I spent the first half of the Liberal Democrats’ conference in Brighton stalking Paul Burstow, the party’s health minister who was one of the victims of David Cameron’s reshuffle, sacked in this month’s Lansley era clear-out. As I type on a blustery Tuesday the project remains a failure. Last week’s HSJ did better than me.
Seaside storms apart, there’s no pretending the Lib Dems are in a comfortable place. Labour voters who defected from Gordon Brown in 2010 have re-defected or gone off to the Greens, UKIP etc. It’s part of what I call the National Car Park vote which likes to park its election day X anywhere but with one of the two main governing parties. David Cameron’s coalition is in trouble - or f — ing trouble, as Andrew Mitchell would say.
That doesn’t mean Cameron and Nick Clegg’s crew are as doomed at the scheduled 2015 election as most polls currently predict. More than usual, we simply don’t know what will happen: the economy may be picking up (along with this week’s predicted improvement in cancer outcomes) or climate change may be worsening recession woes. But political activists travel in hope. So Lib Dem loyalists did in Brighton.
Cue Paul Burstow. I can’t vouch for post-sacking Tory murmurs that he briefed against his department when a minister, especially over proposed A&E/maternity closures at his local St Helier hospital in south London. Whenever we spoke (rarely) he seemed loyal to me. But it’s now said he also annoyed Clegg by failing to warn him about the perils of the Health Bill. That seems unfair: can’t the DPM read?
Not in dispute is that, once sacked, Mr Burstow openly urged Jeremy Hunt to bin the “dangerous” St Helier shake-up. Then he wrote that Daily Telegraph article, fingering the Treasury (as usual) for blocking progress on reform of social care of the elderly, despite the Dilnot report’s proposed cap at around £35,000 - a notion that commands cross-party support, but would cost George Osborne’s coffers £1.7bn a year. He also spoke to HSJ to confirm cuts in some mental health budgets, a theme repeated on the Brighton fringe. Here in Brighton he was due to speak at several fringe meetings and was clocked at least once. On Sunday night he stressed the need for a “personalisation of healthcare”, attacked the Treasury and revealed there had been no contact since last summer’s social care white paper, not even to discuss the option that the £1.7bn cost might be found from the health department’s own budget, so I was told.
Osborne’s Lib Dem No 2, Danny Alexander, popped up this week to insist “we are not blocking this in principle”. Ho, ho.
We learned last week that the NHS is sitting on £4bn worth of accumulated surpluses. Since Clegg assured Burstow’s successor, Norman Lamb, that social care is a priority and Cameron tells journalists the same, it might allow them to introduce a Dilnot cap and ease the fears of the frail elderly before 2017, the earliest date envisaged.
The fears are very real. When I turned up at assorted fringes to hear Mr Burstow I usually found Mr Lamb, being fluent and decent (“perhaps a bit naive,” muttered one lobbyist) about the importance of integration of health and social care to replace what he calls “institutional fragmentation” (“it’s a catchy phrase”). Lamb cites the pioneering Torbay model which gives patients better care and saves money. Bliss!
In the real world, Unison’s Christina McAnea was not alone in telling harrowing stories of shrinking personal care budgets, of harried and poorly paid staff ticking activity boxes during hasty home visits, rather than the elderly clients’ needs. Tough issues which Paul Burstow may have addressed in Wednesday’s platform speech. Too late for me.
Michael White writes about politics for The Guardian.