An embattled Andrew Lansley makes a staunch defence of the importance of greater competition in the NHS this week, as Liberal Democrat peers pressed to further reduce its importance in the Health Bill.

Writing exclusively on earlier this week, the health secretary says competition is a “critical element” of healthcare reform, but the term was “often used pejoratively by vested interests with something to fear from change”.

Providing “clear freedoms” for any qualified provider to deliver NHS services would help to ensure “those who strive to innovate to provide the best possible care should find their efforts supported rather than stymied”, he writes.

The piece, commissioned by the think tank Reform, was published after prime minister David Cameron was forced to reiterate his backing for Mr Lansley to remain as health secretary. It comes a month before the Lords debate the controversial competition provisions of the bill.

HSJ understands the government plans no further substantive changes to the provisions; any amendments will be for “clarity and reassurance”.

However, Liberal Democrat peer Shirley Williams, writing in the Guardian on the same day, said the way out of the “mess” surrounding the bill was for the government to drop the entire section on competition and retain Monitor as merely the foundation trust regulator.

“I do not favour a complete abandonment of the bill, given the changes already made,” she wrote. “But these further changes are essential.”

A Liberal Democrat source expected the government to give further ground on competition, although it was not yet clear where concessions would be made.

The party has tabled amendments to remove the bill’s requirement for the Competition Commission to review the development of competition in the NHS.