Lords debate sections on psychiatric care and public health amid increasing unhappiness over the bill among GPs and Lib Dems
The health and social care bill is returning to the House of Lords amid increasing unhappiness about the proposed reforms among GPs and Liberal Democrat activists.
Peers will debate amendments to the bill around public heath and psychiatric care on Wednesday – the controversial third part of the bill dealing with competition has now been moved to next Tuesday.
The health secretary, Andrew Lansley, is working with the Liberal Democrats on further amendments to the bill to provide the final reassurance Nick Clegg believes is needed to see off a damaging backlash by activists at the party's spring conference next week.
He told the BBC on Tuesday that the legislation would ensure "competition is a means to an end, not an end in itself".
Lansley's bill suffered another setback when a key group of GPs withdrew their support before the latest debates in the House of Lords.
The Tower Hamlets Clinical Commissioning Group wrote to David Cameron, urging him to ditch the legislation and echoing the concerns over its impact on services expressed by professional bodies including the British Medical Association and the Royal College of GPs.
The east London group is the first clinical commissioning group to go public with a call for the bill to be scrapped. Its chairman, Dr Sam Everington, was formerly an adviser to the health secretary. The group said the goal of improving services to patients through clinically led commissioning could be achieved without the extra bureaucracy the bill would create. The restructuring of the NHS being conducted by Lansley was getting in the way of GPs' work, they said.
They told Cameron he was wrong to claim repeatedly that GPs' willingness to participate in preparations for the new arrangements meant they supported the bill.
Lansley told the BBC: "What [Dr Everington] and his colleagues don't yet appreciate is that the only way in which they actually will have something which is sustained into the future and enables them to develop all the opportunities that they have is if we get rid of two tiers of bureaucracy in the process."
Asked why the GPs might not have taken his arguments on board, he said: "It's probably because the BMA and a lot of other organisations are constantly telling people things that are not in the legislation."
He said he did not worry that he might not be the right person to take the government's NHS reforms forward. "Do you know why I don't do that?" he added. "Because I do know a lot of people across the NHS and I visit them all the time, and I've done so for years, and I know absolutely where they are."