Plenty of my Liberal Democrat colleagues – Gareth EppsDaisy BensonPrue Bray, for instance, – have come out against the NHS Bill. In fact, Prue sums up my own feelings quite succinctly:

At this point few people in the wider world understand what is actually in the bill, and virtually nobody trusts it. And it has lost the support of the health professionals. That´s why I personally think it would be better to ditch this bill and start again, difficult though that would be.

Prue was brave enough to be one of a stream of Liberal Democrat activists who stood up at Liberal Democrat Spring Conference in Gateshead just a few weeks ago to oppose the NHS Bill.

Those who regularly go to Liberal Democrat Conferences will know that there are always plenty of people standing outside the Conference venue asking voting reps to vote for this or that. But it’s not often that the people standing there are Liberal Democrat members handing out leaflets denouncing what to all intents and purposes is ‘the official party line’.

Of course, those of us at Conference already knew that by the time Prue, Gareth, Daisy and others took their respective stands (literally debating the motion, or figuratively voting to make the best of a raw deal) at Conference, the terms of the debate had been set as the ‘Shirley Williams Motion‘ had already won through the internal Party democratic process, beating a motion calling unequivocally for Liberal Democrats not to support the Bill.

But we can’t now go back in time to undo that which has already been done. Time is against us, and it’s not the first time this has been the case.

In May 2011 the toxic combination of public perception on tuition fees – yes, it was wrong to break the pledge, but having said that, the overall outcome of the fees changes was something which I wasn’t concerned about (read this straight-forward guide from non-partisan Martin Lewis), coupled with a high turnout of people wanting to vote against fairer votes meant the Liberal Democrats suffered the loss of many hard working local Councillors for no other reason than to give the Liberal Democrats a good kicking.

Now, with local elections approaching again, the Liberal Democrats are being seen to support a Bill which is unpopular with it’s own members along with the general public.

Few people actually understand this Bill, and the overwhelming majority of professional bodies are against it.

It looks to me that even after Liberal Democrats have fought for and won concessions, the NHS, rather than going through a process of gradual evolution, will in fact be subject to a ‘big bang’. This is not so unlike the deregulation of financial markets championed by Thatcher in the 1980s. And we know, now, where that ended up.

Don’t get me wrong. I’m not against change within the NHS. Change to reduce cost and to improve efficiency, change to improve health outcomes. An organisation that stagnates in the way it works is not long for this world, just ask Kodak. But I’ve still not been sold on how this Bill will achieve those aims. And I’ve listened to Andrew Lansley defend his Bill, but I’m not at all convinced.

Gareth Epps makes a fair point when he says that using Shirley Williams as a“human shield” was distasteful, and it was clear at Conference that Baroness Williams was uncomfortable with her name being used to squeeze the motion through. It seems to me though, that the timing of the Health and Social Care Bill could mean that a great many more “human shields” will pay the price for NHS reform.

If the NHS Bill is passed in the teeth of such vehement opposition, we could well be seeing a great number more Liberal Democrat Councillors being lost to us in May in large part because the public see us as failing in what I would call the Liberal Democrat fiduciary duty.

And for what?

Yes, we may well have won thousands of concessions in the Bill from our Conservative colleagues in Government, but if the overall effect now is that we cannot demonstrate how this will bring about improvement in health care, who cares about those concessions?

And with George Osbourne’s Budget getting closer, what’s in it that could possibly overshadow what many see as the dismantling of the NHS as we know it? We are being primed to expect the abolition of the 50p tax rate, a measure which will, first and foremost, benefit the top 1% of earners in the UK.

What happened to being fair? What happened to being in this together? Liberal Democrats have been talking about fairness, but on the huge headline issues we are not being seen to deliver fairness.

Yes, dropping the 50p tax rate is a Conservative policy. And yes, the NHS changes are Conservative through and through, but like a child who disappoints in it’s behaviour because it knows better, so to the Liberal Democrats are dissapointing the electorate because we do know better.

That’s not to say Liberal Democrats have had no successes. Pupil Premium, raising the income tax threshold, same sex marriages, the Green deal, and more come to mind. But my argument is not that Liberal Democrats are not winning individualbattles, we are, but it somehow feels like we are losing the war.

Apart from being wrong and unfair, the timing of the NHS Bill along with abolishing the 50p tax rate (if it indeed turns out to be so!) could not be worse, just as the timing of the Fairer Votes referendum could not have been more wrong (a lesson in impetuousness which the current Government in Scotland has learnt).

How much more ill-timed legislation can the Liberal Democrats sustain? 2015 is not so very long away, and whilst I’ve no doubt that the coalition Government will survive until then, my concern is about what’s going to happen in 2015.

Let’s not forget that whilst we pat ourselves on the back for getting a higher percentage of the overall vote in 2010, Liberal Democrats actually lost 5 seats in the House of Commons during the last election. That was after amazing performances from Nick Clegg during the televised debates. It’s difficult right now to see how we could re-create such favourable circumstances in 2015.

The NUS understandably turned against the Liberal Democrats, and threatened ‘decapitation‘ of Nick Clegg. That was to be expected. But when 240 doctors commit to running a campaign against Liberal Democrat MPs in marginal seats, one must pause to appreciate the irony that if these medical professionals follow through on their aims, it could either strengthen or offer an alternative to the duopoly of Labour or Conservative rule which Liberal Democrats have worked for years to overcome.

It’s a precarious position the Liberal Democrats are now in, at best.

Given that our timing as a Party is not the best. Given that we lost MPs when we should have been gaining them in 2010. Given that we are seen as supporting a Conservative assault on the NHS, and that tuition fees and the NHS Bill are likely to be key weapons against us in 2015, how can the Liberal Democrats use the remaining time of the coalition Government to build trust with the public and regain good faith with activists and members who will be taking the brunt of the punishment being meted out?

No. I don’t have the answers, but Liberal Democrats cannot afford to treat the question as a rhetorical one.

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