Government concessions over the Health Bill may be insufficient to dispel “profound disquiet” over the legislation in the House of Lords, which could significantly delay its passage, a senior peer has warned.  

A pamphlet published today by crossbench peer Lord Owen describes health secretary Andrew Lansley’s reforms as “fatally flawed” and calls for the prime minister to replace the current ministerial health team.

The former health minister and medical doctor told HSJ he expected strong opposition to the Health and Social Care Bill in the upper house unless “wholesale amendments” are made.

He said possible concessions being suggested around accountability in the reformed NHS would not be enough to appease “a profound disquiet in the House of Lords”.

The upper house has the power to refer the bill to a Lords select committee, which would hold up its passage significantly and Lord Owen believes a motion to that effect would be successful.

He also warned that even after amendments are made the Lords could delay the bill for a statutory period of a year.

He said there are a lot of peers who have been involved in the health service and the house would have no “inhibition” forcing change because “by any standard there is no mandate”.

“We are going to see some significant coalitions [of opposition],” he said.

The pamphlet, which sets out Lord Owen’s argument against the bill, draws a line between the internal NHS market and the “imposed external market” of the bill. Such a market would “have a deep impact on the behaviour of health professionals in the NHS” and “alter the relationship of trust between patient and doctors”, according to Lord Owen.

It says prime minister David Cameron will “hopefully act… and replace the existing health ministers in the House of Commons and allow for fresh thinking, and much less dogmatism”.

It also points out that it was only following the “reprieve from price competition” from NHS chief executive David Nicholson in January that the decision to rule out competition on price was reinforced by ministers. The pamphlet states: “There must be no equivocation on this matter”.