Liberal Democrats need a health policy of their own

The Liberal Democrat Conference has voted by a narrow majority not to mandate our peers to vote for the Health & Social Care Bill as it currently stands.

But does the Lib Dem Conference mandate the party's elected and unelected representatives how to vote on individual pieces of legislation while the are passing through Westminster anyway? It makes party policy, of course, but that is rather a different thing.

So I found it hard to be as moved by events in Gateshead earlier today as the people who were there - and are still shouting about it on Twitter as I write. (Shirley Williams has gone from heroine to dupe within the last 24 hours, for those who are not following it.)

My own view on the Health and Social Care Bill remains that the Conservatives were foolish to bring in a flagship bill on health in the first place. I have blogged about this before.

But I share the mystification of David Boyle that so many Liberal Democrats attach such importance to maintaining untouched the bureaucratic NHS structure bequeathed to us by Labour. Much of what the bill proposes, such as giving GPs an enhanced role in commissioning, seems to me thoroughly sensible - even if it could have been done without the bill.

So I am puzzled by the assertion of the normally sensible Mark Thompson that the Lib Dems "will reap an electoral whirlwind" if the support the bill. I can seen that Labour will blame any future problems in the NHS on the bill, whether it has anything to do with them or not, but nowhere does Mark tell us why he thinks the outcome of the bill will be so dreadful in the eyes of voters.

My own chief concern with the bill was the original draft's removal of the secretary of state's obligation to provide a service. This is all the more important if you introduce more competition and local control into the NHS, because there has to be someone for people to appeal to if things are not working. But I am assured that this - or something that will mean the same if it comes to court - has been restored to the bill in the Lords.

David Boyle also puts his finger on what has been wrong with the Liberal Democrat to health and the NHS for so long:

For ten years, we failed to work out what a Liberal NHS might look like for the century ahead. When the new legislation was being drafted by the coalition, there was a vacuum where major Liberal thinking ought to have been. 

All we could do was to look back fondly to the way we imagined things to be a generation ago, and we clung to it manfully. All we could say about the NHS was – apart from the usual principles – what we didn’t want.

As one way forward, I would suggest we take seriously the proposal for "democratically controlled and clinically led" health boards that John Pugh makes in his new report A Way Through: NHS Reform without strife and upheaval.