Editor's blog Wednesday 17 November: Dorrell decoded
If you haven't already read Sally Gainsbury's HSJ interview with health select committee chair (and ex-Health Secretary Stephen Dorrell, you should go and do so now.
It contains a big, unmistakable message.
Some will see it as Dorrell explicitly becoming the health policy Yosser Hughes of the Conservative Party: "gizza job ... I can do that" (though in the interview, he denies the ambition).
Less charitably, others may regard him as The Fast Show's Competitive Dad - "you don't want to do it like that!"
Dorrell's unmistakable message (echoing his questions and comments in the sessions on commissioning with the health select committee) is that he thinks the White Paper is, in the wonderful Whitehall euphemism Yes, Minister-speak, 'round objects'. And quite possibly dangerous round objects.
Dorrell explicitly states, “This reform of commissioning is important up to and only in so far as it reinforces the capacity to deliver the Nicholson challenge (the £15-20 billion un-spend by 2014). If you get that wrong, healthcare delivery is at risk". Scant ambiguity or room for interpretation there.
He also told HSJ that the White Paper's policy requires “a different narrative ...(as a) means to an end”. Asked if Equity And Excellence offer the best means, Dorrell replied (with 'deliberate emphasis', as Gainsbury notes) “I think my answer is we’ve got to make it the best way, because it’s the one the government has chosen and time isn’t on our side”.
He repeatedly and fundamentally challenges Lansley's ideas on decentralisation of power - which are the core of Equity And Excellence. "I’m in favour of liberalising the system, but I’m not in favour of imagining the secretary of state isn’t ultimately accountable for what’s delivered tomorrow morning in surgery in every part of the NHS, because he is ... Nobody should believe [he] makes all the decisions; but he is accountable for the structures under which those decisions are made. And if the structure delivers [negative] outcomes, you get into that world where you find yourself on the Today programme, quite rightly”.
This is the absolute, polar opposite of the White Paper's vision.
Over to you, Liberator
If Lansley accepts this public dissing meekly, he confirms himself as a lame duck. Orange sauce, anyone?
And Dorrell? In the interview, he denies any ambition to return to the job he once held claiming this gives him license to speak his mind.
Does ambition expire so gracefully in an experienced, front-line politician?
We will see. Perhaps quite soon.
But as we have mentioned previously, he looks very well-positioned if The Liberator were, politically speaking, to fall under one of those double-decker buses that chug down Whitehall.