Lib Dem peer Baroness Shirley Williams has hotly contested Health Secretary Andrew Lansley's claim that none of the almost 2,000 amendments made to his controversial Health Bill changed the legislation's 'fundamental principles' at all.
Bns Williams, who was influential in securing a number of amendments to the legislation – said there is "no doubt it is a different bill" than the one originally published in June 2010.
In fact, she claimed a third of the bill was written subsequent to the white paper Equity and Excellence: Liberating the NHS being released.
"It is understandable he would say something like that as a Minister that has been bashed about a lot, but I don't think he can quite get away with [that statement]," she said.
"I absolutely do not agree the amendments didn't fundamentally change the direction of the bill."
Bns Williams pointed to a number of amendments to support her case. They include the throwing out of the Competition Commission; the reintroduction of a 5% private patient limit for Foundation Trusts; the continuation of the Secretary of State's role to be held accountable for the provision of NHS services and the creation of training and research legislation.
In an exclusive interview with GP Business, Lansley accused protestors of not reading the bill's white paper – published in 2010 – claiming a lack of understanding as the root cause of the bill's troubled passage through parliament.
"I think there was a big issue about the lack of engagement at a practical level in the service in the first six months," he said.
"What became obvious in February [last year] was that, firstly, lots of people had not really read any of this and, secondly, that even if they had read it they had not really understood it or engaged with it."
Conceding the government were not ready to reassure frontline clinicans with practical concerns, Lansley also expressed regret that the unprecedented move to pause the legislation and instruct a 'listening exercise' should have happened "three or four months earlier".
This lack of engagement with those responsible for making the changes in the health service led to the flurry of amendments conceded by the government in the Lords.
However, such amendments may not have been as significant as was first thought.
"Although we made further amendments [to the bill] in the Lords, in truth, a lot of those amendments were practical things in order to give further reassurance," said Lansley.
"They did not really fundamentally change the principles [of the bill] at all."
President of the National Association of Primary Care and DH advisor for clinical commissioning, Dr James Kingsland said the legislation's direction is often misunderstood thanks to the number of amendments made during its time in parliament.
"Lansley message that the policy's fundamental principles remain the same following the changes is an important one," he said.
"Many believe that the high number of amendments meant the bill was flawed but most of the changes made were minor technical issues."
Dr Laurence Buckman, Chair of the British Medical Association's GP Committee, said that far from the amendments delivering reassurance, they may have actually made the legislation worse.
"The majority of the health profession is aware the bill's fundamental principles look pretty similar to its original draft – it is not a remote surprise," he said.
"Furthermore, the amendments made to the bill have certainly not offered the profession any reassurance and in fact some of the reform's implementation plans have been made less attractive by the changes made to the legislation."
Don't forget to read Health Secretary Andrew Lansley's full interview featuring in the Spring edition of GP Business, in which he sets out his priorities for CCGs and the wider NHS during this tricky transition year.