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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Scotland's vast deficit remains an obstacle to independence

Though the country's financial position has improved, independence would still risk severe austerity. 

For the SNP, the annual Scottish public spending figures bring good and bad news. The good news, such as it is, is that Scotland's deficit fell by £1.3bn in 2016/17. The bad news is that it remains £13.3bn or 8.3 per cent of GDP – three times the UK figure of 2.4 per cent (£46.2bn) and vastly higher than the white paper's worst case scenario of £5.5bn. 

These figures, it's important to note, include Scotland's geographic share of North Sea oil and gas revenue. The "oil bonus" that the SNP once boasted of has withered since the collapse in commodity prices. Though revenue rose from £56m the previous year to £208m, this remains a fraction of the £8bn recorded in 2011/12. Total public sector revenue was £312 per person below the UK average, while expenditure was £1,437 higher. Though the SNP is playing down the figures as "a snapshot", the white paper unambiguously stated: "GERS [Government Expenditure and Revenue Scotland] is the authoritative publication on Scotland’s public finances". 

As before, Nicola Sturgeon has warned of the threat posed by Brexit to the Scottish economy. But the country's black hole means the risks of independence remain immense. As a new state, Scotland would be forced to pay a premium on its debt, resulting in an even greater fiscal gap. Were it to use the pound without permission, with no independent central bank and no lender of last resort, borrowing costs would rise still further. To offset a Greek-style crisis, Scotland would be forced to impose dramatic austerity. 

Sturgeon is undoubtedly right to warn of the risks of Brexit (particularly of the "hard" variety). But for a large number of Scots, this is merely cause to avoid the added turmoil of independence. Though eventual EU membership would benefit Scotland, its UK trade is worth four times as much as that with Europe. 

Of course, for a true nationalist, economics is irrelevant. Independence is a good in itself and sovereignty always trumps prosperity (a point on which Scottish nationalists align with English Brexiteers). But if Scotland is to ever depart the UK, the SNP will need to win over pragmatists, too. In that quest, Scotland's deficit remains a vast obstacle. 

George Eaton is political editor of the New Statesman.