Andrew Lansley goes on the attack and accuses Labour of planning £30 billion of cuts to NHS

By Tim Montgomerie
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One of the most significant components of Ed Miliband's reshuffle was that Andy Burnham has moved from education to health. The first implication of this has been noted by Toby Young; the new and very able shadow to Michael Gove - Stephen Twigg - appears to have shifted Labour policy towards free schools in a more favourable direction. Very welcome. The second implication is that Andy Burnham will have to defend his record as Gordon Brown's Health Secretary.

As the numbers on the right show, health is currently the Tories' weakest policy link. In his letter to Mr Burnham, Andrew Lansley has decided that the best form of defence is attack:

"The legacy I inherited from you overall has been appalling. NHS Trusts in some areas of the country are struggling under the twin burdens of PFI repayments and other forms of debt. The NHS you left the Government with had witnessed a decade of declining productivity and - in your last year in office - the number of managers increased at six times the rate of the number of nurses. Mixed-sex accommodation was still rife, despite your pretence that it had been abolished. In contrast, in just the Government's first year in office, we have turned this abysmal record around: increasing the number of doctors by 1,500; reducing the number of managers by 5,000; securing productivity improvements of £4.3 billion; and reducing the number of breaches of mixed-sex accommodation by over 90%."

Mr Lansley also attacks Mr Burnham's position on health spending:

"I am disappointed that you did not take the opportunity to apologise for your opposition to our real-terms increases to the NHS budget, which last year you described as, "irresponsible". I presume, therefore, that you and your colleagues remain committed to cutting the NHS budget by £30 billion over this Parliament."

Mr Burnham's past is not Andrew Lansley's main concern, however. When the NHS reforms were revised earlier this year David Cameron thought he had struck a final deal with Nick Clegg. Unfortunately the Lib Dem leader hasn't been able to get all of his party in the Lords to agree that enough concessions were made. Former leader of the SDP and now a crossbencher, Lord Owen has proposed an amendment that would require a new super committee to examine the NHS reforms. This is seen by Number 10 as a wrecking amendment that would both seriously delay the reforms and provide further scope for significant amendment of them. If Owen isn't defeated - and a range of Lib Dem and crossbench peers are expected to join Labour in supporting him - there is a risk that the whole Bill will sink. Benedict Brogan described it as an "iceberg" facing the Coalition. Philip Stephens says the reforms - if they go ahead - amount to a home-made calamity.

In his letter to Mr Burnham, Andrew Lansley defended his reforms. You can read a PDF of the full letter here. The Health Secretary was in no mood to change course when he addressed a ConHome fringe meeting in Manchester last week. He predicted that the reforms would be in place by the time of the next election and Labour would not seek to amend them. He also predicted that the BMA would shift position, too. The BMA had always opposed every reform, he said, and that they would support the new status quo and all its vested interests once the caravan had moved on.