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Editor's blog Wednesday 16 March 2011: What shall we do with the Andrew Lansley?

Following Prime Ministers' Questions today, PM David Cameron may have a merry (if non-Bullingdon) drinking song in his mind heading into the rest of his day. To paraphrase the old sea shanty, the PM may ask himself, 'What Shall We Do With The Andrew Lansley?'

Yesterday, the Forces Of Keeping Your Head Screwed On prevailed at the BMA, with their votes to avoid outright opposition to the whole Health Bill and swerve a vote of confidence on Mr Lansley. If a thing is worth saying, it is worth saying twice: well done, the BMA.

Now, Prime Minister's Questions can get people who are interested in Westminster party politics very exercised. It is unwise to read too much into them (although it can give a 'winning' party a sense of momentum, both internally and in the Whitehall Village People Media).

Nonetheless, it was interesting today. In the aftermath of the BMA votes and the weekend's fascinating events with the Lib Dems, opposition leader Ed Miliband (who is not a natural PMQs performer) used all his questions on the subject of NHS reforms; and PM David Cameron (who is a PMQs natural) blustered, evaded, struggled - and totally failed to answer a single question.

And the Chamber got it.

Cameron was reduced to selective quoting from shadow health secretary John Healey's Kings Fund speech, and from an adviser to the former Labour Government in his defence. The misleading statistics on heart attack deaths, as famously debunked by the iridescent Professor John Appleby of the Kings Fund in the BMJ, also made another outing.

BBC footage of most of it is online here. And the Hansard of the session is now online.

The sage Michael White of The Guardian pointed out that Lib Dem leader Nick Clegg nodded his way through Cameron's answers to the NHS policy questions he would rather have been asked.

Lucrative European competition - not just the Champions' League
The fun did not stop there: on the BBC2 Daily Politics programme, host Andrew Neil asked Culture Secretary Jeremy 'Pronounce With Care' Hunt "why is a Eurosceptic government like yours bringing the NHS under EU competition law?".

An uncomfortable Mr Hunt replied, "we'll have to ask Andrew Lansley about that". Cabinet understanding of the NHS reforms is not, perhaps, all it might be ...

Meanwhile, Health Minister Simon Burns told the Health Bill committee yesterday that "As NHS providers develop and begin to compete actively with other NHS providers and with private and voluntary providers, UK and EU competition laws will increasingly become applicable. The safeguards offered by those laws will therefore apply equally to all providers. In the health care sector, 90% of health care provision has been delivered by public providers fulfilling a largely social function. Organisations fulfilling a purely social function are not for profit and are not considered to fall within the definition of undertakings, so they are not subject to EU competition rules. Markets have been developing only in certain limited sectors over the past decade, as, for example, in elective care. However, in a future where the majority of providers are likely to be classed as undertakings for the purposes of EU competition law, that law and the protections it offers against anti-competitive behaviour will apply".

This is unambiguous. The Bill creates the future in which EU competition law will apply more in the NHS.

Let's have a heated debate!
At 4.30 pm today, Labour have secured an Opposition Day debate for their motion on the NHS reforms, which you can watch here.

The Guardian's political editor Patrick Wintour reports that four Tory MPs -  Dr Sarah Wollaston, Charles Walker, Douglas Carswell and Anne Main - have tabled an amendment to the Labour motion, and another amendment has been tabled by a group of Lib Dem MPs, including Greg Mulholland, David Ward, Ian Swales, John Leech and John Pugh (of the Bill committee).

The hope might be for these amendments to sop up Liberal Democrat and Conservative discontent.

The signal that these three votes send will determine Andrew Lansley's political future.

Hooray, and up she rises.