Amidst chants of ‘shame on you for turning blue’ outside the Sheffield City Hall venue this weekend, Nick Clegg addressed the LibDem Spring Conference. Throughout, he maintained that the party – which he has led since 2007 – will ‘never lose their soul’ and that, despite assuming the office of Deputy Prime Minister, he has not changed ‘one bit’. While Clegg attempted to reassert the individuality and independence of the LibDems in the build-up to May’s local elections, dubiously proclaiming the party to ‘own the freehold to the centre ground of British politics’ and thereby rendering any attack on the Conservatives redundant, the whole affair was dominated by one headline issue that could determine the future direction of the governing coalition: Tory-led reforms of the NHS.
Clegg warned his party at a rally on Friday to ‘get used’ to protesters now that they had become a party of government, defending his party’s record so far through such policies as increasing the income tax threshold. Indeed, Clegg pleaded with party members to ‘hold their nerve’, insisting that the LibDems are helping to build ‘a new economy from the rubble of the old’. However, Clegg was dealt a blow on Saturday when delegates voted overwhelmingly in favour of amending controversial proposals to overhaul the NHS, placing GPs in charge of 80% of health service budgets for commissioning services in England while introducing private sector competition into care provision.
The amendment declared many of the proposed reforms to have ‘never been Liberal Democrat policy’, having failed to feature in either the 2010 election manifesto or in the agreed coalition programme. Indeed, with the plans also failing to feature in the Conservative Party’s manifesto, the coalition agreement had pledged instead to end the very ‘large-scale top-down reorganisations’ that the legislation proposes – a factor which has angered party members and the wider public, neither of whom were consulted on the proposals prior to the general election. With the vote at the conference constituting the only view that the party as a whole has expressed on the issue, LibDem ministers have necessarily been granted a mandate to seek changes to Andrew Lansley’s tension-causing reforms; Clegg and his ministerial team must convey this message through seeking substantial changes to governmental health policy. However, while Clegg promised to take delegates’ concerns seriously, vowing to look ‘in detail’ at the proposals during a Q&A session, he refused to be bound by them. This could have serious implications not only for the party, but also for Clegg’s leadership.
Primarily, further questions will be raised regarding the nature of the coalition; the issue of health reform, when considered alongside ongoing themes such as Trident and electoral reform, represents a further crack in the bond that holds together two parties who, prior to the general election, seemed to be diametrically opposed (barring a desire to prevent Labour retaining power). Sadiq Khan, the Shadow Justice Minister, has remarked that ‘Nick Clegg is propping up a Tory-led government that is undermining our economy and destroying our communities’. A failure to respond to the expressed will of the party would seemingly confirm this interpretation of Britain’s coalition rule, doubtlessly prompting further accusations of Clegg becoming increasingly “blue blooded” and calling into question the continued workability of the Conservative-LibDem partnership. Equally, given the reductions in popular support, rifts within the party itself could prompt calls for Clegg to step aside as party leader, or even contribute to a potential split in the party. While such outcomes are not immediate threats, owing largely to the party’s ascendency to the position of co-governing party, disgruntlement and disaffection within party ranks is unsustainable if the LibDems are serious about maintaining this rank.
To his credit, Clegg, in his speech to the conference, vowed not to let the ‘profit motives drive a coach and horses through the NHS’, pledging to pursue reform but not privatisation. Baroness Williams rightly described the reorganisation as ‘stealth privatisation’: with private companies looking to ‘cherry pick’ profitable services rather than treat patients according to need, the NHS would be privatised via the back door. With most profitable sections of the health service likely to be the first to be tied up, the viability of what remains of the NHS will be somewhat compromised. Thus, reforms would not only damage the holistic nature of the health service and the efficiencies that this produces, but would place the very existence of the NHS itself at risk. Furthermore, by placing GPs in charge of commissioning services, there arises a potential conflict of interest: the incentive for rapid and effective treatment is arguably diminished under a system incorporating private competition, with unscrupulous GPs potentially being more concerned with protecting a budget than providing first class healthcare for patients.
Facing growing public and professional discontent – the BMA is scheduled to meet to discuss the reforms, while 38 Degrees collected in excess of 80,000 signatures against the proposed reforms over the weekend – Lansley signalled a willingness to make concessions. Speaking after the LibDem vote, he suggested that reforms were not set in stone, maintaining that ‘[o]ur proposals are always under review’. However, despite these overtures, Downing Street has ruled out making ‘significant’ changes to the proposals. With no agreement being discussed prior to the formation of the coalition, MPs are under no obligation to back Tory-led reforms – the passage of the proposals through parliament without substantial modifications and alterations being imposed is thus by no means guaranteed. However, Clegg’s inability to assert any meaningful influence in stimulating a government rethink on such a high profile issue that has little by way of mandate within his party could spell disaster for the LibDems: Clegg has been portrayed to be, at best, a weak leader who values power over principle; at worst, as having Conservative tendencies that are ideologically incompatible with the outlook of the party he leads.
Highlighting the discontent with the party, the LibDems, for the second time in as many weeks, lost ground in an electoral contest, falling from first place to third in a council by-election at Burnley Borough (the LibDems also took the Commons seat in 2010). Labour scored another landslide victory, with winning candidate Beatrice Foster gaining an 11.8% swing compared to last May’s polls. The BNP came second, though failied to repeat the performance of 2002 when they returned a councillor in the ward. If such trends continue into May’s local elections, as is widely expected, greater pressure will be placed on Clegg’s leadership and the feasibility of the coalition.
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