Another day and another policy to be saved. The great reforming agenda of the coalition’s ship keeps hitting the rocks and today it is desperately trying to avoid another policy running a ground while the light house shines brightly into David Cameron’s eyes.
This time it is the NHS. This one has been coming a long time, I have discussed the madness over the ideological nature of the so called reforms previously here. As time has gone on it was obvious that there were major problems with the NHS bill, yet Andrew Lansley has been carrying on regardless on a crusade with few followers except for private medical practices.
Anyone could have seen the rocks before they came to power but it has taken 11 months of power and 2 large scale U-turns in other areas to realise that the bill requires changing.
I have said before over the Forests and over EMA that U turns are sometimes necessary and essential for a listening government. I have indeed praised the Prime Minister for listening and not carrying on regardless.
However, there is an underlying theme to these U-turns that are most concerning and may well cause him trouble as time goes on by both wings of his critics.
Firstly, the right wingers like Fraser Nelson will snipe at his power base for being too weak and in his and others eyes on the right like Norman Tebbit, for not going far enough in destroying the welfare state and cuts in public services.
Secondly, there are those who feel that he is not listening and appears to be pushing through a program of reform that has neither a mandate or has been well thought out, and the U-turns he is performing rather than giving David Cameron credit is causing him more problems.
The underlying problem though in my mind is not that he is altering course after listening to concerns, but that flagship policies were so ill thought out and so badly explained that they even got to the stage that a U-turn should be made.
The Forests were a classic example that defy belief. It is also amazing that Caroline Spelman still has a job. Anyone looking at the public’s attitude to the Forests, concerns regarding access, how much money it would make and the details of the bill could see that this policy was never going to work. This was a pointless waste of time and energy by the government.
Now we have the reforms to the NHS. Reforms that will cost around £3 billion to enact; where there was little if any debate on before the general election and one that even the beneficiaries (the GP’s) are not keen on.
Andrew Lansley was shadow Health Secretary for around 7 years before he got into government, yet his ideas have no wide spread approval either from within the health professionals or with the public at large.
If this is not incompetence I do not know what is. His use of statistics to shore up his argument for change are shall we say less than based on fact as discussed here.
It beggars belief that a controversial policy; that has no electoral mandate; where the main reform was not even known before the 2010 election; (namely that of disbanding all PCT’s), and that will actually cost the public purse massive amount of money just to introduce it at a time when we cannot afford such luxuries, just smacks of idiocy.
It is reported that David Cameron is seeking to make “concessions”, to the Conservative and Lib Dem back benchers to head off an embarrassing rebellion.
There is talk within Tory circles that concessions will be made like:
- New clauses limiting the ability of private firms to “cherry pick” the most lucrative work
- Redefining the role of the regulator from the promotion of competition to a concentration on value for money
- Improved public accountability for the GP consortia who are expected to take control of a budget in excess of £60 billion
- To no longer make it compulsory that GP’s have to take over the budget, however, allowing other GP’s consortia to take over their budgets
The real problem however with this bill is that no one knows if it will work or not. The crucial question is whether patient care will IMPROVE with these changes or not.
Even with these concessions it does not stop GP’s from benefiting financially by referring patients to their own private clinics, and it also smacks in the face of localism by allowing other areas’ GP consortia take over GP funding.
It is a mixed up policy, based on ideology and not real outcomes that can be measured and improved over time and costing far too much money.
David Cameron is looking for wriggle room because Andrew Lansley is digging a massive hole for the coalition, due to his ideological intentions and the lack of clarity and detail in the planning of the NHS reforms.
This goes to the heart of Cameron’s government. He has been so hell bent in not repeated the often quoted failures of the Blair government, that he has lost site of what is good for the country and how to enact good government.
The government started off with far fewer government advisers, which he has now redressed; has allowed his ministers free reign to develop policies, only for him to have to take charge and re vamp or jettison policies like Forests, EMA, Education and school sports funding.
David Cameron may well be a competent person with a nose for political maneuverings but the team around him are neither competent or have a head for the common sense political decisions. This could ultimately be his downfall.
Andrew Lansley has been incompetent in developing his bill and poor at explaining it to an increasingly skeptical public. This NHS bill will be a fundamental battleground and could make or break the coalition.