3 min read

Editorial Tuesday 7 February 2012: Mr Lansley's cavalry ride to the rescue: his political hero and the PM

I'd forgotten how much fun a bit of Health Bill action can be.

The battle of the bylines continues, after this morning's not-very-good-for-morale Times car crash.


Click here for details of 'Taking the pith out of the Health & Social Care Bill - “Integrate my chutzpah”, says Andrew ‘Not Looking For  A Fight’ Lansley', the new issue of subscription-based Health Policy Intelligence.


The battle is joined by two important advocates for Andrew Lansley (saviour, liberator).

The first is his political hero, Lord Tebbit.

The second is his boss, the Prime Minister.

Holding out for a hero
Lord Tebbit writes in the Telegraph that his former principal private secretary "has won the right to see his NHS reform Bill be given the chance to work". The reasoning behind this is, I think you will agree, a must-hear.

He adds that the Health Secretary has "alongside the Home Secretary, one of the two big jobs in government that are all but guaranteed to bring unpopularity to their holders".

Tebbit paints a candidly nuanced picture of the variable reality of the NHS: "The NHS is one of our great institutions ... full of devoted staff giving their all for the care of patients. Yet it also has scandalous instances of mismanagement, terrible professional failures and downright neglect. There has to be something sick about an institution in which gravely ill patients can be left to die in filthy bed linen, without food, water or comfort. And there has to be something admirable about an institution in which so many staff go far beyond the minimum required of them".

Alas, Lord Tebbit's balance slips over the issue of NHS funding, saying that the NHS Mr Lansley "inherited from his predecessors was unsustainable. It had been lavishly financed by a government dedicated to the belief that more money would automatically bring improvements. To be fair, there were some, but while spending rose, productivity fell".

Wow. Where to start? With Labour's plans at the 2010 general election to reduce NHS spending to fund improvements in social care? With the fact that productivity inevitably falls as both spending and workforce were increased 2000-2010?

There is also confusion between Lord Tebbit's lines that the BMA "are entitled to look after the interests of their members, but they should recognise the extent to which some groups have done rather well in recent years", and yet "of course, when one is ill or injured, nurses and carers at their best are worth every penny, and more, that they are paid". Ummm ...

He also has a wonderfully Pooterish pop at NHS management: "jobsworth, politically correct, health and safety culture has been allowed to hinder effective management and best care practices". An example would be nice, but none is offered.

On other points, Tebbit is on firmer ground, such as "the use of the private finance initiative was, and shamefully still is, wrecking the balance sheets of many hospitals". He also concludes, "as a former minister responsible for nationalised industries, I worry about the difficulty of ensuring that where the public and private sector come into competition, it will be on a level playing field. There may be a need for more than a touch of tweaking to get it right".


Lord Tebbit then concludes that "to wreck the Bill and run away from the consequences, would be an irresponsible surrender to self-interest masquerading as the public interest. It will be a year or two before we can reach a verdict on every bit of the Lansley Bill. But his reforms surely deserve a fair wind. Mr Lansley has done his bit: he has, after all, won a steady increase in NHS funding when other budgets are being cut. Now it is up to those who work in the NHS to do theirs".

Errmmm ... let's see if I've got this right: Labour increase in NHS funding bad; Lansley increase in funding good? We'll have no idea whether this will work for years, but let's go ahead anyway?

Well, I'm reassured.

Flashman goes macho
In The Guardian, Juliette Jowitt and Patrick Wintour report that PM Cameron will "insist that the coalition will force its health and social care bill on to the statute book despite growing opposition within the NHS and the Conservative Party".

Oooh! That Nice Mr Cameron is coming over so macho! Has he been hanging out with Jeremy Clarkson more?

Jowitt and Wintour report that "Cameron is to undertake a series of NHS events next week, and is said to be confident that opposition to the bill in the Lords will be overcome. He is determined to set up the battle as one between a bureaucrat-run NHS and a doctor-run NHS".

This is the strategy. Oh yes. I laughed until I stopped.

More NHS events with the PM: brilliant! What could be better?

And a polarity between clinicians and bureaucrats is probably going to win NHS managers more friends in the clinical community than 'The Dark Side' would ever have believed possible. Aspiring clinical commissioners have spent the past eighteen months starting to look at all the work former NHS managers did, and realising that there is an awful lot of it - and much of it is profoundly thankless.