When facing an audience of ambulance workers in a speech last Friday, Andrew Lansley had the ideal joke to warm them up. ‘People always imagine politicians are a bit brain dead,’ he said. ‘Well I am — and I have the MRI scan to prove it.’ He was being absolutely serious. In a freak medical incident while playing cricket in Kent 14 years ago, the shadow health secretary became one of the 150,000 people in Britain to suffer a stroke.
While he has made no secret about his condition, few in Westminster are aware of it. Yet plenty of clues exist for those with an eye to see them. Mr Lansley chairs the all-parliamentary group for stroke, and has bombarded ministers with questions on the subject for years. Even when he was a backbencher it seemed to be a preoccupation for him. Reclining in the chair of his sparsely decorated Commons office, he explains how his near obsession with the subject has been fuelled by more than professional interest.
‘All of us have journeys, some series of incidents in our lives which impact on us,’ he says. His journey dates back to the summer after the 1992 general election, when he was not the sensitive Tory moderniser he is seen as today. Then, he ran the Conservative research department and had a reputation as a right-winger in the mould of Norman Tebbit, whom he had served as a civil servant.
His all-star staff at the CRD included David Cameron as political secretary and Steve Hilton, now Tory communications director, as the graduate trainee. Ed Llewellyn, now Mr Cameron’s chief of staff, led the CRD’s foreign and defence section. Mr Lansley was running the group which is now running the Conservative party — and they had just helped John Major win a general election, against all expectations.
Three months later, Mr Lansley was playing cricket in Rochester on a Saturday. ‘I went to pick up a ball, stood up again and suddenly I couldn’t stand straight,’ he remembers. ‘I tried to stabilise myself on the pitch, but I had lost my balance. I walked down to the pavilion and sat down, but it got progressively worse.’ He collapsed and was taken to hospital where he was diagnosed with a simple ear infection and sent home the next day.
But his then wife, a junior doctor, was instantly suspicious. ‘She said I had no symptoms of ear infection, no raised temperature, nothing. Now it was true, and continues to be true, that if you have somebody who knows their way about, you can argue your way through the system without being dismissed by the authorities. We badgered the GP so much that he eventually sent me off to have an MRI scan.’
Lansley was referred to a private hospital, where the staff invited his wife to look at the scanning machinery, then quite new. ‘She is a doctor, so they talked her through it. They were all chatting away merrily as the results came in, then they suddenly all went a bit quiet. The pictures came up with bits of dead brain.’ It was thought at first that the cause was a tumour, but then the picture became clearer. At the age of 36, and in full health, Mr Lansley had suffered a stroke.
While most strokes are suffered by pensioners with heart disease, they also affect the young. For reasons Mr Lansley’s doctors have never managed to establish, a vein in his neck had been damaged and the blood had started to clot internally. When he picked up the cricket ball, a clot had temporarily blocked the blood supply to a part of his brain. He was shocked by the randomness of it all: had blood been denied to a different area of the brain he could be paralysed or worse. ‘It could have killed me. It was just a chance event that the net result for me was just losing my balance.’
His decision to talk about his condition fits a pattern of behaviour in the Cameron Conservatives. At a time when the party does not have a health policy, Mr Lansley has the unusual job of championing ideas which do not yet exist. But he can pick themes and plot personal narratives, which are increasingly considered more powerful than political policy.
Mr Lansley’s story highlights a notorious flaw in the NHS: that he only had proper treatment because he was married to a doctor and able to bully his local GP. The Tories could always produce a research paper showing that poorer people are treated worse by the NHS as they are less likely to have such expertise — but it is personal anecdotes and individual cases which are being used to get the broader message across.
Mr Lansley is taking his campaign a stage further. Next Tuesday, the House of Commons public accounts committee will publish a report on how stroke patients are treated by the NHS and asking how many people could be spared paralysis if they were treated with the same urgency as heart-attack victims. If suspected stroke victims are detected and scanned within three hours, there is a chance of removing the blood blockage and minimising brain damage. Mr Lansley has the figures: 75 per cent of stroke victims in New York are given a brain scan within three hours, but in Britain just 0.2 per cent are treated as emergency cases.
So there may not be a Conservative health policy, but we can have individual Conservative health campaigns designed to give a flavour of what that policy would be when it arrives. The NHS failure to catch up with other countries in treating stroke, Lansley says, is indicative of its bureaucratic culture which a Conservative government would change. ‘Nobody is rewarded for being enterprising; you just do your thing and travel in the middle with everyone else. You don’t want to be an out-rider, you just keep your head down. And I think that’s a real shame.’
But how would a Conservative government act differently? Here Mr Lansley is at a disadvantage. Until Oliver Letwin’s policy group reports by the end of next year, he will have no idea. He indicates that he will not necessarily adopt the findings of the health review group, and has been developing ideas of his own in the last few months. This is another indicator of the crunch that will come when Mr Cameron’s policy groups publish results which will clash with each other, and with the views of their relevant spokesmen.
When asked why he made the transformation from right-winger to mod, Mr Lansley looks almost offended. ‘I still believe in the free market,’ he says. But he dates back to 2001 the speeches he started giving in support of the modernising cause — he had backed Kenneth Clarke in the leadership race that year and refused to serve under Iain Duncan Smith. He also remarried that year, and his fifth child was born last year. Pictures of his children are one of the few adornments on his wall. ‘I’m doing my bit to defuse David Willetts’s demographic time bomb,’ he laughs.
It is an unusual trait of the present shadow Cabinet that most wish to stress how much they want to keep their jobs until the next general election. Mr Lansley is no exception, saying he asked both Michael Howard and David Cameron to be put in for health. ‘People say politics is about that greasy pole and you don’t climb up it unless you move jobs. Well, I’m not interested in all that. I find health endlessly fascinating,’ he says. He declares no ambition other than to do the same job in government.
It was not always thus. This time last year Mr Lansley was being encouraged by people like Mr Letwin to stand for party leader and was giving it serious consideration. ‘I was not sure that David Cameron would physically be able to demonstrate that the party had changed,’ he says. But he decided against standing, thinking that his strengths would be better championed by other candidates.
‘If you wanted the purely intellectual approach, you would have David Willetts — if not him, then me. If you wanted a moderniser, then you’d say David Camer on. If not him, then me. And if you wanted a social liberal, you would choose Ken Clarke — if not Ken, then me. I was the second choice on each of these parameters.’ But as a future Tory health secretary, the man who escaped death that summer afternoon in Rochester seems ideally qualified.