So the fighting is over, now comes the reconciliation. David Cameron’s concessions on the health bill – giving more leeway on GP-led commissioning and changing the role of the medical regulator (Monitor) so it is no longer purely to promote competition – have made the breakthrough. Nick Clegg is willing to support the proposals and is telling his parliamentary party exactly that now.
There will be a statement next Tuesday by the NHS Future Forum on their views on what should happen to the service, but Cameron’s speech has made that less relevant: he has made the key achievement of winning back the Lib Dems. The FF’s statement will be followed quickly by a ministerial statement and the coalition government will then take the reforms forward together.
The question now is whether each can take their own parties with them. The obvious problems will come at the Liberal Democrat end – Cameron’s repeated references to competition on Tuesday show he is not completely rejecting the Lansley reforms, even though some Lib Dems will settle for nothing less.
Clegg is currently locked in talks with his parliamentary party to persuade them to back the reforms. We will have to see what the reaction of likely rebels – Andrew George, Evan Harris, Baroness Shirley Williams et al. – will be.
But while they digest the proposals, Cameron is already having problems with his own backbenchers, fed up with what they see as Lib Dem vacillation on the issue. Nick de Bois sent round an email to fellow Tories before the recess decrying what he saw as “rather concerning change [to the reforms], coming not from within our own ranks but from amongst our coalition partners”.
And today, despite the rapprochement at the top of the coalition, the backbench catfighting continued in the chamber. Tory Karl McCartney stood up to criticise the “flip-flopping of our coalition partners” on the issue. He was followed immediately by Lib Dem Duncan Hames, who insisted he was “wearing neither sandals nor flip-flops”.
Reasonably good natured stuff, but the tensions are still there and will only be exacerbated if Cameron and Clegg start looking like best buds once more.
Jim Pickard
Kiran Stacey