More by accident than design, Andrew Lansley became such a hero of the Tory right during passage of the Health Act and such a swivel-eyed fanatic to his many critics that it’s going to be hard work persuading any of them that he can actually be quite pragmatic. Let’s try.
Dame Jo Williams, chair of the embattled Care Quality Commission, had a point when she wrote to the secretary of state asking that Kay Sheldon, the Mid-Staffs whistleblower, be removed from the regulator’s board. When Mr Lansley declined to take her advice, HSJ suggested that Dame Jo might consider walking the CQC plank instead.
Critics have a point, too. Just as Sheldon went public at the Francis inquiry last November rather than take her concerns to ministers - as she could properly have done - so Williams (“very pleasant, a bit nervous, she’s had a rotten time,” one MP tells me) didn’t exhaust all her own internal options before pressing the nuclear sacking button.
So Lansley didn’t see it as a black and white issue, let alone a political one. He saw it as an HR question and sought expert advice, a case review from the Cabinet Office which concluded that, on balance, Ms Sheldon should stay on pragmatic grounds, including legal ones, and the possible impact on the overdue Francis report and on the media if she did not.
At a time when whistleblowing is again causing soul searching among Whitehall policy makers, the incident serves to remind us all that the public spirited can be awkward people, too, though the media loves them. I like to remind colleagues of Ibsen’s 1882 play, An Enemy of the People, in which Thomas Stockmann gallantly blows the whistle on a polluted water source which threatens his community’s prosperity.
Are they grateful? No. But why go to 19th century Norway? Closer to home, The Guardian doggedly exposed widespread illegal activity at the News of the World, underpinned by police and political complacency (or worse). Is Fleet Street impressed? Not much. The paper stands accused of making the industry’s frantic efforts to survive the internet revolution that much harder.
I can follow that. So can you. The CQC has high hopes of its new chief executive, David Behan, well-qualified and likeable, being a man who will ease the institutional conflict structured into his relationship with Whitehall while maintaining his own independence. Only Sir Mervyn King at the Bank of England has a harder comparable task.
Did I say pragmatic? Ali Parsa, the fast-talking, PR-conscious chief executive of Circle, the private sector health company now running Hinchingbrooke hospital - deep in Lansley Country - popped up on BBC Radio 4’s Today programme the other morning to spin an upbeat account of Circle’s turn-around successes during its first six months in the Fens. The Daily Telegraph was predictably impressed.
It didn’t take HSJ long to remind its sceptical readers that, for all its fine talk, Circle is still behind its savings targets and may need a loan. Were ministers impressed or alarmed? Neither. They know Parsa always talks a good game when fundraising in the City, but do not assume they will accede to his wish to run flagging George Eliot hospital in Nuneaton as well.
Even local Tory MPs prefer an NHS trust to take over, not Serco, nor Care UK or Circle, which is yet to prove it can run a major hospital trust. MPs remain sceptical about private sector cherry-picking. Lansley sees Hinchingbrooke as a one-off, a Labour-sanctioned alternative to closure.
He is all too aware that if Circle screws up there it will set back UK private sector healthcare for a generation - which is more than Shirley Williams managed.
Michael White writes about politics for The Guardian