Lansley needs to get his quiet friends talking

Is Andrew Lansley hearing rather than listening? Dame Barbara Hakin, one of the Department of Health’s national managing directors, has written a letter to some GPs that suggests the pace of health reform will not be affected by the ‘legislative pause’. Hakin writes:

‘Everyone within the Department of Health is very aware of the support shown by the GP community to date and we have been struck by the energy and enthusiasm demonstrated in pathfinders across the country. Therefore, although the Government has taken the opportunity of a natural break in the passage of the Health and Social Care Bill, we are very keen that the momentum we have built to date should not stop.’

On the face of it, this is another PR disaster for the hapless Health Secretary. But that perception is misleading. The letter was sent to ‘pathfinder’ consortia: the thousands of GPs’ surgeries across England that are eager to take control of commissioning. The government is determined not to dilute the fundamentals of the NHS reforms; therefore, it must press on with its key allies in the health service. And, as you can see from the map of pathfinder consortia below, the government is not short of friends.

Besides, Lansley hasn’t simply dreamt these reforms up. Pockets of GP commissioning already exist and they are being used as an example to aspiring consortia and recalcitrant sceptics alike. The government can’t sit on its hands until the end of the pause, especially as the reforms’ fundamentals are expected to survive largely unscathed. It would be far more damaging if the government lay inert for months and then had to rush towards implementation in 2013. Improvements and amendments, it is argued, can be added later.    

So, this letter is not all that surprising. However, there is no explanation why the government is so reticent about its allies, especially as the opposition is voluble and organised. This leaked letter looks like a PR disaster for Lansley; and, in a sense, it is.