The government used its commons majority to overturn amendments to its National Health Service Reform and Health Care Professions Bill which had been passed in the lords. These would have established patients' councils - usually based on the areas covered by local authority scrutiny committees - to take over most of the functions of the former community health councils, and specify in law the responsibilities of NHS bodies for education, training and research.
Although the government accepted some lords amendments and introduced others of their own to reflect some thinking from the second chamber, the whips were out to defeat these proposed changes. The move to identify responsiblities for education, training and research was overturned by 321 votes to 193. Proposals for patients' council were defeated by 303 votes to 179.
They would involve a system were a body purported to speak on behalf of the public. 'That is fundamentally opposed to the whole system that we have tried to establish, which enables the public to speak for themselves', she added.
Liberal Democrat spokesman Evan Harris said the government's proposals for enhanced primary care trust patients forums would produce twice as many bodies as there would be patients councils based on overview and scrutiny committee areas.
Health minister John Hutton said the arguments in favour of the amendments on education and research were based on two assumptions. Firstly, that the existing legal framework to ensure that education, training and research is properly underpinned in the NHS was either inadequate or ineffective, and. secondly, that the NHS did not take those matters seriously enough.
The minister insisted that necessary statutory powers already existed to ensure a proper focus on education, teaching and research was maintained right across the service.
However, Simon Burns, Conservative MP for West Chelmsford, said problems of delivery was at the heart of disagreement with government. It was plain to many people, particularly those in training and research, that those disciplines were vulnerable and threatened in the NHS. Teaching and research resources were squeezed, and lecture theatres used for other purposes.
The government should listen to the advice of the lords, a more reflective and less political or partisan body than the commons.
The question for the government now is whether it will invoke the Parliament Acts if the lords insist on restoring their amendments when the Bill returns to their house.
Hansard 22 May 2002: Column 300-354