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Why Andrew Lansley is getting a raw deal

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by Paul Goodman

The Health Secretary is the latest politician to be humiliated by the producer interest.  Some of his predecessors have deserved it.  Lansley doesn't, for three reasons:

  • Downing Street signed up to his plans...   The Conservative manifesto said that GPs would be given "the power to hold patients' budgets and commission care on their behalf".  The Coalition Agreement committed the Government to strenghtening "the power of GPs as patients’ expert guides through the health system by enabling them to commission care on their behalf".  It will be said that neither document specifically pledged to scrap PCTs.  But this proposal was spelt out both in Lansley's Health White Paper and in the Health Bill - which David Cameron, Nick Clegg, the Cabinet and the Government signed up to.  Downing Street sent Oliver Letwin in specifically to give the Health Secretary's plans the once-over in advance.
  • ...And let him press ahead with them...  So no-one can complain that Lansley rushed recklessly forward.  Indeed, he's probably the last member of the Cabinet who can fairly be charged with such an accusation.  Lansley's been the Party's health spokesman for the best part of ten years, and believes that his reforms are necessary if the NHS is to prosper on a 0.1 per cent funding rise for four years while saving £4 billion a year.  If Cameron didn't want Lansley's plan, he shouldn't have approved it (and should have appointed someone else as Health Secretary).  But either way, Lansley shouldn't have been put in a position in which - uniquely among modern Cabinet Ministers - he was asked by his colleagues to delay a measure which they'd agreed to, and which was already making its way through Parliament.
  • ...Which leaves him deserving better.  Lansley isn't a first-rate politician in the mode of the Prime Minister or Chancellor.  He wasn't destined for the Treasury - even before the current difficulties - or for the other "great offices of state".  But that's exactly why he deserves better.  The legend goes that Lansley's felt a vocation to be Health Secretary since suffering a stroke which was misdiagnosed.  Whether this is so or not, the key to him is that he's from a public service background first and foremost.  His father worked in a pathology department.  One brother is a policeman.  Another trained as a teacher.  His first wife was a doctor.  He could quietly have dropped his reform plan last summer.  But he's what he seems to be: a public servant who wants to improve the NHS.  Which is why his colleagues will be asking: if he can be treated like this, what could that mean for me?

As I've written before, the Government can survive a U-turn on Lansley's plans.  And it's true that trying to push through four lots of public service reform at once is one set too many.  But make no mistake: delaying the Health Secretary's programme won't stop an "NHS crisis", which is coming anyway.  True, the Health Secretary's not the world's slickest salesman, and he didn't sign up enough supporters in advance.  (Look, by contrast, at the way Chris Grayling prepared the ground for the Work Programme.)  None the less, Andrew Lansley, public servant, is getting a raw deal.


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