Coalition 'united' on NHS reforms

Changes to NHS reforms backed publicly by Nick Clegg in a bid to see off a Liberal Democrat grassroots revolt were drawn up with the help of Tory ministers, Andrew Lansley has told MPs.

The Health Secretary dismissed Labour claims that a letter issued by the Deputy Prime Minister and a leading critic of the legislation betrayed a Government in "disarray".

Responding to an urgent question in the Commons over the controversial Health and Social Care Bill, he repeatedly insisted that the coalition was entirely united.

Mr Lansley conceded that the amendments, set to be accepted tomorrow as the reform package continues its stormy passage through the House of Lords, were "significant".

That appeared to be at odds with statements by Downing Street on Monday, which had played down the impact of the changes backed by Mr Clegg. But he insisted that they did not alter the fundamental nature of the reforms.

Nothing in the legislation as it existed would allow a US-style "market free for all" in healthcare, he said, but "further reassurance" could be given to opponents. Competition elements in the legislation remain the most controversial with Lib Dems.

Granted a chance to grill Mr Lansley over the letter to Lib Dem peers and MPs - signed by Mr Clegg and Baroness Williams - shadow health secretary Andy Burnham said either the Government was in disarray or the letter had been carefully choreographed by the coalition to save Mr Clegg embarrassment.

Party activists are gearing up to take on the Lib Dem leadership over the shake-up at the party's spring conference - a year after a previous revolt there forced a "pause" in the Bill. Both governing parties were "putting their political pride ahead of the best interests of the NHS", he suggested, questioning who was in charge of the policy.

Mr Lansley told him: "The point of the letter was to reflect the debates we've been having. We, and I do mean all of us on these benches, are using the debates in the Lords further to reassure all those who care about the NHS.

"The Deputy Prime Minister and Baroness Shirley Williams were explaining to their Liberal Democrat colleagues some of the amendments we have been working together on in order to make sure there is further reassurance."