I heard a senior NHS manager on the radio mid-week sounding like Sharon (“I don’t do blame”) Shoesmith, Haringey’s ousted children’s services chief, as he defended his hospital against a damning report from the Care Quality Commission.
That may all be logical, but it’s wiser to put your hands up. I made a note to consult his local MP. Then Andrew Lansley was forced – this time by evidence, not politics – to reverse his freeze on public health marketing campaigns. Interesting too, I thought.
But no, the bill (yes, that bill) got interesting again and rival impulses died. Nick Clegg and John Healey made head to head speeches on the same day, the “sack Lansley” story got another puff of wind, then Number 10 signalled what we suspected here last week: that it would rather lobotomise the bill than lose the coalition.
To Tory MPs, Clegg’s speech must have been exasperating because, like David Cameron a few days earlier, it made the familiar case for Lansley-ism, then backed away from it in the name of “peace of mind, the best care and a say in decisions” for NHS patients.
That translated as no compulsion for GPs to join what will become wider professional consortia; a slower pace too for competition where appropriate; no “top-down” opening up of all services to any qualified provider.
The deputy PM further complicated matters by making an unscripted, unilateral pledge that the bill would go back to its Commons committee stage for further line-by-line analysis and amendment before heading for the Lords in July – or is that September?
Probably, although that decision remains unresolved. But Labour’s John Healey, unfairly pilloried in some newspapers for having no impact on the controversy, has now tabled new amendments: on accountability, insolvency, the private patient cap and other issues, notably the abolition of Monitor as the NHS’s economic regulator or (his fallback position) the reassertion of collaboration over competition.
Healey’s own critique of the bill’s flaws, his speech to the Royal Society of Medicine, was (says me) the most lucid he has made in this campaign, some points reiterated on BBC One’s Andrew Marr Show.
Putting his political point scoring aside he argued that the bill breaks up the NHS at both national and local level; that it breaks public accountability; and unleashes the beast of competition that “can’t be put back in its cage.”
To Labour’s amazement its lobbying is finding that some key health policy makers in Whitehall haven’t actually read the bill – unlike ex-health minister Lord (David) Owen.
No enemy of pro-market reform, Lord Owen has obtained damning legal opinion on the ending of the secretary of state’s duty “to secure the provision of services”. Instead it would lay much responsibility on local providers/commissioners who may not be equipped to cope with the flak.
No wonder the medics are alarmed!
Incidentally, Lord Owen also established that no new legal advice was sought on the impact of the bill on EU and UK competition law because it does not change the status quo – a much disputed point. He is fighting the Department of Health’s use of a Freedom of Information Act loophole to deny him the advice it got in 2007.
All jolly interesting, eh? Sack Lansley? I remain confident he will neither quit nor be fired, but will bend with Number 10 wind and cut a deal. And Nick de Bois, the Tory MP who tried to establish Tory “red lines” to counter Clegg’s? He’ll fight on too but will bend after a row.
It’s an undignified dog’s dinner of a retreat, but pragmatic David Cameron has decided that survival matters more. Clever chap.