David Blackburn

Those three little letters

The NHS saga is over at last, or so the government hopes. The coalition is expected to adopt the recommendations of the NHS Future Forum, which have been delineated by panel member Stephen Bubb in this morning’s Times (£). Last night, the prime minister and his deputy addressed their respective parliamentary brigades and each claimed the credit for re-shaping Andrew Lansley’s bill for partisan gain.

The political saga continues. The Lib Dems have been crowing over their victory; the Tories are licking their wounds –a voluble Conservative MP has told Philip Johnston that a ‘once in a generation opportunity to reform the NHS has been lost.’ Some of the anger may be synthetic, a prefabricated ruse to enable the Lib Dems to recover from last month’s electoral catastrophes. Nonetheless, the coalition remains fractious.

In terms of long-term strategy, the u-turn is supposed to insulate Cameron from the charge that the Tories can’t be trusted with the NHS. Before the 2010 election, the Tories were more trusted on the NHS than Labour; but, as Jonathan has noted, polling suggests that the public perception has altered dramatically. The poll embodies the danger of fiddling with the sacrosanct NHS.

Events may now conspire against Cameron. Lord Warner, a health minister in the Blair government, was on the Today programme this morning worrying that constrained competition would impede efficiency. It is a familiar call: the NHS must find 4 per cent in efficiency savings year on year to save the health service from plunging into a morass of unsustainable debt. As Andrew Grice argues in this morning’s Independent, if the impaired reforms do not deliver savings then the quality of care will likely diminish. In that event, voters will probably hold the government that defiled the beloved NHS responsible. No Labour leader could waste such good fortune, no matter how inept. Tony Blair bore the scars of public service reform on his back; David Cameron may yet have those three letters, NHS, branded onto his. 

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