken to are reassured by this letter, relieved that Clegg and Williams have been able to come together to author it. But we will see at their spring conference on 9 March if Nick Clegg has relieved the concerns of his party and if he is able to deliver the changes he calls for in today's letter.