Written by Peter Bingle, Chairman, Bell Pottinger
I have never really understood why the NHS is a no go area for Tory politicians. We all know in our heart of hearts that it is not perfect and needs reform. We have all had good and bad personal experiences. At its best it is superb. At its worst it will kill you literally …
It has long been the case that there needed to be a grown up debate about the future provision of healthcare. It would have made sense for a think tank or health foundation to bring together twenty of the brightest new young MPs (from across the political spectrum) and ask them to establish a new political consensus on health reform. We have to move beyond a debate simply about funding levels.
The irony of the current situation at Westminster is that nobody is really defending the status quo. Even the Shadow Health Secretary John Healey accepts the need for change. Where there is no consensus is over the precise details of the reforms which are needed.
Andrew Lansley was given the health portfolio in opposition with a very simple and precise mandate. Go around all the professional health bodies and get them on board. This is precisely what he did. Never has a newly appointed Heath Secretary been in such a strong position. Yet those relationships are now in tatters and the PM is doing the one thing he never wanted to do – he has had to get involved in a partisan and bitter public debate about the future of the NHS. Despite all the guaranteed additional funding (in real terms) for the lifetime of this parliament the Tory Party is once again on the defensive over the NHS.
It was a mistake to treat the NHS differently from the rest of the public sector. This is an organisation which more than any other needs the rigour of market testing and competition. Yet, in the face of opposition from the Labour Party and the Lib Dems, there has been a disappointing retreat on this key element of reform. What is wrong with competition? What is wrong with further involvement by the private and voluntary sectors?
The irony is that Tory Health Secretaries have never really been very supportive of the private healthcare sector. The last Health Secretary who had the courage and vision to understand the potential contribution by the private healthcare was Alan Milburn supported by John Hutton as his deputy at the Department of Health and three great political advisers, Simon Stevens, Darren Murphy and Paul Corrigan. I doubt that we will see such a radical team again.
After all the recent controversy about the health reforms I am still none the wiser about what is actually being proposed. I am equally in the dark about why they are so unpopular with everybody other than right-wing Tory MPs. The communication has thus far been truly terrible. If you can’t explain what you are trying to do in a simple sentence something is very badly wrong.
The comparison between IDS and Andrew Lansley is fascinating. In welfare IDS has been a success for two reasons. The first is that he cares passionately about the people he is trying to help escape from poverty and a culture of dependency and welfare. Secondly there is a public mandate for the reforms. In contrast Andrew Lansley displays no passion whatsoever and has no public mandate. It is hard to see how he can reassert his authority going forward. If he does not do so the case for radical reform will be lost for another generation.
I have argued previously that the PM should replace Andrew Lansley with Norman Lamb. The case grows stronger by the day.
One day I hope to see a radical Tory Health Secretary …
Why has Andrew Lansley come so unstuck? Why is the Tory Party so scared of being radical when it comes to the NHS? What should the PM do to kick start his health reform policy?
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