Whip’s Notebook: Top down NHS reorganisations, Hulk Hogan and Oliver Letwin

by Jon Ashworth

Last week the leader of the House of Commons and lord privy seal Sir George Young (who by the way reads my posts for Labour Uncut or at least his special advisers do and then lets him know if I say anything interesting) announced the likely date for the Queens Speech.

Get your diaries out because the next Gracious Address is set to be May 9th. It didn’t come as much of a surprise to Labour MPs as Politics Home’s brilliant Paul Waugh revealed weeks ago. But MPs are always the last to hear these things anyway.

It means we will have had one of the longest parliamentary sessions on record even though we’ve hardly been scrutinising any legislation at all in the Commons in recent months. Instead we’ve been spending our time on innumerable backbench business debates with countless one line whips. All important stuff of course but rather odd when you consider we are elected to be legislators and we’ve not been doing much actual legislating.

Take the controversial Health and Social Care Bill. So despite it being one of the biggest issues in my postbag (actually inbox, nearly everything I get is by email but us MPs like to say “postbag”) and I suspect colleagues’ postbags (inbox) too, MPs have only had the opportunity to debate this monstrous bill in recent weeks because Andy Burnham tabled an opposition motion on the NHS Risk Register and asked what’s known as an urgent question on Nick Clegg’s health amendments as well last week.

So effectively Andrew Lansley in recent weeks has only come to the Commons to defend his policies because Labour has forced him to. Last month at health questions, genuine Lib Dem rebel Andrew George had a question on the order paper asking the Secretary of State whether he would withdraw the Health and Social Care Bill. Did Mr Lansley step up to answer it? No his loyal deputy Simon Burns was sent into the breach instead. “Frit” was the inevitable heckle from the more boisterous Labour MPs.

But the poor downtrodden health secretary has had a torrid time of late with a run of blue on blue briefing against him regularly in the papers. We read he can’t communicate, we read that No 10 spin doctors want him to meet a grizzly end, that he refuses to read out the speeches they write for him, that he will be put out to pasture once the bill is pushed through. Tory cabinet ministers let blogs know that they oppose the bill, that’s it’s a car crash and that it could be the new poll tax. What an utter shambles.

Then throw in the cynical intervention from the deputy prime minister who started the week with a round-robin letter to Liberal Democrat politicians boasting they had won “significant” amendments to the Bill in the Lords. Right on cue Simon Hughes speaking in the Commons welcomed the Clegg letter. Meanwhile No 10 spinners were insisting the amendments in questions amounted to no more than a mere “reassurance”. By Wednesday Clegg had been goaded by Ed Miliband at PMQs to admitting he fully supported the bill. And the week before, despite around a dozen or so Lib Dems MPs signing an EDM calling for publication of the NHS Risk Register, when the exact same motion was voted upon in the Commons only a couple of Lib Dems voted for it.

The truth is in the Commons, the Lib Dem opposition to this bill has become more choreographed than Hulk Hogan verses Randy Savage at Wrestlemania.

But it’s too easy to become distracted by what has been one of hell of a soap opera and forget what a disastrous set of changes to the NHS Cameron is pushing through. These changes will mean widespread variation in the treatments available on the NHS. In some areas, people may have to go private to get services available for free elsewhere.

Throughout his time as leader of the opposition, the prime minister used the NHS as the exemplar of how the Tory brand had been detoxified. He continually reassured us there would be no more reorganisations, for example telling the Kings Fund in 2006 “the second key component of our approach will be to end the damage caused by pointless and disruptive reorganisations of the NHS. We will not mess around with existing local and regional structures; we will allow the current structures to settle down and bed in.”

Yet perhaps we ought not be surprised where this Conservative-Liberal Government have ended up. The Prime Minister’s policy strategist is Oliver Letwin. Years ago Letwin co-wrote a pamphlet – ‘Britain’s Biggest Enterprise – Ideas of Radical Reform of the NHS.’ In it he described the NHS “a bureaucratic monster that cannot be tamed” and called for the NHS to be established as an independent trust with a much larger-scale role for the private sector where the principle of charging should be introduced and expanded. Fast forward to 2012 and arguably much of this thinking is central to the Lansley Bill.

Its remarkable that after all the effort that went into detoxifing the Tory image, the NHS has now become an exemplar of David Cameron’s Conservatism but not in the way he had hoped. Rather than a demonstration of a genuinely compassionate conservatism in fact it has become a symbol of the limits of David Cameron’s modernising instincts.  These NHS changes again reveal the inherent tension within the Cameron project – the Tories are simply caught between what they think they should say (promising no more reorganisations) and what they really believe (the Letwin health agenda).  Those tensions are one of the reasons why the Tories were not sufficiently trusted with a majority at the last election and why they won’t be trusted on the NHS at the next.

Jon Ashworth is Labour MP for Leicester South and an opposition whip

Tags: , , ,

Leave a Reply