Being the second
in an occasional series. Part one is available here.
Let me see if I can get this straight. The British Conservative Party has not won a general election since 1992, in part because the voters did not trust it to run the NHS. Ever since David Cameron became leader, the Tories have made a mighty effort to stop health destroying their electoral hopes. Through no fault of his own, David Cameron could not rebut the suspicion that toffs with private insurance would leave the common man and woman to suffer and die in under-funded NHS wards, by pointing to his family’s unhappy history. Because of the sickness of his son, he was able to say that he had seen the NHS up close, and came to admire its staff and its principles. Cameron did not win the 2010 election, but the NHS, the club with which Labour has battered the Tories for a generation, was no longer a weapon the left could wield against you. If the NHS was raised in any of the three prime ministerial debates, I am damned if I can remember when. Certainly, it was never a big issue in the campaign. The detoxification process was a success.
George Osborne backed up Cameron as soon as he entered the Treasury by ring fencing the health budget. I imagine the conversation with his permanent secretary Nicholas Macpherson went something like this:
Permanent Secretary: “It is my duty to warn you Chancellor that you will have to impose far more severe cuts on defence, education and social security if you are to stick to your promise.”
Osborne: “I know, I know, but this is politics, Nick. I have to silence the canard that we want to destroy the NHS. The ring fence is the price I must pay to keep the NHS off the front pages. It allows us to dream of winning a majority once again.”
In my Observer column today I point out that the NHS is likely to be on the front pages for as far ahead as you can see. The Lansley “reforms” fail all kinds of tests. As the Commons Health Committee points out, the coalition is trying to do two complicated things at once: impose an unprecedented efficiency drive on the NHS, at the same time as Lansley smashes its structures, throws the pieces up in the air and sees where they come down. The chances of failure are high, and the chance of institutional breakdown cannot be written off. Much of what Lansley wants to do, can be described as “privatisation,” and, trust me, although Spectator readers may think that privatising NHS services is worth a try, the public does not.
In my piece, I repeat the speculation that Lansley has become the Conservative Party’s Nick Leeson:
‘There’s a feeling at Westminster that Lansley is now a rogue middle manager. Not to put to fine a point on it, seasoned observers believe that he’s howling at the moon and imagining he’s Napoleon Bonaparte. Cameron ordered his former boss to prove that the Tories could be trusted with the NHS by doing nothing controversial. But Lansley saw Michael Gove win applause from the Conservative press for his “schools revolutions” and Iain Duncan Smith win applause for his “welfare revolution” and thought: “I, Andrew Lansley, don’t have to take orders from that pipsqueak Cameron, who once jumped to my commands. I want my name in the history books too. I want the Lansley Health Revolution!”‘
Tellingly, however, when I spoke to John Healey, Labour’s health spokesman, he was very anxious indeed to discount the “Lansley is off his rocker” thesis (if I may phrase it crudely). He did not want to single out the Health Secretary but to paint his unpopular and potentially disastrous health policy as all of a piece with the rest of the coalition’s reforms. You did not need a devious mind to understand that he wanted to use the NHS to besmirch your whole domestic strategy, and that soon the rest of the Labour front bench would be be doing the same.
Why aren’t you angry? You should be telling your leaders, “This was not in our manifesto. Lansley does not have a mandate. We won’t be able to blame the mess Labour left for trouble in the NHS now. Lansley is making it our trouble and our fault. Can’t you see that we are throwing away years of hard work, and making the worst mistake generals can make in battle: doing what our enemies want us to do.”
But instead of protesting, you encourage. I don’t understand you. Really I don’t. Do you have something against winning elections?
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