A Healthy Coalition?

In a constructive spirit, having said that the AV concesssion was unnecessary and mistaken, it might be helpful to suggest a policy area in which making some concessions to the Lib Dems might bring dividends. Given the importance that all parties attach to health and the NHS in particular, it's been a little surprising that so far as I have seen health has not yet been identified as an issue for coalition discussions, whether LibDem-Lab or LibDem-Con.

There are some areas where adopting the LibDem position would help disimpale us from hooks that, upon reflection, we may wish we had not fashioned and open up positions that we might like to move into:

• The "independent NHS Board": this would diminish public and political accountability not strengthen it. The Lib Dem policy of locally-elected health boards is much more appealing to many conservatives.
• Care of the elderly: our £8,000 insurance policy to cover the cost of care homes is actuarially vulnerable. It needs widespread take-up, and assumes that people won't use their insurance policy to enter care homes earlier than they might otherwise have done. The financial services industry needs to ensure that it comes up with transparent, loophole-free products, which it's not always good at doing. Insurance might have a place as part of a pluralist system, but it's not a complete answer. We have said very little about the cost of home care, which is the setting where most people want to stay as long as they can. The Lib Dem call for a Royal Commission to look at all of this is sensible, provided we then go on to implement its recommendations swiftly.
• Deficit reduction. It may well not prove possible to increase health spending every year. The Lib Dems did not make this commitment. In order to help fund other Lib Dem proposals which we might agree to (eg lifting the very poorest out of income tax altogether) we may need to revisit this. I accept this may carry too much political risk, but we should consider it.
• Personnel: Norman Lamb is liked and trusted in health and social care. He's also a reformer - Nick Bosanquet frequently calls him one of Reform's (the think tank's) "favourite sons." Andrew Lansley could still become Secretary of State for Public Health if David Cameron wants, but Norman Lamb could become a senior minister with special responsibility for accountability and efficiency. If for no other reason than my desire to see the headlines: "Lamb chops health fat" or "Lamb fleeces health waste", "Lamb shears...." etc etc

There are lots of issues in common between the parties as well, for example, shared commitments to reduce the DH, join up health and social care services, empower patients and carers, and do more to focus on prevention and public health. I hope they're talking about this behind those there closed doors.