Fraser Nelson

Can Cameron afford Lansley?

Can Cameron afford Lansley?
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Is Andrew Lansley using his untouchable status* to bounce David Cameron into a three-year budget settlement? On the Marr sofa (or the Sophie Raworth sofa as it was today), he announced that the Tories are planning "real term increases to the NHS year on year." Well, David Cameron has only said he would protect health from cuts - but he has not specified how long for. It could be as little as one year.

In my political column for this week's magazine I recommend Cameron keeps uses this to wriggle out of what is now an unaffordable promise. He should freeze NHS spending for a year, then take a scalpel to it. When Lansley first gaffed about how protecting health cuts would mean 10 percent cuts, there was a key part to this overlooked at the time. The 10 percent calculation, which was first aired here in Coffee House, was on the premise that Cameron would protect the NHS budget for all three years, Apr 2011 to Apr 2014. And it was made on the assumption that Lansley's Cabinet colleagues would have to eat the cuts - and his precious NHS bureaucracy would be safe. So in using the 10 percent figure, he was bouncing Cameron into a position further than he stated. The thinking in Norman Shaw South (the Cameroons' nest) is that Lansley is incapable of such cunning, so they are inclined to forgive him. I'm not so sure. I do detect a trend. He seems locked in Labour's mentality - that if something isn't up to scratch the answer is "more money". As he told Raworth:

"...we have outcomes for health in this country that are not yet as good as elsewhere in Europe, for example, and they need to be better, and we need the resources to make them better."

It is this logic which Cameron simply cannot afford - especially from a man who will be running a budget that consumers a quarter of all departmental expenditure. Britain is ageing, Lansley says, ergo the state needs to spend more on health. That's about as sophisticated as his logic gets. It's a line of argument that could have been drafted by the NHS Confederation (and probably was).

Lansley is a clever, amiable guy who has a solid background as chair of the Conservative Research Department. I do wonder how he went so native. It is said that any minister who spends enough time in the Foreign Office becomes pro-Europe and anti-Israel. Spending time with the NHS now seems to have the same effect: spending is seen as a good in itself. What business director would proudly say "my aim is to ensure there are no reduction in costs?" At the spring conference, Cameron said he wanted his ministers to be representatives of the government in their departments. Lansley seems to have this the wrong way around. At this rate, Lansley is fast becoming the single most expensive member of David Cameron's team. He may be a casualty of an

attempt to find the savings so desperately required.

* When Cameron said that Lansley and Osborne would definitely be health secretary and Chancellor respectively - in a bid to show how he doesn't chop and change - Ben Brogan dubbed them "untouchables" - a label which was widely picked up, to the fury of the Cameroons. It coincided with Lansley being a lot more careless in what he said to the media. I'd link to it but the Daily Mail has locked all Brogan's old blogs. The hackers amongst you can access it here.