Charles West has been a District Councillor, Parliamentary Candidate and Chair of local parties in Shropshire - this article was previously submitted to Lib Dem Voice who refused to publish it. Fellow Liberal Democrats, our policy-making processes are broken. We are not as democratic as we would like to believe. I have long been frustrated by the fact that we lack a coherent overall policy for health and the NHS. I now know at least some of the reasons for that failure. It was certainly not party policy to break up the NHS and replace it with a National Health Scheme.[i] The first hurdle is to get Federal Policy Committee (FPC) to decide that we need a policy working group. As an area that accounts for 18% of public expenditure and regularly comes among the top areas of public concern you might think that health is quite important. But no, alas, FPC decided to have a Public Services Working Group that would look at health, education, transport and other locally delivered services. As someone with a life-time’s experience of the NHS both locally and nationally in General Practice, Management and Health Informatics, I have something to offer on the subject. As a councillor, parliamentary candidate and Local Party Chair I can also consider the political context. Despite not being on the original list produced by the Party leadership, I was appointed to the working group. The problems of our wide brief were compounded by a very tight time-scale: we had in effect five months to produce a consultation document. Had we been set up to fail? There are twenty-one members of the working group. Apart from the chair, I am the only member to have attended every meeting. Typically we have between six and twelve members attending. We are sometimes outnumbered by Special Advisers and policy analysts seconded from Price Waterhouse Coopers. The chair of our group, FPC member Jeremy Hargreaves, decides on the agenda and the evidence givers. During the meeting I find that he is quicker to give his own opinion than to listen to those of others. He writes and approves the notes of meetings himself, which are erroneously referred to as minutes. And he has written the consultation paper. He has flagged up issues as important and persisted with them despite disagreement from members of the group and contrary evidence from witnesses. I have raised with him directly my concerns that this approach is not best practice, to no avail. The remit of our working group included a requirement to “review the current legislation governing the provision of these services, including recent reforms to the NHS, and consider what changes to recommend.” To focus our discussions I wrote a draft paper which I circulated in early October. Four meetings came and went while our chair prevaricated. Interestingly, other papers from members have been discussed within 24 hours of circulation. Finally, several members of the group supported me in my insistence that it should be discussed. At the last minute our chair arranged that Norman Lamb should come to the same meeting and present a different paper. When the notes of that meeting were circulated they contained no reference to my paper or any of its recommendations. And so it is, fellow Liberal Democrats that you will be offered a consultation document at York that totally fails to address the most important issues facing the NHS and that neither reviews the Health and Social Care Act of 2012 nor recommends any changes. It does not even invite you to say whether you think that we should review these things. Why is that? Some people do not want to rock the boat. They do not want to change anything. There are even some who think that it would be embarrassing if we came up with policies now that seemed out of line with legislation that our parliamentarians helped to pass while in coalition. If that is the case we might as well all join the Conservative Party and have done with it.

[i] These were policies advocated by Nick Clegg and David Laws in 2005 and 2004 respectively.
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