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Editor’s blog Wednsday 13 April 2011: Relying on the confidence of nurses

Today, the Royal  College Of Nursing Annual Congress will debate a motion of no confidence in Secretary Of State For The Time Being Andrew Lansley.

He will not address the conference, choosing instead to listen to a carefully-screened 'respectful' group of nurses.

In A Streetcar Named Desire, tragic anti-heroine Blanche DuBois memorably exited to the line "I have always depended on the kindness of strangers".

In A Bill Named Disaster, will comic anti-hero Gris Cheveux's exit line depend on the confidence of nurses?

It might. The media scent blood, and will be filming what they can of Our Saviour And Liberator's arrival and exit.

The Congress is also being streamed online, with unrestricted access, at the RCN website. This is, as the BMA discovered with their recent SRM, a good way to a) extend your reach, and b) put heavy manners on your delegates to consider how their actions and words come across.

I wrote at the time of the BMA's SRM that "Lansley is safe for now, until the waiting times go north and the money goes south". Both areas are starting to look distinctly iffy.

There has also been the humiliation of the pause.

It is also interesting to see the BBC's political correspondent for BBC East Anglia Andrew Simclair write on Twitter, "this is pure unfounded speculation, but three people have now suggested to me that Andrew Lansley is moved in reshuffle and replaced by Norman Lamb".

BBC East, of course, covers Lamb's constituency of North Norfolk.

The politics of putting Norman Lamb in look challenging - it would be pretty unpopular with the more party-chauvinist Conservatives.

Then again, Mr Lansley is not currently an enormous hit among that group either.

PM David Cameron will be watching Lansley closely. He agrees with the reforms' emphasis on competition and choice. Yet he is also making calculations about how much political capital is sufficient investment in Mr Lansley. Like a hedge fund manager, Mr Cameron will have a short position ready for the passing of the tipping point.

Could nurses tip the balance?

The present pause for consultation, which has come following the summer-long White Paper consultation last year and the Bill's first and second Commons readings and Committee stage, makes such an outcome look much less unlikely than, in the abstract, it otherwise might.

UPDATE: RCN Congress motion of no confidence in Andrew Lansley carried by 98%.