Andrew Lansley has declared that the latest amendments to his controversial NHS reform bill would be "significant". The health secretary was responding to an emergency question from his Labour shadow, Andy Burnham, after the coalition government's apparent confusion over the changes announced on Monday by the Liberal Democrat deputy prime minister Nick Clegg.
In an effort to head off a backlash against the health and social care bill from within his party at its spring conference in March, Clegg wrote to his MPs and peers promising important changes to "rule out beyond doubt any threat of a US-style market in the NHS". However the promise of five new amendments through the House of Lords was undermined by his Conservative coalition partners after Downing Street said that the changes would be "not significant".
On Friday, and at lunchtime on Monday, government ministers had also said there would be no further changes to the bill. Burnham challenged Lansley to tell MPs whether the latest changes were "substantial or cosmetic", and whether they had been agreed by the prime minister and health secretary in advance. "The government appears in complete disarray, or maybe it was … coalition choreography to save face for the deputy prime minister," said Burnham. "The NHS matters too much to leave it to be carved up in cosy coalition deals."
Lansley avoided at least three times answering questions about whether he had been consulted about Clegg's letter. "The point of the letter was to reflect the discussions we have been having," he said in reply to Labour MP Gisela Stuart, apparently referring to the government and the House of Lords, which has discussed amendments in the committee and now report stages. "The amendments to the report would, by their nature, be significant," he added later.
Labour MP Rushanara Ali challenged Lansley on the decision by Tower Hamlets clinical commissioning group, in her constituency, to ask the health secretary to drop the bill. "When the very structures he's establishing to advise him are telling him they don't want to have part to do with this nightmare he's creating, isn't it time to look again and drop the bill?" she asked. Lansley replied: "They will use the powers in this bill and they will use them effectively."
Later Burnham also criticised the decision of the backbench business committee of MPs, which decided not to hold a debate on the e-petition signed by 162,000 people asking for the health bill to be dropped. E-petitions hosted by the government website are eligible to be debated when they are signed by more than 100,000 people.