Reassurance — that’s what the happy trio of David Cameron, Nick Clegg and Andrew Lansley sought to emit during their NHS event earlier. And reassurance not just about where the coalition is taking the health service (although there was plenty of that), but also about the “listening exercise” they are engaging in now. Although all three men suggested that the broad scope of the NHS reforms would remain — decentralisation, greater responsibilities for GPs, and all that — they also hinted that “substantive” changes will be made to the Bill as it stands.
As for what those changes will look like, there were few specifics. Yet it did sound as though the coalition is dwelling on the recommendations made by the health select committee yesterday. Both Cameron and Clegg implied that the GP consortia could be broadened out to involve hospital doctors, nurses and local councillors as well. A Lib Dem councillor, Richard Kemp, has since reinforced that impression.
Politically speaking, this is probably a tempting escape route for the coalition. Sure, it would mean chipping away at one of the keystones of Lansley’s new architecture. But it would also satisfy the Lib Dems’ council-centric brand of localism, and have the support of a cross-party Commons committee. Yet would it actually work in practice? The coalition’s stated aim is to remove undue bureaucracy from the system. Filling the GP consortia with all sorts of stakeholders, turning them into “local commissioning boards,” could work against that. Or at least that’s the fear.