David Maddox: The NHS reforms are making Lansley’s life a misery, but the Health Secretary may yet have the last laugh

Published on Tuesday 21 February 2012 02:46

A near mugging by an angry pensioner, protesting against NHS reform yesterday outside Downing Street, pretty much sums up the woes of the Conservative Health Secretary Andrew Lansley.

His confrontation with June Hautot, 75, came not long after a Downing Street adviser privately suggested the Health Secretary should be taken away and shot for messing up so badly.

While Mr Lansley’s task affects England only, with health being devolved, his increasing difficulties with reforming the NHS still affects those living in devolved areas in the way it is now destabilising the Tory/Lib Dem coalition government.

The problem that Mr Lansley faces is that, despite having had six years in the health brief in opposition to prepare for this job, both he and David Cameron promised “no more top down reorganisations of the NHS”.

But that great promoter of “top down reorganisations”, Tony Blair, when he was still prime minister, used to rail against the “forces of conservatism”, by which he did not only mean the Conservative Party, but those opposed to change because of vested interests.

Those involved in the heart of an organisation are, on the Blair view, usually the most reluctant to accept change. This means that reorganisations by necessity have to be top down. And this is particularly true of the NHS which, in the British Medical Association, has the most effective trade union in the UK. No other body could have won a massive pay rise at the same time as abandoning its commitment to provide out-of-hours GP visits to agree to meet targets which were already being met, as happened under the last Labour government.

Meanwhile, the Lib Dems are not exactly rushing forward to support the reforms. Their objection is that it brings private sector involvement and more competition into the NHS, something that, now it is in opposition, Labour has rediscovered its dislike for too. Yesterday Mr Cameron insisted that the government will stick with the reforms, despite opposition from Conservative peers. It is a policy that could yet bring the coalition edifice crashing down.

In contrast to all this, SNP Scottish health secretary Nicola Sturgeon looks like a heroine of the NHS by resolutely doing nothing to change it in Scotland.

Yet things are not always what they seem and time can change perspectives. Ms Hautot, who made the fuss outside Downing street, is not a random granny but a seasoned hard left activist who once shared a cell with Arthur Scargill.

And there are concerns that the lack of change in Scotland, perhaps driven by a need not to marginalise interest groups before an independence referendum, could see Scotland fall behind England in service provision.

Mr Lansley has almost no friends in his endeavours, either on his own side or in the wider public, but if he succeeds against increasingly stiff odds then he might yet be judged kindly if England pulls ahead from other parts of the UK that are stuck with their status quo.

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samcoldstream

Tuesday, February 21, 2012 at 08:12 PM

The Tories have still failed to grasp that the National Health Service is an iconic totem created in the post-War period with the consensus of all the political parties. It is everything that is good about the United Kingdom, yet, the Tories seek to "introduce competition"(code for privatisation)and dismantle it. David Cameron should be building on the foundations of the NHS and not trying to pull it down. However, IF the English Tories take this route for the NHS then this United Kingdom will undoubtedly develop into a Federal or Con-Federal State, the evidence of which is all around us.

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Faceless_bureaucrat

Tuesday, February 21, 2012 at 04:52 PM

Time to privatise this ugly monument to socialist extravagance. The inefficiencies in that system are mind bending and all politicians have a duty to get the best for the taxpayer.

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Marga

Tuesday, February 21, 2012 at 02:40 PM

".. there are concerns that the lack of change in Scotland, perhaps driven by a need not to marginalise interest groups before an independence referendum, could see Scotland fall behind England in service provision." Whose concerns? What interest groups? Is this journalism?

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Alicia Murray

Tuesday, February 21, 2012 at 12:38 PM

This unionist didn't read the recent report by Nottingham university praising Scotland's NHS. This is just another unionist on the make - surprised that Rennie hadn't 'seized' on this piece of bad reporting to criticise the Best Health Minister we have ever had in Scotland and certainly the best one in Britain at present.

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Jimson

Tuesday, February 21, 2012 at 11:43 AM

WTF has the English branch of the NHS have to do with Scotland?

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Family guy

Tuesday, February 21, 2012 at 07:50 AM

Why are you reporting on an devolved and English problem relating to the NHS Maaadddoxxxx? Because the Scottish NHS is superior?

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