Health set to be the big issue for Liberal Democrats at spring conference

The debate on the future of the NHS is shaping up to be the defining event at the Liberal Democrat conference this weekend in Sheffield.

There are other significant items on the agenda, but their outcome is almost certain – Nick Clegg will give a speech that gets a standing ovation, the strategy debate will see plenty of people talk about the need for the party to be independent and no support for pre-election deals, and so on. But the outcome of the health debate is far less certain.

For those more familiar with the way the Labour or Conservative parties are run, it is easy to underestimate the role that conference votes play in Liberal Democrat circles. What conference votes for is not guaranteed to be followed to the last dot and comma by the party’s senior figures, but it is an extremely weighty consideration. Moreover, a hostile verdict on the NHS White Paper, and a defeat for the party leadership in a debate where the final speech will go to Liberal Democrat health minister Paul Burstow, would trigger a raft of negative media coverage.

In the run-up to conference, critical noises have been made by grassroots favourites such as Liberal Democrat peer Shirley Williams and former MP Evan Harris. However, behind the scenes there is more agreement within the party than may appear, with government movement – such as more firmly speaking about having competition on the basis of quality rather than price – being both welcomed by Liberal Democrats outside government and having been pushed for by Liberal Democrats within government.

Williams, Harris and other like-minded colleagues very much have an eye on how they can use party conference to help strengthen the hand of Liberal Democrat negotiators within government.

There is also common ground on wanting to see a bigger role for local government, something the NHS motion stresses with its reference to the public health powers and responsibilities being passed to local government.

There are some points on which agreement is unlikely to be found, however, such as whether there should be a level playing field between state and private providers of services to the NHS or whether state providers should be the default, preferred option. On that, critics of the health white paper are likely to take the opportunity in Sheffield to criticise the plans, regardless of the fact that those criticisms will leave Health Secretary Andrew Lansley unmoved (and indeed regardless of the fact that the Liberal Democrat general election manifesto called for a level playing field).

But on other issues, expect them to be willing to moderate their demands in the hope that these will become reasonable negotiating aims for Liberal Democrats in government.

And in that they will be encouraged both by Norman Lamb MP’s appearance on last Sunday’s The Westminster Hour, where he went beyond the usual pleasantries about listening to critics and promised to take concerns back to government after the weekend debate, and by Paul Burstow’s pledge to listen to what Liberal Democrats have to say.