Lansley stands up for his reforms

If there’s anything that stands out from Andrew Lansley’s interview with the Sunday Times (£) it is his air of quiet defiance. Of course, the Health Secretary sounds some of the conciliatory notes that have crept in to the government’s rhetoric since they decided to pause, listen and engage on NHS reform. But he also stands up for the original reforms as he conceived them. “From my point of view,” he says, “the White Paper was setting out what sensible, intelligent people inside the NHS were saying.” For him, the concerns that remain are not with the general thrust of his reforms, but with “implementation, the nuts and bolts of how it will work.”

Lansley also makes sure to bind Cameron into the White Paper. “David and I go back 20 years,” he stresses, “and every step of the way we’ve worked together on this.” But are the two men in accordance now? We shall be better able to judge after the Prime Minister’s speech tomorrow, but the early signs are that he might sound vaguely Lansley-esque: defending the principle of NHS reform against the eroding demands of the Lib Dems.

The real question, though, is whether this defiance is merely a front, or whether Lansley’s NHS reforms will actually be spared from the “substantive changes” that Nick Clegg has in mind. As it stands, the only change that we can be confident of is that the GP consortia will be broadened out to include nurses, local officials and the like. For the rest, nothing is really clear, and we shall probably have to wait until the current listening exercise is at an end. Only then will we be able score the Lib Dem victories, the Tory victories, and where the public has lost out.