Friday, 1 April 2011

The politics of healthcare

There was an interesting article in the UK Times newspaper yesterday entitled ‘Cameron puts brake on NHS reforms – Fear of political damage prompts second thoughts’

The piece suggests that David Cameron is rethinking the speed of the recommended changes and may try to take the political sting out of the restructure by slowing down the whole process of reform.

When I first started writing this blog last October, I assumed the Health and Social Care Bill was a done deal. I was, like many healthcare commentators, shocked at it’s proposed content and the sweeping nature and speed of implementation. Drastic change is costly, high speed drastic change is even more expensive. But Andrew Lansley’s intransigence and blinkered belief that his way is the right way, and the seemingly hands-off approach of his leader suggested that the reforms would go ahead, despite strong opposition.

Even when many organisations voiced their unequivocal concerns about the nature and pace of the reforms (see my posting 22nd March – The List), Cameron seemed unmoved. Maybe the quiet determination of the marching masses last Saturday started to make an impact.  Many are beginning to sense that Cameron is realising the long term damage this Bill could do to the Conservative Party. Of course the public sector will argue against cuts, but why would so many general practitioners, the recipients of the £80 billion golden egg disagree with the goose? Even at grass roots level, those of us who previously had no political axe to grind are becoming polarised about these reforms.

At best Cameron has been naive in entrusting such a financial and emotional hot potato to Andrew Lansley, a man who simply won’t listen. At worst, this could be one of the biggest political mistakes Cameron makes in his career. According to the Times, ‘No.10 is seeking advice outside the department of health’. Pity they didn’t do that sooner.

Cameron must now proceed with caution. The horse has started to gallop away and it may be too late to shut the stable door. GP pathfinder consortia have been formed, chief executives appointed. Redundancy payments have been made, decommissioning of some services completed. A U turn is unlikely to be in the best interests of all concerned so will this Bill be reworked or simply tweaked?

Time really is of the essence as the Bill will reach the House of Lords in May, incorporating any new amendments. The Lybian Crisis must be taking up much of the PM’s time and energy, but he, and his closest advisers need to consider their next steps very carefully and Lansley and his team need to fine tune their listening skills – quickly.


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