Cameron cannot win every fight with flowers

By Tim Montgomerie
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Yesterday we had the u-turn on health. Today we learn of a very welcome u-turn on discounted prison sentences. Talking to a Conservative MP last night, however, he warned that the Coalition's dizzying inability to stick to a course was threatening backbench discipline. One day, he said, the whips are asking us to write letters to constituents defending the government's plans to reform school sports funding, the EMA, forestry privatisation, the NHS... and the next day they are abandoning or diluting those plans. "Ten times bitten, eleventh time shy," he said. Tory MPs simply won't get up in the Commons and defend controversial reforms if they are going to be made to look silly.

Yesterday's concessions on the NHS reforms may not be the last. The Lords were always the biggest barrier to the passage of Andrew Lansley's reforms and I suspect that Baroness (Shirley) Williams and the reform-sceptics who sit with her on the red benches may press for further changes. What I fear is a repeat of the tuition fees process where concession after concession turns a good policy into something of a dog's breakfast (see Charles Moore's brilliant column on where we've ended up in higher education).

What is clear is that Andrew Lansley may remain the Health Secretary in name but decisions on health policy are now being made in Downing Street; between the PM, George Osborne, Nick Clegg and, particularly, Nick Clegg's Chief of Staff - Norman Lamb MP, the Lib Dems' former health spokesman. Not only is David Cameron deciding healthcare policy he is also now the salesman for the NHS policy and his five guarantees. As a Downing Street source told me last night, we should now think of David Cameron as Secretary of State for Health because he will be the policy's public face.

Yesterday, with his speech on healthcare, we saw Cameron in full reassurance mode and he's good at it.  My big question is whether he is ready and able to wield a sword as well as carry flowers?

In the last year we have seen radicalism from the Coalition - particularly on schools, welfare, local government, policing and, of course, health. This 'breakneck radicalism' was out of character for David Cameron. His default mode is caution, particularly when he's been confident of his electoral position. I wonder if we are seeing Cameron now return to his 'normal' setting? Are we at the beginning, middle or end of revisiting the Coalition's first year programme? Will the PM stand firm, for example, when the welfare overhaul starts causing pain?

When his back is against the wall the Tory leader has shown a willingness to fight. Although he dragged his feet for a time he eventually fought the AV campaign with gusto. But where is the fight for the kind of unpopular policies that are essential to Britain's future success? For patient choice in the NHS? For the benefits of profit-making enterprises in education and other public services? For the supply-side benefits of lower taxation? He seems unwilling to take on these fights and as we approach the middle stages of the parliament it will get politically harder.

It's important that when the Downing Street polling operation measures the public's individual view of issues that it also steps back and asks broader questions of Cameron's standing. It may be that individual reforms - like on the NHS - are unpopular but if repeatedly abandoned they are dangerous because they will leave the government looking weak, even incompetent. None of this matters - electorally - at the moment. Labour is so weak and Ed Miliband's ratings so poor that Cameron faces no serious competition. But as the cuts bite the Coalition must appear rock solid and face down the public sector unions that will fight them.