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Cameron slows down the NHS revolution

PM prepares to water down Andrew Lansley’s reforms after a political backlash.

David Cameron's political survival instincts finally appear to be asserting themselves. The PM, who was surprised by the level of opposition to the coalition's NHS reforms, is planning to put the brake on Andrew Lansley's revolution.Today's Times (£) reports that, instead of transferring 80 per cent of the NHS budget to GPs within two years, Downing Street now favours a slower pace of change, with 2013 "a goal rather than a deadline".

It's not hard to see why. Cameron worked hard in opposition to convince the public that the Tories could be trusted with the NHS. But the coalition's reckless reforms (likened by the Conservative MP Sarah Wollaston to tossing a "grenade" into the health service) have had the reverse effect.

Lansley is reportedly insisting that there should be no change to the scale and speed of the reforms. But he has already performed a U-turn on price competition and that weakens his hand. If the reforms can be amended once, they can be amended twice.

The "mad" decision (in the words of the British Medical Journal) to introduce the biggest upheaval in the service's history, just when the NHS is required to make unprecedented savings of between £15bn and £20bn, was never likely to bear scrutiny. I'd wager that the coalition will look again at the "any willing provider" rule and at the decision to place the NHS under EU competition law for the first time (something Cameron seemed only dimly aware of at a recent PMQs).

Cameron will reportedly sit down with Nick Clegg, George Osborne and Danny Alexander – "the quad" – to thrash out a solution in the next two weeks.

The PM is clearly determined to blunt Labour's sharp attack on his handling of the NHS. As I noted yesterday, he moved at PMQs to insist that the coalition will not break its pledge to increase NHS spending in real terms. But this expensive promise on its own won't be enough to win back goodwill.

Tags: andrew lansley  David Cameron  NHS

29 comments

Ken Oliver's picture

The cuts and reforms into the NHS needs to stop. What has happened to the service that was supposed to be free at the point of delivery. THis was the vison that started the NHS.

Anton Jury's picture

David Cameron is just trying to find a way to do it deceitfully by stealth.

Dont trust the Tories with our National Health Service because rain or shine they will try and find a way to fool us and get what they want.

Just take a look at the Financial Supporters of The Conservative Party and you will realise what I am saying.

Barry West's picture

The greatest danger is that the coalition is doing so many hideous things, in education for example, that opposition to these appalling "reforms" will be fragmented. We need a national campaign under the banner Save our NHS NOW!, which will bring everyone together, and maybe even bring the coalition down, rather like the opposition to the Poll Tax caused the demise of Thatcher. My fear is that if these proposals go ahead, they will be well nigh impossible to reverse. Time is short. I for one would willingly march on this issue, though I'm now 73 and not been much of a marcher in the past.

Russell Gray's picture

Some very interesting and valuable comments here...but hang on if, by insinuation, the coalition government is intending to 'privatise' our NHS (which I have subscribed to for 50 years) is there an issue here for compensation of these monies by refund, or credit. To date I'm certain, luckily, that I have been a net contributor financially, as many of us have, although I'm sure I will need the NHS sometime, but if the government is putting a price on this precious service, will I be allowed to evaluate the organs in my body. How much for a pint of rare blood these days...I've been giving it free for half a century...anything else of value as a working part or bodily function asset???

CrISpY DuCk's picture

You'd imagine Lansleys office being funded by private medical companies and his wife being a GP who could be set to profit from his reforms would be an issue but it's obviously not.
How much damage has already been done and are PCT's actually able to function properly in the current climate ?

Jack Holroyde's picture

As a LibDem party member, I think conference made it quite clear what we expect Clegg & Alexander to do now.
http://www.guardian.co.uk/politics/2011/mar/20/liberal-democrats-health-...

The key is now reminding Clegg of his duty to do as conference says, and keep up the internal pressure.
I'll be more than happy to start today.

Russell Gray's picture

Re: Barry West 01 Apr...I noticed your comment about people (individuals) banding together and forming a valid protest bloc. Though I would add that these people have organised almost 250000 already http://www.38degrees.org.uk/NHS-email-MP. Have a look at it and see what you think. It doesn't matter what your politics are, this is so vital to us all.
Stay healthy...that'll stop the plunder!

Danensis's picture

So, we have to pay the private providers more than we did when the service was nationalised. Haven't we been here before with the railways?

Linda and Brian Hinkins's picture

The NHS has served this country well from conception, with some of the best medical staff and is the envy of the world. It has progressed with technology which in turn gives many of us a better quality of life, which if privatised would become a big money spinner for the buisness man and the care in the community will disappear.

Dr Fiona Wright MBChB MSc MFPH's picture

It is essential that these NHS reforms are halted and re-considered. These reforms threaten the major principles of the NHS - universal, comprehensive care free at the point of use- that the NHS white paper states it aims to achieve. The Bill opens up the NHS to competition and wider engagement of private providers. There will be opportunities for charging for some elements of NHS care and for profits for staff and shareholders from tax payers funding. We are at a time of major financial difficulties and, although always room for improvement, the NHS was at a time of high satisfatcion. There is no evidence that these reforms will save money or improve quality. The bill must include provisions that the Secretary of State for Health must ensure comprehensive health care in England free at the point of use, to ensure that commissioning consortiums provide comprehensive health care to all residents and they cannot charge for NHS services.

Richard Blogger's picture

Cameron's "chairman of the board" role to leadership has clearly failed here. It has been very obvious for more than two years to those who could be bothered to follow Lansley what he was intending to do (Labour: you are guilty here too, you couldn't be bothered to read Lansley's policy documents).

Cameron gave Lansley a free reign throughout the election campaign and in government. A "chairman" is supposed to keep an eye and to make sure that cockups do not happen, but Lansley's policy was a massive cockup waiting to happen right from the publication of the Tory draft manifesto on health in Jan 2010. (Remember the ludicrous pledge to provide 45,000 single rooms in the draft manifesto? Anyone who knows about health policy saw that as extremely expensive policy with zero change of implementation, its inclusion in the draft manifesto shows what a sloppy and clueless team Lansley had then.)

If Cameron makes serious changes to the H&SC Bill it will reflect very badly on him for allowing its development. It will also reflect badly on Letwin and Alexander who gave the Bill a thumbs up at the beginning of the year (they could have stopped its publication). And then there is Lansley, who has consistently said that the Bill must not be amended (Sarah Wollaston has complained about this, she was told that even Tory MPs could not change the Bill). All of these people will be seriously damaged from a climb down.

Call me cynical, but I do not think that Cameron will allow such damage to happen.

Concerned Pro Labour Anti Tory and big fan of Gordon Brown's picture

Having just reached 60 and looking forward to my HUGE pension (for how long?) I am horrified at the thought of what the Coalition are planning to do to our way of life. Having worked for all of my working life as an employer and employee I feel justified in expressing concern that the conributions I, personally, have made into the system can be so cavalierly used and abused. I support Barry West when he says we need a national campaign under the banner of Save our NHS NOW! and hopefully rid our country of these meddling, public school upstarts who have more money than sense and HUGE egoes to boot!

Syzygy's picture

The problem with the so-called u-turns is that closer examination indicates more of a 'swerve' which can rejoin the original track easily!

The 'U-turn' on price competition is not about removing any of the main legislation but is removing the clause whereby private providers would charge 16% more than the NHS to compensate them for 'subsidies' accruing to the NHS. The argument was that to produce a level playing field the private providers would need additional payments... fortunately the Unions picked up and successfully contested.

It will take very little to reintroduce that change again when the fuss has died down. This government lies and lies!

Richard Blogger's picture

Re-read the Rachel Sylvester Times article again:

"ministers insist that the broad principles will be retained"

"David Cameron ... is now said to be coming round to the idea of making some 'clarifications' on the speed and scale of the proposals."

"a Tory Cabinet minister says: 'The Bill is not quite as scary as people have made it seem'"

None of this indicates that the major policy issues of "Any Willing Provider", removing the responsibility of the government to provide health care, of removing accountability in commissioning, none of these will be amended. If they are taken out of the Bill then the Bill will no longer exist. What is being suggested is a new campaign to convince the public that they want the Bill.

Jean Seaman's picture

I think you should think very hard about causing distress and heartbreak over the proposed plans for the NHS.

Richard Blogger's picture

The review of the Bill at the end of last year was by Letwin and Alexander. Both signed it off. Both will be damaged if any substantial amendments are made to the Bill because it will appear that they did a bad job reviewing the Bill. The most damaged will be Alexander. In fact, why hasn't he been castigated so far? The LibDem spring conference says that they disagreed with substantial parts of the Bill he signed off, doesn't that show how out of touch he is with the LibDem grassroots?

Derrick & Margaret's picture

Gas, water, electricity, railways ?Post Offices, prices go up every year to cater for dividends. Health
services are precious and need to be protected at all costs.

Syzygy's picture

Richard Blogger

You are always someone to listen to in this respect ... the LP, or rather the blairites, are guilty of opening the door or at least not shutting it. All of these changes follow from the 96 GATS treaty signed up to by the EU Commissioners, and every government since then have been privatising the lucrative public services by stealth... and without any public discussion or assent. Particularly alarming is the clause which prevents reversal if foreign providers have contracts. Hence, the involvement of so many US health providers and in other areas, the proposal for the Dutch to take over Royal Mail.

The dismantling of the PCTs and SHAs is already well underway and GP consortia are being set up, largely under the wing of McKinseys and other global management consultancies. Putting the NHS back together again requires a return to nationalisation proper.

edulike's picture

A lot of people voted for the Tories as they promised to protect the NHS. The Lib Dems promised (nay pledged) to oppose tuition fee increases. Small wonder that no one has any trust or confidence in politicians any more. This lot hate the ordinary people and just want to fleece us to feather their own nests. The biggest joke of the lot was "we're all in this together".

richy's picture

It'll be fascinating to see how Cameron responds.
Im not a fan of this Coalition, but i suspect Cameron was unaware of the full implications of this bill.

I can't see how the Treasury signed off on this, given the estimated £3 billion in reorganisation costs.

My bet is a watering down of "any willing provider" and removal of placing the NHS under competition law.

Which will sort of bring us back to where we were before. So $3 billion wasted, countless management expertise in PCTS lost, widespread demoralisation, management time wasted on reorganisation rather than clinical priorities.

Even with a major u-turn, this will still register as a major cock-up!

VOICE OF REASON's picture

Rarely will you get a complaint if you put up taxes for the rich to support the health service, as we all will use it at some point in our lives. What we don't want is to lose it. I speak as a nurse. it the most valuable asset we have and and remains the only part of Great Britain that is truely classless. It gave the Great to Britain, You've screwed up already with eyes sight, hearing and teeth. Don't take away the heart of Britain please. Our health service belong to more than policy makers and politicians. We want it to remain. We support the NHS SAVE IT NOW, stop meddling with it ever five minutes and give it a chance to thrive.

Wendy Savage MBBCh FRCOG MSc(Public Health) Hon DSc's picture

We need to push MPs to vote against this bill at 3rd reading as tinkering with it to water down its proposals is not enough. KONP has been fighting privatisation and marketisation of the NHS since 2005 join us and write to yoru MP to tell him/her to vote aginst the bill at 3rd reading. We need all small party MPs and 48 LibDems to vote against it and it could be stopped in its tracks. We were going to have the 'new politics' but parts pf this bill have been implemented before it even reached parliament and Lansley and the DH are acting as if it has already been passed. Is this democratic? The consultation failed the first test of a consultation -it was about the 'how' not the 'what' of the bill. Did Lansley take any notice of the 6000 responses to this document? MPs should stand up against this assault on their authority and vote against it. What is the rush? The NHS does need to change to accommodate the aging population but it does not have to do that overnight.This Bill does not address this problem. Lansley's stated aims could be achieved without this massive re-organisation which is going to cost billions. The BMA SRM voted on 15.3.11 almost unanimously to ask Lansley to withdraw the Bill and he has ignored this and all the 27 other critical motions against this continuing to say that the medical profession are for his changes. They are not and neither are the people of England who understand what he is trying to do. Visit our website www.keepournhspublic.com,
Sign the 38 degrees petition andt hey can send a letter to your MP if you do ot want to write personally.
WDS Cochair of steering group of KONP

Concerned Pro Labour Anti Tory and big fan of Gordon Brown's picture

David Cameron needs to listen to the 'Big Society' when they are telling him he has got it wrong - LABOUR didn't cause the financial mess our 'big society' is in - it was the greedy selfish uncaring banking fraternity who caused the WORLD crisis and they continue to hold us by the short and curlies because they and other greedy people like them voted in their droves to get him in to continue pouring the country's wealth into there insatiable pockets! Shame on him and his followers !!!

Syzygy's picture

One of the aspects which I find surprising is that the Tories are proposing to place the standards and practice of the NHS under the ultimate authority of the EU and their courts.... ironic or could they really not know the implications of making our health service subject to EU competition laws?

Ann Walker's picture

Yet again we are back to traditional Tory politics - supported now by a pathetic Liberal Party - thirsty for power at all cost. The Coalition's approaches to the NHS and our Education system are knee-jerk and retrograde. There is money for MPs to increase their personal allowances but not enough money for the future health and education of our people. Shame on them all!!!

Nilsey105's picture

The plot thickens hour by hour.

The coalition are showing themselves up for what they really are; totally inept and an absolute laughing stock both individually and collectively.

No need to bring on the clowns this lot are unbeatable and unbeleivable.

Dr Mike Jones's picture

We have I guess all moaned at the high cost of administrators in the NHS but from experience over the last decades of what happens when other services are privatised, the administrative costs will be just a drop in the ocean at the private costs extract4ed by all the predatory organisations and individuals queuing up to make money if the NHS is privatised - not to mention tjhe costs of other regulatory bodies which will be set up as ineffective "ombudsmen" to see fair play

Michael T's picture

It seems very odd that the Government are making all these cuts on the NHS and our front line services whilst at the same time giving £45 million to the European Union.
Is it not time
we withdraw from the EU and be able with a responsible Government put back all this money into where it has been taken from and also get our country back on its feet.

Carole D's picture

Why are the real problems with the way
the NHS is run not addressed.
There are too many free loaders/cowboys at the top getting too much money and perks, have you seen the cars they are provided with.
Who supervises the managers?
We should go back to the past with Matrons in charge of the wards so they are clean and well run.
Nurses trained on site under the supervision of the Matron.
Only employing inhouse accountants accountable for any money lost/wasted.
Proper Management.
It worked in the past.
Follow the US system, foreigners needing treatment, leaving a credit card for payment before any treatment is carried out.
Get tough and run the NHS like the business it is.
The money that could be saved would be
mind boggling.
We are too soft in this Country and it has to change if we are going to survive.
As it stands we are the laughing stock of the world over our inability to run our 'business' properly.
Mr. Cameron and Mr. Clegg get harder
and forget about the do gooders.

First step - LEAVE THE EU then we will not be dictated to about our we run
OUR country.
As an aside - is the Uk borrowing money
to pay the 50 million plus pounds to the EU EVERY DAY.?? money better spent
on the things that needing sorting out
i.e. the NHS

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