The events set in train by last Friday’s HSJ exclusive about the prime minister’s NHS summit proved highly revealing about the tactics the government is adopting to drive through its reforms.
When hsj.co.uk broke the news of the summit and its “selective” guest list, the government had two options. The first was to say, “Sorry, the invitation must have got lost in the post” and make it clear David Cameron was prepared to sit down with all, regardless of their opinions.
Instead the government actually hardened its line on the invitations, saying the views of the royal colleges of GPs and nursing and the British Medical Association were well known and the PM only wanted to talk to those prepared to “constructively engage” with the reforms.
It is a tactic which, for the moment, appears to have worked. The opponents complained and strode to the moral high ground. But they stopped short of taking their opposition to the next level. Perhaps their bluff has been called; more likely they plan to shift their energies into fighting government pension proposals even more fiercely.
As the summit took place health secretary Andrew Lansley was writing to clinical commissioning groups, promising them a relatively free hand on competition and commissioning support. The PM included “freedom for local decision making” as one of the “four Fs” underpinning the coalition’s approach to reform.
The CCG pioneers are one of the few cards the government holds in the reform battle – and it wants them to feel loved and reassured that they are not serving as a Trojan horse for increased competition. It championed their efforts in a press release on the day of the summit, despite knowing that many similar achievements predated the existence of CCGs. CCGs leaders will have been a little embarrassed. The last thing they need is the government overclaiming on their behalf for political reasons so early in their development.