Michael White: relief for supporters as Health Bill scrapes through Lords

In Syria, hospital doctors are being arrested and their equipment smashed this week for treating injured opponents of the Bashir regime. In Spain, hospital doctors, acting in collusion with a reactionary Catholic hierarchy, stand accused of complicity in the theft-for-adoption kidnapping of up to 300,000 supposedly “dead” babies, a practice that endured long after the Franco dictatorship ended.

It may not make you feel better about the latest noisy wave of recriminations about NHS failures or about the coalition’s health and social care reforms, the Pandora’s Box bill which has now had its second reading in the Lords after two days of impassioned debate. But it should remind us all that worse things can happen, even in scary 2011 when reports surface daily that frontline NHS staff and services are being cut all over Britain (SNP-led Scotland too!) in the name of efficiency.

Even before the clash in the Lords David Cameron had wasted no time in attacking Andy Burnham, Labour’s newly reappointed health chief. At prime minister’s questions he quoted Burnham as saying “it is irresponsible to increase NHS spending in real terms” and told MPs he was wrong. What Burnham actually said was that Labour would protect frontline services.

The reality is that the coalition is protecting neither and Labour might well have done no better in the current financial storm.

What Labour would not have done is impose another top-down reform on a cash-squeezed service when, as former Labour minister Lord Darzi put it in the debate, “we live in a time of rising fear… today people need our NHS more than ever”. Quite so, but as I predicted here last week, it was not enough to persuade peers to vote no or – Lord Owen’s compromise – refer to a special committee the constitutional dimension of the bill.

“Lib Dem discipline was Stalinist,” a Labour whip confided after the vote (though I think Shirley Williams abstained). Six bishops, 46 crossbench peers (retired medical grandees are often non-party) and just two Lib Dems joined 198 Labour lords (plus 10 others) in backing Owen, a Labour renegade 30 years ago. In the 262-330 result, 193 Tories and 51 crossbenchers were joined by 80 Lib Dems and six others.

So Nick Clegg’s troops saved it for Cameron. “You backed us in founding the NHS in 1946 but you have lost your NHS reputation now,” Labour peers warned in vain. My sense is that, as Lord Darzi himself conceded (before voting for Lord Owen), the bill has become like a bank: not “too big to fail” but “too complex to quit.”

All the same there were some terrific speeches on both sides, worth an online look at Hansard for 11-12 October. Minister Lord Howe makes a much better job of things than his boss, Andrew Lansley, and is widely admired by fellow peers which always helps. The ex-Blair aide Lord Birt, who once likened his own reforms at the BBC to the medicine the NHS needed, backed the bill. So did Virginia, Baroness Bottomley, and Mencap’s gallant comic-actor-turned-peer, Lord Brian Rix.

Plenty didn’t, although I am tempted to cite Lord Andrew Mawson, theologian turned social entrepreneur, founder of the Bromley-by-Bow Centre which pioneered all sorts of public service integration in tough east London. “For 25 years I have danced with the dinosaur-like structures of the NHS” to promote such local reforms, he told peers before voting for the bill.

When I later bumped into silky Lord Howe he was relieved. He admitted he had not been sure of beating Lord Owen, but is determined to be open minded towards amendments during committee stage. “Combative but emollient” are his watchwords. We shall see.