Has Lansley seen the light?

Tiberius

My reservations about sweeping supply side reforms in health and education stem from a kind of resignation about the likely chances of success. I don't see any value to fleshing out radical policies if the usual vested interests (the BMA, the LEAs, and the Trade Unions) are going to frustrate you. I've always thought that these two areas of policy will need to be changed incrementally because change can only be achieved by taking the pressure groups with you or, at least, by winning a series of battles rather than a whole war in one go. Blair came to office promising the earth, but he not only had those factions to deal with, but Brown and the Labour Party. He's almost a forgotten man now. I do, of course, welcome the Tories proposals on education, and will welcome similar radicalism over health, even if it's taken the EU to open it up, but they may suffer huge strife. But if Cameron and his team think they can effect change in one Parliament, great: it's what the country needs but it's risky not only for the Party, but for the country, since failure would leave the vested interests further entrenched than they are now, a state which the incremental approach is far more likely to avoid.

Bert Puttocks

I just Googled "muscular supply-side reform agenda with the Swedish voucher system" and, apart from Fraser's post, my computer blocked the first twelve sites.

David Lindsay

Has anyone who does not read the Spectator, or at least the Telegraph, actually heard about Cameron's voucher system? Expect an extremely watered-down version, if any, in the manifesto. And anyway, why are you so keen on the obvious beginnings of an EU Health Service? Apart, I suppose, from the fact that it will never work, just a US Health Service would never work: only national sovereignty can restore social democracy to Europe, just as only states' rights, as advocated by Ron Paul, can bring it to America, state by state, spreading rapidly by example.

pabw

I think that's wishful thinking Fraser. The interesting contrast between education and health policy is that currently the essential message for education is 'power to the parents,' whilst for health is 'power to the professionals.' I don't believe this will reflect any great change in policy. Cameron understands that such contrasting positions reflects majority view. He would never say 'power to the teachers' (obviously) but I'd be suprised if he changed his stance on health. Too easy a target for Brown.

Fraser Nelson

David, you cut to the core of the Tory problem. No one does know about their plans, they've done a dire job of explaining - and I know some Shadow ministers who dont even know. Still you'd be amazed how many Tories are deluded into thinking that just because they've printed a "green paper" on this the plans are understood by the public. They have little idea how little attention the public pays to politics in general, and them in particular. Who, apart from a few freaks like me, knows what on earth the Swedish system is? Tiberius: I agree in general. If you tell the public sector to reform it won't. But Sweden set up a new breed of schools, when they got to 10% of the total it reached a tipping point when other schools shaped up or lost pupils. The only way to reform the state-runs sector is to give it palpable competition. Which is what the Tories wld do for education (and, who knows, after today, the EU for health). Bert, just as well you didnt do a google image search. But your computer does seem to be unduly censorious. Do you work for the DoE or something? I hear it's got a Pravda filter. And pabw, I agree. Yes it is wishful thinking. But doesnt everyone get to make a wish for Christmas?

TGF UKIP

Fraser, I was and am highly sceptical over Education Vouchers being "policy" - floated again yes, but " Party Policy", well I am surprised. Perhaps, though, it was intended to be so well buried that it remained a "hidden secret" rather like their disgraceful support for state party funding. On health reform, I'm afraid that once again I disagree with Tiberius and yourself on an incremental approach. The reason? simple, I have much greater faith in the determination and stickability of the unions, the professionals, the sundry tax payer funded "patients groups" the other parties and their friends at the BBC than I do in the willpower of this bunch of Tories to see such a policy through. If (and it's a huge "if") they do want to embark on any seriously radical conservative policies they have but one choice and that is to win an explicit manifesto mandate for it/them. This is not entirely fanciful. If a serious recession with unemployment and negative equity does ensue, Labour's support will collapse and full focus will be on the Brown Sea of Debt with "billions spent, billions wasted" on the NHS and Education as the most mountainous waves in that sea. Radical reform will, therefore, be a legitimate subject, but most important of all at that election the people would simply be voting against Labour and manifesto content would be almost entirely irrelevant (except of course that the Tory extreme SocDems would as usual do their best to undermine and sabotage any genuine conservative proposals.) One final thought is that in any discussion on health spending the figure I never see used is the one that would mean most to most people - i.e. the NHS costs each household over £5,500 per annum. Question - do you feel you get value for your £5,500 each and every year?

Caroline

How would anyone know if they've had their £5,500 of NHS household value unless they know the price of a visit to the GP, an MRI scan, a baby delivered, the cost of prescribed drugs? Better to do a price list and then we'll be able to calculate it. Or give out a written cost at the end of every completed treatment. Otherwise it's a silly and unquantifiable question.

Tiberius

Fraser: yes, the Swedish model could remove the LEAs from the equation, but you would still have a teaching profession drawn from British teacher training colleges and universities, and represented by the NUT, UWT and the rest. Did Sweden have equivalent groupings, I wonder, and if so, how were they persuaded that indeed the state did not know best? TGF: the incremental approach is borne out of pragmatism. Radicalism is preferable. For my money, if Cameron has to pick a fight early in any premiership of his, it has to be with the public sector unions over pension rights. It is a subject which appears only fleetingly in the news, but I consider the projections for public sector pension liabilities to be so jaw-dropping, that they should be considered on a par with Blair's clause 4 moment and Mrs Thatcher's fight with the miners. Not only are the national finances severely threatened by them, but the inequality with the private sector provision (thanks to genius Chancellor Brown) simply has to be levelled out.

Fraser Nelson

Caroline, the NHS do a price list - called the "NHS Tariff". Its artifically low, though, it doesnt include overheads and stuff like pension costs factored into the prices of BUPA etc. Even this fake cost list allows us to trace the hyperinflation which has gripped the NHS since the "investment" tap was turned on in Apr00. TGF, I hope the first Tory gvt will prove Tiberius and myself right. Tiberius, Swedish unions make ours look like the Adam Smith Institute. They started out opposing choice, but were forced to accept it later when it was clear that teachers in the "free schools" (as they're called - free as in 'independent') are better paid and work better hours. Teachers would hugely benefit from the Tory proposal: it is, in effect, a vote of confidence in them. And I suspect I depart from most CoffeeHousers in saying that'd be a good thing.

TGF UKIP

Tiberius, I entirely agree that public sector pensions are the pre-eminent causus belli but I would again maintain that the subject is best tackled before rather than after an election. It is so central that it will need to be a specific mandate if it is to be successfully tackled. All those public sector strikes will reasonably be able to claim legitimacy and media and public support without a mandate. With one, even the BBC would be hard-pressed to support the strikers. Moreover, there is no chance of the Tories getting through an election campaign without this being brought up by Labour as a major issue to bolster their client vote. The Tories, and Osborne in particular, have been on TV too often to say that the 06 settlement cannot stick, for Labour not to raise it centrally in a GE. Better by far therefore to raise it on the front foot rather than be put on the backfoot by a Labour bouncer with a bit of mendacious spin added. Should, God forbid, the Tories win, they are going to be faced by hostile unions, a recalcitrant, sulky and leaky pro-Labour civil service, a set of professionals determined to derail any reforms that may threaten their special interests and a broadcast media only too willing to provide the lot of them with succour and support. The Tories cannot hope to glide through an election and a first term of govenment in the hope of a bigger majority for second term real reform. Nor should they be afraid of fighting on this front. As I have posted recently the Tories appear to forget that even after Brown's massive expansion, the public sector still accounts for only 25% of employees. Rather than sucking up to them as Dave has done ("we promise to respect and refer to the customs and working practices of the public sector" or words very similar) they should forget them and instead concentrate on the other 75% of increasingly resentful employees and taxpayers. The looming economic crunch is going to provide the perfect opportunity to go on the offensive on these issues. Not that your SocDems will, of course, Tiberius.