Exclusive: Health Bill concessions on 'autonomy' and SoS accountability

The issue forced crunch votes in the Lords before Christmas with some crossbench peers – including Lords David Owen and Peter Hennessy – leading the opposition along with Labour.

Peers are due to meet tomorrow to discuss new government-proposed amendments, which have been seen by HSJ. They are made in a letter to peers from Earl Howe.

The letter says: “I think this provides a strong foundation for agreeing a final package of amendments… in order to attract broad support from across the house.”

One change amends the first clause of the bill, on the health secretary’s “duty to promote a comprehensive health service”, to “make clear [he/she]… retains ‘ministerial responsibility to Parliament’”.

Another change waters down the bill’s controversial Clause 4, which gives the health secretary and NHS Commissioning Board a “duty as to promoting autonomy”.

Earl Howe’s letter explains: “The amendments would (a) weaken the duty… and (b) make it explicitly subsidiary to the duty to promote a comprehensive health service.”

A further three changes include a new clause giving the health secretary a “duty to have regard to the NHS Constitution”.

Labour and others who oppose parts of the bill will attempt to force the government to make further changes to the legislation, either in further concessions to be discussed in coming weeks or by pressing for votes at report stage.

Key issues are likely to include education and training; Monitor, competition law and the private patient income cap; clinical commissioning group governance; public health and HealthWatch England.

Changes are expected to be made at the bill’s report stage in the Lords. Dates have not yet been confirmed, but it is expected to begin in the second week of February and last for around one month.

Sources involved in discussions said the new proposals are likely to be agreed, perhaps with slight alterations, although Labour frontbench peers are likely to call for a further shift.

Labour health spokeswoman in the Lords Baroness Glenys Thornton said: “It is still a very unsatisfactory bill and we would prefer it not to be there. We are working our hardest to find a consensus that would mitigate its worst effects.”