“Profound ambiguities” still remain concerning the responsibilities of the secretary of state for health and the role of competition, despite amendments to the proposed Health and Social Care Bill, the Liberal Democrat peer Shirley Williams warned last week at the annual meeting of the NHS Confederation.

And the fact that the parliamentary process allowed for only five days to consider these “huge and far reaching amends” was, she said, a matter of “very great concern.”

Speaking as part of a panel discussion on how the NHS would navigate the healthcare reforms, Baroness Williams welcomed the greater levels of openness, transparency, and public accountability that would now be written into the forthcoming legislation, prompted by the NHS listening exercise.

But serious issues remained, she said. “There are profound ambiguities . . . …