Questions for Lansley on abortion inspections

Did the Health Secretary put his political interests before patient care?

With the NHS bill finally making it onto the statute book and the media focused on the Budget, the past two weeks have been unusually peaceful for Andrew Lansley. But that's all changed this morning. The Health Secretary stands accused of diverting resources away from patient care by ordering the Care Quality Commission [CQC] to carry out unannounced inspections of more than 300 abortion clinics. The CQC has revealed that the £1m four-day inspection of clinics meant 580 inspections on other parts of the health service had to be "forgone".

In a sternly-worded letter to the Department of Health, Dame Jo Williams, chair of the health regulator, said: "Such a request at short notice entails operation’s management time in planning the visits, cancelling pre-planned inspections as well as the compliance inspector’s time in carrying out the visits and drafting the reports.

"Add to this the anticipated enforcement activity that will inevitably arise and it is clear that this has a considerable impact on our capacity to deliver our annual targets."

The suspicion among some is that the inspections were ordered by Lansley in a bid to placate the Conservatives' pro-life wing and to generate positive headlines.

The shadow health secretary, Andy Burnham, commented on the Today programme this morning:

It's hard not to draw the conclusion that the health secretary was desperately trying to get on the front foot. Nothing else explains why he gve the findings to a newspaper midway through this programme of visits that he ordered, and you may remember that this was the day when the home secretary had been brought to the Commons to make a statement on alcohol.

More strikingly, Stephen Dorrell, the Conservative chairman of the health select committee and the man often touted as a possible replacement for Lansley, warned that the "independence" of the CQC was in doubt:

I think we need to be clear whether the priorities of the regulator are genuinely determined independently by the CQC itself, or whether the priorities are determined by the secretary of state. Is it independent or is it not? I would argue it's very strongly in the public interest, as well actually as it being in the secretary of state's interest for it to be clearly established that the CQC is an independent regulator.

Shortly afterwards, Dorrell was attacked by Nadine Dorries, the leading Conservative pro-lifer, who accused him of putting "his own personal ambition above proffessional (sic) morality".

But it is Lansley who stands accused of putting his own political interests above patient care, a grave charge that he must now fully answer.

Health Secretary Andrew Lansley. Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

Photo: Getty
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The Prevent strategy needs a rethink, not a rebrand

A bad policy by any other name is still a bad policy.

Yesterday the Home Affairs Select Committee published its report on radicalization in the UK. While the focus of the coverage has been on its claim that social media companies like Facebook, Twitter and YouTube are “consciously failing” to combat the promotion of terrorism and extremism, it also reported on Prevent. The report rightly engages with criticism of Prevent, acknowledging how it has affected the Muslim community and calling for it to become more transparent:

“The concerns about Prevent amongst the communities most affected by it must be addressed. Otherwise it will continue to be viewed with suspicion by many, and by some as “toxic”… The government must be more transparent about what it is doing on the Prevent strategy, including by publicising its engagement activities, and providing updates on outcomes, through an easily accessible online portal.”

While this acknowledgement is good news, it is hard to see how real change will occur. As I have written previously, as Prevent has become more entrenched in British society, it has also become more secretive. For example, in August 2013, I lodged FOI requests to designated Prevent priority areas, asking for the most up-to-date Prevent funding information, including what projects received funding and details of any project engaging specifically with far-right extremism. I lodged almost identical requests between 2008 and 2009, all of which were successful. All but one of the 2013 requests were denied.

This denial is significant. Before the 2011 review, the Prevent strategy distributed money to help local authorities fight violent extremism and in doing so identified priority areas based solely on demographics. Any local authority with a Muslim population of at least five per cent was automatically given Prevent funding. The 2011 review pledged to end this. It further promised to expand Prevent to include far-right extremism and stop its use in community cohesion projects. Through these FOI requests I was trying to find out whether or not the 2011 pledges had been met. But with the blanket denial of information, I was left in the dark.

It is telling that the report’s concerns with Prevent are not new and have in fact been highlighted in several reports by the same Home Affairs Select Committee, as well as numerous reports by NGOs. But nothing has changed. In fact, the only change proposed by the report is to give Prevent a new name: Engage. But the problem was never the name. Prevent relies on the premise that terrorism and extremism are inherently connected with Islam, and until this is changed, it will continue to be at best counter-productive, and at worst, deeply discriminatory.

In his evidence to the committee, David Anderson, the independent ombudsman of terrorism legislation, has called for an independent review of the Prevent strategy. This would be a start. However, more is required. What is needed is a radical new approach to counter-terrorism and counter-extremism, one that targets all forms of extremism and that does not stigmatise or stereotype those affected.

Such an approach has been pioneered in the Danish town of Aarhus. Faced with increased numbers of youngsters leaving Aarhus for Syria, police officers made it clear that those who had travelled to Syria were welcome to come home, where they would receive help with going back to school, finding a place to live and whatever else was necessary for them to find their way back to Danish society.  Known as the ‘Aarhus model’, this approach focuses on inclusion, mentorship and non-criminalisation. It is the opposite of Prevent, which has from its very start framed British Muslims as a particularly deviant suspect community.

We need to change the narrative of counter-terrorism in the UK, but a narrative is not changed by a new title. Just as a rose by any other name would smell as sweet, a bad policy by any other name is still a bad policy. While the Home Affairs Select Committee concern about Prevent is welcomed, real action is needed. This will involve actually engaging with the Muslim community, listening to their concerns and not dismissing them as misunderstandings. It will require serious investigation of the damages caused by new Prevent statutory duty, something which the report does acknowledge as a concern.  Finally, real action on Prevent in particular, but extremism in general, will require developing a wide-ranging counter-extremism strategy that directly engages with far-right extremism. This has been notably absent from today’s report, even though far-right extremism is on the rise. After all, far-right extremists make up half of all counter-radicalization referrals in Yorkshire, and 30 per cent of the caseload in the east Midlands.

It will also require changing the way we think about those who are radicalized. The Aarhus model proves that such a change is possible. Radicalization is indeed a real problem, one imagines it will be even more so considering the country’s flagship counter-radicalization strategy remains problematic and ineffective. In the end, Prevent may be renamed a thousand times, but unless real effort is put in actually changing the strategy, it will remain toxic. 

Dr Maria Norris works at London School of Economics and Political Science. She tweets as @MariaWNorris.