Those of us who have been deeply troubled by the Tory-led government’s Health and Social Care Bill, since it first came under intense scrutiny a year ago, have sought nothing less than for the entire project to be scrapped. A thorough “top-down reorganisation,” despite a promise by David Cameron that he would do no such thing, it was intended from the beginning to break open the NHS, to make room for private predators, with rules regarding enforced competition, and the health secretary’s own intention to remove the entire service from direct government control, that were far too alarming to allow for anything other than total opposition.
Criticised by a majority of health professionals, by the Tories’ Lib Dem partners in the coalition, and by the House of Lords, the bill was paused for a period of reflection last spring, and has been subjected to so many amendments, in an attempt to keep it alive, that it is now an almost inconceivable mutant monstrosity, albeit one that, at its dark heart, still seeks to fatally undermine the NHS.
Despite the relentless criticism, the Tories managed to retain a united front until last week, when cracks began to show, beginning on Tuesday, when, in an explosive article in the Times (hidden beyond the Murdoch paywall), Rachel Sylvester quoted an unnamed official in 10 Downing Street as saying that the health secretary Andrew Lansley “should be taken out and shot” because he’s “messed up both the communication and the substance of the policy.”
Another huge blow came on Friday, on the influential ConservativeHome website, where editor Tim Montgomerie, in an article entitled, “The unnecessary and unpopular NHS Bill could cost the Conservative Party the next election. Cameron must kill it,” explained that, following Sylvester’s article, “three Tory Cabinet ministers have now also rung the alarm bell. One was insistent the Bill must be dropped. Another said Andrew Lansley must be replaced. Another likened the NHS reforms to the poll tax.”
Bluntly, Montgomerie stated:
Many Conservatives think that the NHS needs fundamental reform but for far-reaching reform to succeed certain pre-conditions must be met. The public needs to have been persuaded that substantial change is necessary. The Government cannot be distracted by other consuming projects but its best brains must be focused and single-minded in ensuring the policy’s success. The Whitehall machine needs to be prepared and co-operative. The Health Secretary needs to enjoy significant goodwill amongst NHS staff and possess exceptional communication skills. Few — perhaps none — of those preconditions exist.
He also provided a telling sketch of how the bill came to be pursued:
The NHS Bill emerged during the early days of the Coalition. Cameron and Clegg seemed to think the normal laws of politics had been suspended in the weeks following their rose garden romance. Desperate to prove that their alliance was not a lowest common denominator arrangement they over-reached and the Lansley Bill was the biggest product of this heady period.
In conclusion, he also noted that meeting what is known as “The Nicholson challenge” — a commitment to make £20 billion of savings by 2015, which was inherited by the Tory-led government from its Labour predecessors – “was always going to be nightmarishly difficult” but “didn’t require new legislation. Nearly all of the necessary efficiencies could have been delivered with existing powers.”
In the wake of these damning revelations, Prime Minister David Cameron nevertheless promised to keep pushing ahead with the planned reforms. The Guardian noted that he was “said to be willing to endure three final months of political controversy to push the health bill through parliament,” because he was “convinced there is no serious dissent in his cabinet, parliamentary party or in the country at large.”
However, today, a YouGov poll, commissioned by the public sector union Unison, has found that 62% of voters do not trust the government to protect the NHS, in contrast to just 34% of respondents who said that they do. Among Tory voters, 24% said they “did not now trust their own government to handle the NHS,” as the Observer described it, adding that this was “a belief shared by 59% of Liberal Democrat voters.”
This is disastrous, given that, before the election, Andrew Lansley claimed on his website that he was “responsible for the Conservatives becoming the most trusted party with the NHS,” after a Harris poll, just before the General Election, “showed that 27% of people believed the Tories would be the most effective party to manage the NHS compared with 26% for Labour.”
The Observer also noted that the Tories received more damaging news on Saturday “after a leaked letter from the NHS’s deputy chief executive, David Flory, revealed that 30 acute care trusts failed to meet the required standards on 18-week waiting times last year.” Flory described it as “unacceptable for performance to fall below the expected standards,” and the Guardian explained that, in November 2011, 29,508 admitted patients waited longer than 18 weeks for treatment, which was “8,846 more than in May 2010, a 42% increase.”
Summing up this particularly disastrous week, Andrew Cooper, Downing Street’s director of strategy, was described as being “highly concerned about the potential for the Tory brand to be ‘detoxified’” if the bill is forced through Parliament in the face of such overwhelming opposition from health professionals, but it may be that the bigger problem for the Tory party is Cameron’s own MPs. One told the Observer, “The party is now bankrupt [on this issue] and has run out of credit with medical and nursing professionals and with the public. At a meeting of Tory MPs I attended last week there was a realisation that we can’t win an outright majority next time unless we have credibility on the NHS.”
Personally, I would hope that, by the next General Election, this incompetent bunch of swaggering butchers, who already have no outright majority and no mandate, will be further discredited, but I have no objection to Tory MPs, worried about losing their seats in the wasteland of Tory Britain, in which there are ever diminishing job prospects, wrecking this bill in the hope of saving their skins.
Note: To keep up pressure on the government, please sign the 38 Degrees petition (which currently has over 500,000 signatures), and the Keep Our NHS Public e-petition on the government’s website (which currently has nearly 65,000 signatures, and needs 100,000 to qualify for a debate in the House of Commons).