NHS reforms: a lesson in how not to do it

In assuming that Andrew Lansley had it all in hand, David Cameron and Nick Clegg have taken an enorm

"It all seems slightly dramatic to me, but I tend to hope that Lansley knows what he's doing," sums up what friends in the Conservative Party have said to me about the NHS reforms over the past few months.

This remains the danger within any government: to assume someone else is getting on with it and knows what they are doing. I remember a friend in the Labour Party once saying to me, as we debated during the lead-up to the Iraq war, "The thing is, I trust Tony. I assume he knows what he is doing." Well, the rest, as they say, is history.

Within government, within cabinet, everything should be challenged and nothing assumed.

The NHS reforms are turning out to be the perfect example of how not to do it. In assuming that Andrew Lansley had it all in hand, David Cameron and Nick Clegg have taken an enormous risk. Simply sending in their policy lieutenants from No 10 in the early days of drafting was an insufficient response.

It is these bread-and-butter issues – welfare, health, education and crime – that the Prime Minister and the Deputy Prime Minister need to challenge and challenge again until they are satisfied that the policies are right.

If either leader leaves this to others, they will be left with the results, good or bad. Getting the policies right is everything; presentation comes later.

With the Treasury totally tied up with structural deficit reduction, and the Cabinet Office pushing through so many other reforms, the fundamental challenge of these bread-and-butter issues is in severe danger of getting lost.

We are left with the impression that policy is continuing only because it has started, not because it is coherent. We are in danger of driving through a policy that is not a left or right issue, but one that places too much power in the hands of the producers – the GPs – rather than patients themselves.

We now are in a situation where uncertainty means that people will get the impression that the whole reform is a mess.

I remain convinced that we are oversentimental about any discussion regarding the NHS and that the issue is one of behaviour rather than structure. The interview by Claire Rayner's son Jay on the Today programme this morning (starts at 2hrs, 14mins, 25secs) about training people in compassion in the NHS said it all.

Then again, all that said, this is an early lesson for the coalition about the failure to challenge, and assumptions from the very top.

Olly Grender was director of communications for the Liberal Democrats between 1990 and 1995.

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Tony Blair suggests second EU referendum: "Remain voters are not an elite"

The former Labour PM said the facts of Brexit may change minds. 

Tony Blair has floated the idea of a second EU referendum after the terms of the Brexit deal has become clear.

The former Labour Prime Minister told the BBC "you can't just dimiss the 16m people" who voted Remain.

He said: "If it becomes clear that this is either a deal that doesn't make it worth our while leaving, or alternatively a deal that's going to be so serious in its implications people may decide they don't want to go, there's got to be some way, either through Parliament, or an election, or possibly through another referendum, in which people express their view."

Asked whether he was telling the 17m voters who wanted to leave the EU that they were wrong, he said: "You can't just dismiss the 16m people either and say their views are of no account. 

"And by the way, that 16m don't represent an elite, they represent people who genuinely believe that in the 21st century for Britain to leave the biggest political union and the biggest commercial market right on our doorstep is a serious mistake."

There is no way the Brexit decision can be reversed "unless it becomes clear that once people see the facts they change their mind," he said.

Julia Rampen is the editor of The Staggers, The New Statesman's online rolling politics blog. She was previously deputy editor at Mirror Money Online and has worked as a financial journalist for several trade magazines.