In reality, the Lansley “reforms” have not been paused

by Jonathan Todd

Pause, listen, reflect and improve”. That’s what David Cameron and Nick Clegg said they were going to do on the NHS bill. Most people know what these words mean. Cameron and Clegg don’t seem to, though.

The only thing that Clegg now reflects upon is how he can shore up his position as Liberal Democrat leader. With Chris Huhne and Tim Farron, two would-be assassins, both playing to his party’s gallery, he has reason to be worried. He sees the NHS as he now sees everything else: through the prism of his anxiety. For the NHS to relieve this, he needs to come to be seen as the man who saved it. The restorer of sanity subsequent to the Andrew Lansley-induced madness.

He wants “substantial, significant changes” to Lansley’s proposals. But the extraction of compromises is the least of the barriers standing in the way of him being re-born as Mr. NHS. He needs to explain away no Liberal Democrat MP voting against the bill at either first or second reading. Perhaps his MPs followed their whip because they thought the whole thing a Liberal Democrat idea. After all, that’s what Clegg argued not so long ago and, as John Redwood reminded Today listeners, the proposals are consistent with the Liberal Democrat manifesto.

Having broken promises on tuition fees and the depth and speed of cuts, Clegg’s attempt to reposition himself on the NHS bill is supremely opportunistic. Labour needs to expose this manoeuvre for the shallow gesture that it is. Only we have consistently opposed this bill and advocated workable reform in the NHS. The Liberal Democrats must not be allowed to steal our clothes.

Such theft would not be without risk for the prime minister. No government u-turn of such proportions can be without risk for its leader. It is indicative of the pickle into which he has allowed things to descend that Cameron now seems set to open this opportunity up to Clegg, particularly when his personal empathy with the NHS was central to his attempted detoxification of the Tories. Cameron may no longer be the man who loves the NHS if Clegg becomes the man who saved the NHS. It may make the “Thatcherite” label start to stick better on this somewhat Teflon prime minister.

We cannot allow the NHS debate to play out in terms of the politics between the governing parties. We need to make ourselves central to it. Ed Miliband’s speech to the RSA was helpful in this regard. It confirmed that we favour reform that works, not sticking our heads in the sand of the status quo. Our use of Commons debates can further assist.

Miliband is fond of saying “I get it”. The public needs to know that he gets the need to raise NHS productivity to maintain service standards in the context of the cost increases associated with society’s ageing. Obviously, real people don’t speak like this. But they don’t take NHS spending commitments alone to be virility symbols for the extent of a politician’s love for the NHS. They know that what is done with the money matters as much as the amount of money. And they also know that the country isn’t sitting on a bottomless pit of resources to devote to public services, and that tough choices, therefore, have to be made.

People are also worried about their own care and that of relatives, particularly the elderly and young. They want politicians to speak to these worries. But in ways that they consider realistic, given what they understand about the pressures on public expenditure.

The NHS in Cumbria shows that Labour reform works. It now shows that the facts on the ground are changing, even as the Lansley reform is supposedly paused. North Cumbria university hospitals NHS trust is to be taken over by or merged with another trust. This is because the current management has concluded that it cannot meet the strict financial criteria set to achieve the foundation status that the NHS bill requires it meet by 2014. This could well remove control of Cumberland infirmary in Carlisle and West Cumberland Hospital in Whitehaven from Cumbria – a curious form of localism. Try telling the 9,000 signatories on a petition organised by Labour MPs Tony Cunningham and Jamie Reed to maintain services at West Cumberland that the NHS Bill is paused.

Cumbria isn’t an isolated case. At PMQs recently, Labour’s Debbie Abrahams pointed out that the inception of cluster PCTs, which precede the GP consortia, including the Greater Manchester cluster PCT, was brought forward from 1 June to 3 May. The perception that significant swathes of the Lansley reforms are proceeding apace, irrespective of the pause that is meant to be in place, is encouraged by reports that the 50-strong “listening panel” set up to review them is stuffed with “yes men and women”. And, as the focus of the NHS is distracted, waiting times are rising.

Labour’s ground battle is to resist local changes brought about by the non-pause of the Lansley reforms. Labour’s air battle is to stop Clegg becoming the man who saved the NHS and Cameron being someone who gets the NHS. The war will be won when our policy review shows that not only does the government not have the right reforms, but that we do.

Jonathan Todd is Labour Uncut’s economic columnist.

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2 Responses to “In reality, the Lansley “reforms” have not been paused”

  1. Amber Star says:

    John Healey is nowhere near as good at debating health & the NHS as Andy Burnham.

  2. iain ker says:

    Andy Burnham just doesn’t look right without his short trousers, blazer, and cap.

    But hey, he’s one of us because he supports Everton or so he keeps telling us (and telling us and telling us).

    Oh, and in case no-one knew, Alastair Campbell supports Burnley – that means he’s a man aye the people too.

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