House of Lords told delays 'could kill off NHS bill'
The government's bill overhauling the NHS in England could be killed off altogether if peers vote to delay it, a health minister has warned.
Health Minister Earl Howe said the plans, which will increase competition and give clinicians control of budgets, were vital for patients.
His warning came as the House of Lords debated the controversial bill.
Many peers are expected to back an amendment calling for it to be held up while further scrutiny takes place.
The Health and Social Care Bill has already been substantially altered following criticism from NHS staff and Liberal Democrat MPs.
Ministers say the changes are vital to help the NHS cope with the demands of an ageing population, the costs of new drugs and treatments and the impact of lifestyle factors, such as obesity.
They say the bill now has the backing of health service staff and the public, but on Tuesday, more than 60 leading medical professionals, supported by celebrities including fashion designer Dame Vivienne Westwood and comedian Russell Brand, warned in a letter to The Independent that it was still unpopular.
'Health is different'
Two cross-bench peers - Lords Owen and Hennessy - have tabled an amendment calling for part of the bill to be sent to a special select committee - which allows witnesses to give evidence - for further scrutiny.
They say the bill raises serious constitutional issues, particularly aspects relating to the role of the health secretary in overseeing the NHS and the role of a new body, Monitor, in promoting competition within it.
Lord Owen said a special select committee was the only way of looking at "the complexity of this new relationship we are trying to establish" between patients and clinicians.
"Health is not a public utility," he warned. "Health is different."
Labour peers are expected to back Lord Owen's amendment when the house votes on Wednesday.
Baroness Thornton, who leads for Labour on health in the Lords, said the bill would turn "patient choice into shopping", while health care would become a "traded commodity".
Labour's Lord Rea, a former GP, has gone a step further, tabling an amendment calling for the bill to be dropped altogether, arguing it was never a manifesto commitment.
Lord Howe, however, told peers the proposed changes would "liberate the NHS" and improve patient care in England.
In a letter sent to all peers shortly before the debate began, he warned: "[The] potential for slippage in the timetable carries grave implications for the government's ability to achieve royal assent for the bill by the end of the session. The bill cannot be carried over from this session to the next.
"The House must have proper time to examine the bill but the proposal put forward by Lord Owen could result in delay, which could well prove fatal to it. This is not a risk that I believe this House should take."
Labour peers Lord Warner and Baroness Wall of New Barnet both opposed any attempt to slow up the passage of the bill.
Lord Warner, a former health minister, said the "grown-up thing to do" was to improve the bill "as quickly as possible", while Lady Wall, chairman of Barnet and Chase Farm NHS Trust, said staff and patients had urged her not to let the bill get "kicked into the long grass".
The Lib Dems have consistently argued that the bill be watered down, and their leader - and deputy prime minister - Nick Clegg has said the changes already made will make the health service "stronger and more sustainable".
However, Lib Dem peer and former GP Baroness Tonge called for her colleagues to back Lord Rea's amendment and throw the bill out altogether.
She said: "My party is taking part in what I and many of my old NHS colleagues believe is the ultimate destruction of the NHS, that has been and still is the envy of the world. We should be ashamed of this. I am."
The Lib Dems' Lords health spokeswoman, Baroness Williams, also told peers she still had concerns regarding the "ambiguous and unclear" role of the secretary of state under the reforms.
Lord Howe denied the legislation undermined the health secretary's ultimate accountability for the NHS but said he was willing to amend the bill to put the issue beyond doubt.
Labour's shadow health secretary, Andy Burnham, has written to Health Secretary Andrew Lansley offering to work with him to "constructively reform NHS commissioning" if he agreed to drop the bill.
But Mr Lansley, in reply, accused Mr Burnham of leaving an "appalling" legacy of debt, declining productivity and increasing bureaucracy in the NHS from his time in office.
"Given that you do not have a record on which to be proud, I do not believe you have the credibility to suggest the ways in which the NHS can move forward today," he wrote.