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The times we are working in now need a great deal of accelerated change and there must be no negotiating that down. So my mission statement for this part of my consultancy career is to be clear that there needs to be and will be a lot of change from the work that I do with individuals and organisations and if organisations don’t want that, then it is probably best to go somewhere else.

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The winding future path for the Health and Social Care Bill

Filed Under (Reform of the NHS) by Paul on 27-01-2011

The Bill was published last Wednesday in a flurry of front and opinion page interest. Suddenly we were all working in an area that mattered to the politics of the country. . People had heard of the reforms that we all know would have an impact on our world and were discussing it and what it might mean. As I said last week the Government were struggling to move the narrative that the media had latched on to – unnecessary, risky, a bit odd – off of centre stage and replace it with their own– essential, revolutionary, GPs are a safe pair of hands.

Now this week it’s all gone quiet out here but within Parliament there is ferment of activity. Because , whilst it looks on a day to day basis as if Parliament is about the disagreement of political parties, it is mainly about the passage of many important laws. (And as we shall see these are passed through the process of the disagreement of political parties!)

The next public activity will be the second reading debate on January 31st. Depending on the pressure of business a bill of this size could get a two day debate because it is to be hoped that quite a number of MPs will have some things to say.

Whilst it may be asking a bit much for readers to read the Bill, for those that are interested it is really worth looking at the Explanatory Memorandum. This is an explanation of the relationship between what we see as policy and the legislation to make it happen.

Behind the scenes the Government and Opposition will be using this week to prepare for the long Committee stage. After it is passed at its second reading (Governments publish bills and they always get passed at second reading – as the last stage of their pristine nature) the Bill will enter the committee stage. The Committee will be a much smaller group of MPs selected on the same voting patterns as the whole House (so with a coalition majority) who will go through the Bill line by line for two full days a week  for months, the opposition laying amendments to the Bill that will draw a particular clause in a different direction. Over the course of the committee stage there will be thousands of amendments laid.

The Government, since the publication of the White Paper, have had a team of civil servants turning the intent of the White Paper into a Bill. They are very good at this weird translation. The Bill is a very odd piece of literature because it appears to be undoing more things than it is doing. To bring in a new law lots of old laws have to be repealed and then hundreds of bits of other old laws that related to the NHS have to be repealed.

Legislation is a major part of the Government’s business and it is vital that Ministers have a dedicated bunch of people who can provide arguments for how each bit of the Bill fits in with the whole policy.

The opposition does not have such a team of people, but they do have two important resources. When the Bill goes into committee it will become owned by that “Committee  of the House” and by a committee clerk and staff. They are the world experts not on the policy but on the relationship between policy, law and this particular clause. Since they work for the Houses of Parliament, they also work for the Opposition.

Their second resource is the lobbying groups. The BMA, the Confed, and others will have people in their organisation who have been through many Bills. They will know, as the Government civil servants know, the relationship between this or that policy issue and a set of clauses in the Bill. Last Thursday and Friday there will have been people poring over the Bill from all of these organisations seeing how their concerns could be framed as amendments. The BMA will have found the parts that might lessen the effect of competition on their members and will have framed amendments on that.

They then meet regularly with the Bill team of the opposition and try and get them interested in their amendments. So there is an army of different organisations available to work with the opposition, if they so choose, to unpick the detail of the Bill.

The debate in Committee matters. Not because the Government loses votes. It doesn’t lose votes in Committee because the MPs the Government put on it are loyal to the Government and the Bill. But if the opposition win debate after debate and if these debates are picked up – not by the national media but by the trade press – this has an impact on the MPs on the Government Benches and their belief in what this Bill is about.

Winning lots of votes and losing the argument over and over again in the end creates a problem for any Government as the Bill has to come back to the whole House for its 3rd reading and Report Stage before going through the whole process in the Lords.

MPs on the committee stage are volunteers (though there will of course have been some arm twisting since they lose a lot of their life for a couple of months) and have to have spoken at the debate on the second reading. So Government and Opposition will be searching for people who would be prepared to take part in this tough activity for some time and signing them up.

Governments with majorities don’t publish Bills that don’t become Acts. This Bill will become an Act. But whether what comes out of this process is the same as what went in will depend not just on the majority in the votes but the capacity of the Government to link its overall rationale for this Bill to the specifics of each of its clauses.

The Poll Tax was passed by both Houses of Parliament. In fact the problem for the Government is that it was passed. They would have had a much smaller problem if it had been defeated.

I will post about this as the Committee is formed and starts its work.

Comments:

One Response to “The winding future path for the Health and Social Care Bill”


  1. Many thanks for taking the effort to explain this Mr Corrigan – it all becomes clear(er) now.

    Amongst all the mass of reading that I have prioritised this bill was placed on the ‘back burner’ pile – ready to flare up at some inopportune moment.

    So thanks for the pointer re the Explanatory Memorandum. Hopefully this first nibble will give me the appetite to delve further.

    KP

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