A record-breaking 172,475 people have signed Dr Kailash Chand’s e-petition to drop the NHS Reforms bill.

David Cameron promised once upon a time that any e-petition that got more than 100,000 signatures would get a debate in the House of Commons, but he evidently meant “any e-petition that Tories can support without going against the interests of our donors“.

At the Liberal Democrat conference today:

2.21pm: Nick Clegg has won his first battle of the conference. According to Channel 4’s Michael Crick on Twitter, Lib Dem activists have chosen to debate the Shirley Williams health motion tomorrow – the pro-leadership one – instead of the rebel motion calling for it to be withdrawn or defeated. 2.27pm: The Shirley Williams health motion got 309 votes. The rebel “drop the bill” one got 280 votes.

On Tuesday 13th March, the e-petition will have a House of Commons debate and the House of Lords will have a 3rd-reading debate on the Bill.

If the Bill becomes law, while it will not apply to the NHS in Scotland (or in Wales) Scots travelling in England will have to reckon with the possibility they may not get emergency treatment on the NHS. This will apply to anyone travelling outside their region. I get this from reading Allyson Pollock, David Price, and Peter Roderick’s recently published article in the BMJ, Health and Social Care Bill 2011: a legal basis for charging and providing fewer health services to people in England. I may be wrong, but that’s certainly what it looks like.

The new clinical commissioning groups (CCG) are not required to provide the following services to people who happen to be in their area:

Accident and emergency services and ambulance services

Services provided at walk-in centres

Facilities and services for testing for, and preventing the spread of, genitourinary infections and diseases and for treating and caring for persons with such infections or diseases

Medical inspection and treatment of pupils

Services relating to contraception

Health promotion services

Services in connection with drug and alcohol misuse

The regulations requiring local NHS services to provide these to anyone will be repealed, and the NHS Reform bill does not require CCGs to secure any of the above services except ambulance and emergency care for residents of the area [update] people in the area defined in their constitutions:

The bill therefore establishes a legal basis for CCGs to secure fewer government funded health services. The bill also transfers from the secretary of state to CCGs the power to determine what is “appropriate as part of the health service” for certain individuals. The services concerned are care of pregnant and breastfeeding women, care of young children, prevention of illness, care of people with illnesses, and aftercare of people who have been ill.

[Update: Clause 12 of the bill (link goes to the version amended by the Lords in committee), we find:

(1C) The power conferred by subsection (1B)(b) must be exercised so as to provide that, in relation to the provision of services or facilities for emergency care, a clinical commissioning group has responsibility for every person present in its area.

Note – present not resident, so travellers would be covered for emergency care at an A&E, but aftercare or services defined as non-emergency… not.]

If you live in Scotland and visit England – especially while you are pregnant, breastfeeding, traveling with a child, if you had a serious illness and need aftercare – if for any reason you are suddenly ill in London or the West Midlands, or you suddenly need aftercare because you were ill – you may have to pay.

For most of us, the only time we buy private health insurance is when we’re going on holiday, as part of the travel insurance policy. When I’m travelling outside the UK in Europe, I carry my European Health Insurance Card (EHIC) – it’s free, and it means that effectively I’m carrying the NHS with me.

But you can’t use that card inside your own country. You can’t use travel insurance inside the UK.

We could only carry the unreformed NHS with us from Scotland if we voted for independence in autumn 2014, and travel to England became travel to a foreign country.

The Scottish National Party is holding their conference this weekend in Glasgow. I did not expect to hear any new arguments convincing me towards independence.

I certainly didn’t expect the vote that could decide me to vote Yes in Autumn 2014 to be a 29-vote majority at the Liberal Democrats conference in Newcastle Gateshead. And I find it immensely irritating, as a non-supporter of the SNP, a more-or-less devolution supporter and an admittedly-unenthusiastic unionist, that it’s the Westminster parties that are, one by one, convincing me to vote for independence.