If there's one thing that Liberals don't respond well to...

[miss_s_b]

Yeah, OK, there are lots of things Liberals don't respond well to. But really, Cleggy? REALLY? If I don't agree with every word of Shirley Williams' motion I am on the side of Andy Burnham?

Well, I guess I'm on the side of Andy Burnham, then. OR NOT. What is WITH YOU? Do you think that sort of wankery is going to make me, and others who don't appreciate what you're doing IN OUR NAME less annoyed with you? Really? Are you THAT stupid? See, this is the thing. I don't think you ARE that stupid. I think you are actively trying to drive me and others like me out of the party. And you know what? You're going to have to try a damn sight harder than that.

...

I just deleted a long stream of invective here, but I really am, very very angry. It's probably a good job I'm not in Gateshead.

Comments

[bagpuss]

It would be great for someone to a refuation of points like http://abetternhs.wordpress.com/2012/03/10/ldconf/ and http://bengoldacre.posterous.com/what-will-the-nhsbill-do-i-dont-think-youre-w if they arent true

The tories track record does make this sort of thing all to plausible and it would be a great shame for them to get away with this because they can blame the Libdems

[miss_s_b]

I really wish I /could/ refute that.

[andrewhickey.info]

See my post from last night. The bill explicitly states that no new charges can be introduced without further legislation.

[bagpuss]

But there is plenty in the bill which would allow them to seriously reduce the service offered

It's all very well saying the cant charge for it but if they just don't provide it what choice will people have

[andrewhickey.info]

There *was* stuff like that in the bill, there isn't now.
CCGs (the replacement for PCTs) *do* have more discretion now as to what services they provide. The ostensible reason behind this is sensible enough - if you have a population of mostly old people, in a community full of retired people, you want to prioritise geriatric care, while in say Moss Side you might want to prioritise drug addiction treatment more.
However, there are several safeguards there. Firstly, the bill gives local authorities the authority to provide more services themselves, if they disagree with a CCG about what services should be provided. Secondly, the Secretary of State still has an obligation to provide a comprehensive health service free at the point of delivery. And thirdly there is a new obligation for the Secretary of State to reduce inequalities in healthcare provision.

(A lot of trans activists I know are delighted by that third part, as it will reduce postcode lotteries which stop people getting treatment in parts of the country.)

I'm not defending the bill as a whole - I disagree with it and think it's a bad piece of legislation - but a lot of what its detractors claim is not, as far as I can see, in the bill itself.

(A caveat - I am not a lawyer and have no legal training, and this is a four hundred page bill making amendments to two very complex existing acts. My interpretation may well be wrong. HOWEVER, none of the people I've seen complaining about this have been legally trained *either* - all the studies I've seen of the effects of the bill have come from doctors - and so their interpretation should not be trusted much more than mine. It's always best to read these things for yourself, but in this case it's close to impossible. Which is one reason I'm against the bill...)

[bagpuss]

I am sure I have a very naive view not know how legislation works but I can't help but feel any bill that has had more than 1000 amendments added to it wasn't thought through terribly well in the first place and it might be better to go back to the drawing board

[andrewhickey.info]

Couldn't agree more.

[miss_s_b]

I am legally trained, and I know how legislation works (although I haven't studied this bit of legislation in anything like the depth Andrew has). [A]ny bill that has had more than 1000 amendments added to it wasn't thought through terribly well in the first place and it might be better to go back to the drawing board is something many lawyers would shout from the rooftops if they could; although there are also those who would counter any bill that has had more than 1000 amendments added to it wasn't thought through terribly well in the first place and that means more money for lawyers as we fight it out in the courts down to the last comma.

[bagpuss]

Okay having thought about this a bit more I really don't see if a CCG decided it doesn't have the resources to provide a service is a Local Authority really going to go against that.

Even if they believe the CCG is wrong in the level of service that is provided where are the Local Authority going to find the money to pay the service and the infrastructure to actually be able to provide the service, presumably they will have to use what ever, that sounds like a sop rather than anything which will really happen

[andrewhickey.info]

Local authorities currently have a lot of healthcare responsibilities anyway - the idea as I understand it is that they'd contract a different CCG to provide those services.
The main bit though is the responsibility of the secretary of state to provide a comprehensive service, and the obligation to minimise inequalities. Right now, a PCT can, for example, decide that a new Alzheimer's drug is too expensive, while the PCT next door funds it. Under the new bill, though, the government is obliged to ensure that that sort of thing doesn't happen.
So there are actually multiple layers of safeguard in place.