For politics watchers, Liberal Democrat Spring Conference is like a history show. Constitutional manoeuvring, votes on what to vote on, amendments which completely change the meaning if not the substance of motions: this is Labour in the early 1980s all over again.
Party activists will of course point out that this is democracy in action, something now conspicuous by its absence at either Conservative or Labour conferences. They would be right. But this is hardly a process designed for easy government.
Just when it appeared that the passage of the Health and Social Care Bill could not get any messier, the junior Coalition partners have voted to neither support nor oppose the Bill. To cap it all off, the Deputy Prime Minister, who signed the White Paper which led to the reforms and who has repeatedly made his parliamentary party vote for the legislation, declared that this was "not a Liberal Democrat Bill".
Neither supporting nor opposing the Bill, but then seeking to disown it, is unlikely to play well with the public. Nick Clegg, however, will be hoping that his comments will be enough to appease his own party, which finds itself deeply divided over many fundamental aspects of health policy (competition, the role of the centre, who should commission etc). If the Deputy Prime Minister’s new strategy is "to do the right thing," then perhaps he feels the right thing for his party is to do nothing at all.
The attempts to interpret what this all means for a bemused media have been frenetic. Opponents of the Bill have declared that the Liberal Democrats have refused to support the Bill gaining a Third Reading. Proponents have declared that it is Liberal Democrat policy not to oppose the reforms. Both are of course technically correct. In truth, all of this is likely to have little effect on the passage of the Bill, although it shortens the odds on the Coalition not going the full five years and must pose further questions about whether Nick Clegg will lead his party into the next election.
But what does it do to the Liberal Democrats in the meantime? The saga of NHS reform has laid bare the unhealed divisions between the social democrat and liberal wings of the Liberal Democrat party in a way which perhaps has surprised even the leading protagonists. The sheer diversity of opinion on health makes it difficult for the Liberal Democrats to develop a united position and then stick to it. In truth, the NHS was never a priority for the party in opposition – hence the gaping holes in the manifesto. That position, though, is clearly not sustainable in government.
Nick Clegg desperately needs to move the health debate on from the Bill to issues which both wings of his party can unite around. There are issues which he and Paul Burstow could make their own – social care, personalisation and local democratic involvement – yet the party has been curiously silent on these.
All three are difficult in their own way. On social care, the care charities may be warm towards the Dilnot proposals, but the public may be less so when the tax implications become apparent. Also, funding without reform will not work (and the last 18 months tell us how difficult reform can be). Personalisation is a passion of Paul Burstow but, in the current febrile environment, efforts to promote personalisation can sometimes be conflated with marketisation – a discussion no Liberal Democrat would relish. Democratic involvement is meat and drink to the Liberal Democrats and local health and wellbeing boards are their innovation. Yet, as Martha Burgess pointed out back in May, the arithmetic of the polls makes this less exciting. One activist lamented that there aren’t enough Liberal Democrat councillors on local health and wellbeing boards. That is because there are less Liberal Democrat councillors than before, and the polls suggest there could be fewer still in May.
My colleague Mark Pack has commented on his personal blog about the paucity of policy being developed by his party and this is certainly true in health. The issues outlined above are not easy, and they wouldn’t be even for a party that hadn’t had its confidence badly shaken by its first serious brush with health policy. Yet Nick Clegg desperately needs to move the debate on from the Bill and these issues offer an opportunity to do that, giving his party something to rally around. To achieve this he needs to take a position on issues outside the Bill. Almost any position will be better than none.