Yesterday parliament voted against a motion brought forward by the Labour party to express regret that the Queen’s Speech didn’t include a pledge to repeal the 2012 Health and Social Care Act.
All Liberal Democrat MPs abstained from the vote, and a viral tweet subsequently claimed that “19 Liberal Democrat MPs refused to support a motion to stop privatisation of the NHS”
The motion would not have stopped the “privatisation of the NHS”. To describe the motion and the Liberal Democrats decision not to support it as such is misleading and excludes important context.
The tweet was deleted after publication of this article.
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What is the Queen’s speech and what role does parliament play?
The Queen’s Speech is written for the Queen by the government. It lists the legislation which the government plans to introduce to parliament over the following session. After the speech, parliament debates its contents and then votes on issuing a ‘humble address’. This address essentially thanks the Queen for her speech.
To influence the government’s policy agenda MPs can do a few things. They can vote against delivering the humble address, which is essentially a symbolic vote of no confidence in the government.
They can also place amendments on the address, to try and change the government’s policy agenda. For example, in 2017 the government announced funding for Northern Irish women to have abortions in England, after an amendment from Labour MP Stella Creasy on that issue looked likely to pass.
Yesterday the Labour party brought forward a motion that would have added onto the address that parliament:
“respectfully regrets that the Gracious Speech does not repeal the Health and Social Care Act 2012 to restore a publicly provided and administered National Health Service and protect it from future trade agreements that would allow private companies competing for services who put profit before public health and that could restrict policy decisions taken in the public interest.”
The vote failed with 282 MPs voting for, and 310 voting against. All 19 Liberal Democrat MPs abstained.
What would this amendment have done?
The most important thing to note is that had the motion passed, the government would not have been required to scrap the 2012 Health and Social Care Act, nor end privatisation in the NHS.
The wording expressed regret the speech did not “repeal the Health and Social Care Act 2012 to restore a publicly provided and administered National Health Service”.
This would have placed political pressure on the government and indicated a parliamentary majority for that course of action, but would not have guaranteed any action.
So to suggest that “19 Lib Dem MPs refused to support a motion to stop privatisation of the NHS” exaggerates the motion by implying it would definitely have stopped privatisation of the NHS if it had a majority.
What is the 2012 Health and Social Care Act?
The wording of Labour’s motion implies that repealing the 2012 Health and Social Care Act would “restore a publicly provided and administered National Health Service”.
But it’s not the case that there was no privatisation in the NHS in England before the 2012 Act. For example, private providers have been offering services to NHS patients since 2006, and a Cooperation and Competition Panel was established in 2009.
That said, the 2012 Act did contain provisions to increase the role of private providers. The independent health charity the King’s Fund writes that the Act “did not begin the involvement of private sector providers in the provision of NHS services... However, the 2012 Act did extend a market-based approach to the NHS, emphasising a diverse provider market, competition and patient choice as ways of improving health care… [and] clarified the role of the competition authorities in relation to health”.
It's also important to remember that the 2012 Act made other changes to the NHS too, for example making GPs responsible for buying and providing healthcare for their local areas. Labour’s motion proposed repealing the entirety of the Act.
Former Liberal Democrat leader Tim Farron said later in response to the question of why he did not vote for the motion: “The amendment talked of stopping privatisation- and if that was all it said, I’d have voted for it... but it also entailed a massive, pointless restructuring of the NHS, which would be extremely daft.”