By Edward Davie
Exclusive: A leading Liberal Democrat has claimed ministers will be unable to pass the health bill without making dramatic changes, such as making consortia co-terminous with local authorities and putting local councillors on them.
The claim - from one of the major opponents within the Lib Dems to the health reforms - comes after the deputy prime minister Nick Clegg was reported to have pledged to oppose Monitor having a duty to promote competition in the health service.
Dr Evan Harris, a former Lib Dem MP and a vice-chair on the Lib Dem Federal Policy Committee, said that this was only the beginning of Liberal Democrat demands, and that consortia would have strict governance requirements and have places for elected councillors.
Referring to the Tory health minister Simon Burns's characterisation of Mr Clegg's statement as being 'part of the listening exercise', Dr Harris said all of the Lib Dems Spring conference motion on amending the NHS bill have to be adopted in order for it to gain the party's backing in Parliament.
Speaking exclusively to Pulse, he said: 'Simon Burns is wrong. Nick Clegg's remarks are not part of the process of gathering ideas because without Nick Clegg and his troops there isn't a majority for this at third reading regardless of what the listening exercise says.'
'Nick Clegg is not saying "this is my contribution, do weigh it up and consider it," he is saying that for this bill to make progress this has to change. This isn't a message for Steve Field, an idea to be gathered in. It is a requirement for the support of Lib Dems for this bill that this amendment is made.'
Asked if there would be other changes demanded Dr Harris said: 'Yes, there will be other changes, other parts of the bill that will be required to change, everything in the Lib Dems March conference motion will have to be acted upon.'
These include tough accountability and governance requirements for GP commissioning bodies including demands that 'membership of local commissioning bodies to include a substantial proportion of elected councillors'.
Local commissioning bodies would also be required to be co-terminous with local authorities which commission social services.
Mr Clegg addressed Lib Dem MPs and peers on Tuesday night and said that Monitor should have a duty to push NHS collaboration rather than competition.
The BBC has obtained a policy document – signed by Mr Clegg – that states that Monitor should not be established as an 'economic regulator' and should instead promote and protect the interests of the patient.
Mr Clegg is quoted as saying to parliamentary colleagues: 'There must be no change in the way competition law operates in our NHS. No to establishing Monitor as an economic regulator as if healthcare was just like electricity or the telephone and no to giving anyone in the NHS a duty to promote competition above all else.'
Conservative health minister Simon Burns told BBC Radio 4's Today programme that Clegg's remarks were 'part of the process of gathering ideas to see how we can strengthen the bill', during the current listening exercise.
Story updated at 18:25Dr Evan Harris