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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Want to send a positive Brexit message to Europe? Back Arsene Wenger for England manager

Boris Johnson could make a gesture of goodwill. 

It is hard not to feel some sympathy for Sam Allardyce, who coveted the England job for so many years, before losing it after playing just a single match. Yet Allardyce has only himself to blame and the Football Association were right to move quickly to end his tenure.

There are many candidates for the job. The experience of Alan Pardew and the potential of Eddie Howe make them strong contenders. The FA's reported interest in Ralf Rangner sent most of us scurrying to Google to find out who the little known Leipzig manager is. But the standout contender is Arsenal's French boss Arsene Wenger, 

Would England fans accept a foreign manager? The experience of Sven Goran-Eriksson suggests so, especially when the results are good. Nobody complained about having a Swede in charge the night that England won 5-1 in Munich, though Sven's sides never won the glittering prizes, the Swede proving perhaps too rigidly English in his commitment to the 4-4-2 formation.

Fabio Capello's brief stint was less successful. He never seemed happy in the English game, preferring to give interviews in Italian. That perhaps contributed to his abrupt departure, falling out with his FA bosses after he seemed unable to understand why allegations of racial abuse by the England captain had to be taken seriously by the governing body.

Arsene Wenger could not be more different. Almost unknown when he arrived to "Arsene Who?" headlines two decades ago, he became as much part of North London folklore as all-time great Arsenal and Spurs bosses, Herbert Chapman or Bill Nicholson, his own Invicibles once dominating the premier league without losing a game all season. There has been more frustration since the move from Highbury to the Emirates, but Wenger's track record means he ranks among the greatest managers of the last hundred years - and he could surely do a job for England.

Arsene is a European Anglophile. While the media debate whether or not the FA Cup has lost its place in our hearts, Wenger has no doubt that its magic still matters, which may be why his Arsenal sides have kept on winning it so often. Wenger manages a multinational team but England's football traditions have certainly got under his skin. The Arsenal boss has changed his mind about emulating the continental innovation of a winter break. "I would cry if you changed that", he has said, citing his love of Boxing Day football as part of the popular tradition of English football.

Obviously, the FA must make this decision on football grounds. It is an important one to get right. Fifty years of hurt still haven't stopped us dreaming, but losing to Iceland this summer while watching Wales march to the semi-finals certainly tested any lingering optimism. Wenger was as gutted as anybody. "This is my second country. I was absolutely on my knees when we lost to Iceland. I couldn't believe it" he said.

The man to turn things around must clearly be chosen on merit. But I wonder if our new Foreign Secretary Boris Johnson - albeit more of a rugger man himself - might be tempted to quietly  suggest in the corridors of footballing power that the appointment could play an unlikely role in helping to get the mood music in place which would help to secure the best Brexit deal for Britain, and for Europe too.

Johnson does have one serious bit of unfinished business from the referendum campaign: to persuade his new boss Theresa May that the commitments made to European nationals in Britain must be honoured in full.  The government should speed up its response and put that guarantee in place. 

Nor should that commitment to 3m of our neighbours and friends be made grudgingly.

So Boris should also come out and back Arsene for the England job, as a very good symbolic way to show that we will continue to celebrate the Europeans here who contribute so much to our society.

British negotiators will be watching the twists and turns of the battle for the Elysee Palace, to see whether Alain Juppe, Nicolas Sarkozy end up as President. It is a reminder that other countries face domestic pressures over the negotiations to come too. So the political negotiations will be tough - but we should make sure our social and cultural relations with Europe remain warm.

More than half of Britons voted to leave the political structures of the European Union in June. Most voters on both sides of the referendum had little love of the Brussels institutions, or indeed any understanding of what they do.

But how can we ensure that our European neighbours and friends understand and hear that this was no rejection of them - and that so many of the ways that we engage with our fellow Europeans rom family ties to foreign holidays, the European contributions to making our society that bit better - the baguettes and cappuccinos, cultural links and sporting heroes remain as much loved as ever.

We will see that this weekend when nobody in the golf clubs will be asking who voted Remain and who voted Leave as we cheer on our European team - seven Brits playing in the twelve-strong side, alongside their Spanish, Belgian, German, Irish and Swedish team-mates.

And now another important opportunity to get that message across suddenly presents itself.

Wenger for England. What better post-Brexit commitment to a new Entente Cordiale could we possibly make?

Sunder Katwala is director of British Future and former general secretary of the Fabian Society.