More and more people have started to ask me: “Is David Cameron going to sack Andrew Lansley?”
It’s never a good sign for a Cabinet minister when their name begins to appear that way in newspaper speculation. It’s happening to Mr Lansley, although I see that Tory chairman Baroness Warsi is first in the media queue.
What’s more important, Mr Lansley was conspicuously lonely on the government front bench when he was forced to make his “pause, listen and engage” statement about the Health Bill to MPs on Monday. Tory backbenchers loyally swallowed doubts, but no Cabinet heavies came to show solidarity. Being a loner can exact a price when things go wrong.
All the same, my answer remains “No, not yet”. Lansley dug himself and the coalition into this hole, contaminating Dave and George’s detox of the Tory brand with a renewed outbreak of the political equivalent of MRSA. He’s still got work to do digging them out again.
Besides, Cameron and Nick Clegg signed the foreword to last summer’s white paper. “Either they’ve changed their minds or they hadn’t read it and didn’t understand it properly,” waspish MPs point out. My own view remains the latter one: Cameron trusted his old research department boss to get the detail right. Determined to avoid Blair-style interference from Number 10, he let him get on with it.
No longer. Is Number 10 now taking NHS chief executive Sir David Nicholson’s advice as the experienced manager who knows the NHS is a people business where you have to take people with you? I can’t confirm that. But it sounds plausible. Sir David’s robust approach (“I’ll be telling GP commissioners how much they can spend and what they can spend it on”) will also reassure the Treasury.
It is clearly having late-night conversations with Stephen Dorrell, the last Tory tenant (1995-97) of Richmond House, whose health committee report further undermined the health secretary’s defences this week. Norman Tebbit, in whose Whitehall private office young civil servant Lansley caught the politics bug 30 years ago, was also unkind. “There is a lot of good in [the NHS] that should not be put at risk,” he told The Mirror. Ouch.
When friends like this come after a politician an opposition need do little to make progress.
Ed Miliband chose Monday to make a crafty speech offering cooperation to amend part 3 of the bill: the 82 clauses governing Monitor’s new role as economic regulator, treating health like the nominally competitive gas or electricity industries – focus of most criticism.
Lansley’s concessions on the structure, wider (more democratic) membership and accountability of whatever we will end up calling GP-led consortia (“NHS commissioning authorities” is Dorrell’s clunky suggestion) and the avoidance of private sector cherrypicking, chime with what Lib Dem critics like ex-MP Dr Evan Harris and St Shirley Williams have been saying.
So does the Dorrell committee’s report. Much of it overlaps with the amendments on which John Healey’s Labour team was repeatedly defeated in the Health bill committee, the bill which Lansley has now put on hold. Labour’s Graham Morris has been the link man – sitting on both committees.
How useful is Lansley’s pause? Not much. The bill would have left the Commons for the Lords in June. It will now go in July and face a cross-party mauling through the autumn conference season. Can they amend part 3 to restore Monitor’s current role or give it to the CQC – or must it be scrapped as beyond saving?
It is the key question. Old NHS hands describe Lansley as the secretary of state who “knows most but listens least.” There is a personal tragedy in the making.