Liberal Democrat peers are supporting a series of amendments to the Health Bill aimed at curtailing competition regulation, and are concerned it could still extend the application of European competition law to the NHS.
The amendments are supported by several senior Lib Dems so have the potential to force change, but only if the peers decide to push them. The supporters include the Lib Dem Lords health spokeswoman Baroness Jolly, Baroness Williams, and Lord Clement-Jones, a former Lords health spokesman.
Lib Dem peers have tabled more than a dozen amendments, most of them relating to competition and integration. They were put forward in the past week, following apparent government concessions in relation to the health secretary’s duties and accountability.
One amendment would constrain Monitor’s action against anti-competitive behaviour to where it would “improve the quality of those services… the efficacy of the provision of those services” or reduce inequalities.
Another would mean that, once foundation trusts have their private patient income caps removed under the bill, they would only be able to increase that income after their governors had approved a plan to do so. The amendment would mean private income could be used “exclusively” for the benefit of NHS patients.
A further amendent would allow for public interest to be considered when the Office of Fair Trading is considering NHS trust and foundation trust mergers.
Lord Clement-Jones told HSJ: “The thrust [of the amendments] is to balance the competitive powers and the integrating duties. That is what we need to do throughout the bill.”
He said he and colleagues wanted to “make sure we didn’t fall into having a health service covered by European competition law” and to ensure “we don’t have competition red in tooth and claw across the health service”.
Lord Clement-Jones said it was possible ministers could assure him changes were not needed, but currently there was “no doubt there is some ambiguity” remaining about whether Monitor’s competition powers are now appropriate, and about how competition law will apply.
Consideration of the bill at the committee stage in the Lords is likely to continue until January. Other amendments due to be considered would require the government to set out clearer requirements for clinical commissioning group governance, and require GP commissioners to declare interests.