Conservative Prime Minister David Cameron was forced into a compromise with sections of the euro-sceptic wing of his own party and the opposition Labour Party, in order to avoid a defeat over his government’s entire legislation programme for the year ahead.

Last week the Tories outlined their agenda in the Queen’s Speech. But such are tensions within the Tory party over the question of the European Union, with a large section of the parliamentary party and an even wider section of the party’s base opposed to Cameron’s support for remaining in the EU, that they threatened not to support the Queen’s speech without an amendment.

Put forward by the right-wing former cabinet minister Peter Lilley, and signed by 25 Tory backbenchers, the amendment expressed regret that the government did not include a bill in the Queen’s Speech that would protect the National Health Service from the Transatlantic Trade and Investment Partnership currently being negotiated by the EU and the United States.

The amendment was supported by prominent figures of the Leave campaign Iain Duncan Smith, Liam Fox and Steve Baker. Co-authoring the amendment with Lilley was the Labour backbencher Paula Sherriff. It was also personally backed by Labour leader Jeremy Corbyn, who pledged his party’s support, the Scottish National Party and the sole Green Party MP, Caroline Lucas. By backing the amendment Labour, the SNP and Greens allowed Cameron’s opponents in the Leave campaign to pose as defenders of the NHS.

As Cameron only has a parliamentary majority of 17, the amendment, had it been selected for a parliamentary vote, would have the same impact as calling a vote of no confidence, threatening a government that only came to power a year ago. A vote on the Queen’ Speech programme was scheduled for Wednesday but prior to this the government’s representatives in the House of Commons and House of Lords accepted the amendment.

Tory euro-sceptics have previously used the occasion of the Queen’s Speech in order to further their cause. In 2013, 130 Tories backed an amendment to that year’s speech, regretting the absence of an EU referendum bill.

No government has failed to pass a Queen’s Speech since 1924, when the Labour Party successfully tabled a motion of no confidence in Stanley Baldwin’s Conservative government. Following this, Baldwin resigned as prime minister, with Ramsay MacDonald forming the first Labour government.

TTIP, along with the EU’s completed free trade agreement with Canada (CETA), are reactionary treaties. Under the pretext of dismantling “trade barriers”, they aim to clear aside all obstacles which stand in the way of the unbridled accumulation of profit—social and democratic rights, environmental standards and social services. Under its terms corporations can profit not only by buying and selling commodities, but also education, health and social infrastructure.

TTIP is set to include the Investor-to-State Dispute Settlement (ISDS) mechanism, protecting investors against unfair treatment or discrimination on grounds of nationality. This would allow governments to be sued by companies on the basis that their economic interests are being impeded. According to legal advice commissioned by the Unite trade union, from Michael Bowsher QC, “TTIP poses a real and serious risk to the NHS.”

Putting forward the amendment, Lilley struck a nationalist tone. “I support free trade,” he said. “But TTIP introduces special courts which are not necessary for free trade, will give American multinationals the right to sue our government (but not vice versa) and could put our NHS at risk.”

Lilley, a former deputy leader of the Tories is an arch Thatcherite. During his time as a cabinet minister in Margaret Thatcher’s hated government, Lilley was notorious as an avowed proponent of welfare budget cuts.

Accepting the amendment, a spokesman from Cameron’s office said, “We’ve said all along, there is no threat to the NHS from TTIP. So if this amendment is selected, we’ll accept it.”

Cameron’s pose as a defender of the NHS is as obscene as that of Lilley. Over the last six years the governments he has led have accelerated the break-up and privatisation of the NHS that was initiated by the previous Labour government. During the last parliament (2010-2015), the NHS, supposedly ring fenced from cuts, was forced to carry out £20 billion in “efficiency savings.” A similar scale of devastating savings is slated for the current parliament.

The Tories and their then coalition partners, the Liberal Democrats, passed the Health and Social Care Act 2012, the largest single piece of legislation aimed at privatising the NHS.

Health Secretary Jeremy Hunt is seeking to push through an inferior contract on Junior Doctors. This week, a government commissioned report from the Nuffield Health think-tank proposed that all the one-million-plus NHS workers be employed on contracts enforcing flexible work. Under such contracts, they could be asked to carry out any task normally assigned to another employee.

The right-wing forces comprising the Remain and Leave campaigns are seeking to exploit well-founded fears over the future of the NHS. Last month Vote Leave, the official campaign in favour of Britain leaving the EU, unveiled its first billboard poster. “Let’s give our NHS the £350 million the EU takes every week,” it declared.

The Tories in the Leave camp are allied with the xenophobic UK Independence Party, led by Nigel Farage. In 2012 Farage said, “We’re going to have to move to an insurance based system of health care” in the UK. So open was this attack on the principle of the taxpayer-funded NHS that even Cameron was able to declare in Parliament, “That is the Ukip policy, to privatise the NHS.”

This month, Aaron Banks—a millionaire who leads the Leave.EU group and backs UKIP—told the Cato Institute in Washington, “If it were up to me, I’d privatise the NHS.”

The episode demonstrates yet again that Corbyn will do nothing to seriously jeopardise a Tory government, hell bent on accelerating its austerity offensive against the working class. He even refuses to oppose those within his own party who are declared defenders of TTIP. These include the Blairite former Labour minister Rachel Reeves, who said, “Those who want Britain to leave the EU need to stop preying on British people’s love for the NHS by cynically pretending that TTIP poses a threat. It does not.”

With the Conservatives deeply split, Labour’s ability to deliver its nine million voters is considered essential for a victorious Remain vote. This has become even more essential, given the bitterness and rancour of the Tory faction fight and its nakedly reactionary character.