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How much “listening” will Cameron do on the NHS?

The PM plans to delay NHS reform for three months but what concessions will he offer?

By George Eaton Published 04 April 2011 10:47

The "breakneck coalition" has hit another bump in the road. David Cameron has bowed to the inevitable and put the government's NHS bill on hold for the next three months while ministers agree on the way forward.

The announcement of a delay will be made at a joint event later this week involving Cameron, Andrew Lansley and, notably, Nick Clegg, whom the PM is determined to bind in to the changes.

It remains unclear whether the delay is merely part of a "listening exercise" or a prelude to significant concessions on competition, the role of the private sector and GP accountability. What we won't see is a U-turn akin to that on forest privatisation. Cameron is too personally committed to the reforms to change course now. The shadow health secretary, John Healey, has rightly warned that "simply doing the wrong things more slowly is not the answer".

The Lib Dem opponents of the reforms, led by Evan Harris, issued a list of "essential amendments" last night, described as "the minimum" needed to satisfy the party's members. Of the 23 proposed amendments, here are the most significant:

Elected councillors to sit on GP consortiums

"Membership of local commissioning bodies to include a substantial proportion of elected councillors as per Coalition Agreement to improve transparency and accountability."

Piloting of the reforms

"The changes to commissioning to be piloted and evaluated before full roll-out."

A ban on "cherry-picking" by the private sector

"Commissioning to be governed by a requirement/duty on commissioners, when considering contracting with any new provider – or offering the choice of a new provider – to be satisfied that broader service stability is safeguarded and that cherry-picking and cream-skimming are avoided."

Constraints on EU competition law

"Statutory provision to ensure that provision of clinical services to the NHS is not governed by current EU and UK competition law to a greater extent than is the case now. In particular to provide that vertical integration of services is not impeded by competition law."

Lansley, who has already given ground on price competition, is thought to be willing to agree to restrictions on "cherry-picking" and on the role of the regulator Monitor. The government had originally hoped to make changes to the bill in the Lords but, under pressure from Clegg, it is now likely to do so in the Commons. The principles of the bill, ministers insist, will remain in place.

In an attempt to seize the initiative, Ed Miliband will offer cross-party talks to develop "replacement plans" in a speech this morning. Cameron may dismiss the Labour leader as a "roadblock", but he has handed him the sort of opportunity that opposition leaders dream of.

Lansley's technocratic style means that the coalition has allowed the reforms to be defined by the media. As a consequence, it will struggle to convince a sceptical public that the changes are "practical" as opposed to ideological. With the coalition's higher education plans also in chaos, ministers have been taught a salutary lesson in the perils of hasty reform.

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Tags: andrew lansley David Cameron NHS

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5 comments

Fri, 2011-04-08 03:03 — francis (not verified)

Mr Cameron obviously lacks the experience to pace himself,this sledge hammer approach has been his signature in all and everything not just the NHS thing since becoming PM..the stark reality is we have a man with a vission..a Big vission,and it seems to have come to him all at once;..leaving no stone unturned its frightening,it beggars belief that even those in high seats of equally high pay are not protecting us but have all succumbed or been massaged to go along with him...how many people do you know whom fear losing their job next with thousands being laid off every freekin day, and more to come the man says; even some library's are closing, now that is a pathetic state is it not..there are many vulnerable brothers and sisters out there being imprisoned in their own homes by the fact that their centres are closing here and there and even the social services bus cant make the same number of trips to take them to the centres that are open, .if you couple this with the fact that if they have a social landlord,not even your tenancy is guaranteed to be secure anymore..and does'nt that bring alot of people to the point where "if" you have a job and have a social landlord then you could be moved on they say to find your own private rented property besause you are able to afford to do so (hmm is this a discrimination of sorts folks?) when those not or unable to work need the housing stock..of course this must concern us all and anyone with a brain on an ant will work out the "benefits" of not going to work (if you're not layed off anyway) just to keep a roof over your head,so then we all become needy and there's that man with that vission again,intent on making history rather than preserving it like the NHS.. oh and he wanted us to Migrate to find work.."What Work",Where??..tell us where this place is and i am sure if there is such a place,there won't be enough housing stock and we would get our heads kicked in like fighting over a hotdog pitch,yeh, his head must be in the clouds watching the cuckoo's migrate(or is it the cuckoo watching the migration?) and he expects us to join em..no sir, did'nt he say he wants to cut the benefits/dole bill??... so you beter build more houses me think's Mr Cameron..
for those that might be genuinley sick or disabled, the hypocrites are re-assessing these people for work doing a u turn on their orrigional decission to the claimant!!..a dog after it's tail indeed but its worse than that,its scary,we are most of us unsure of what lies ahead,lying awake at night feeling like we are in a spin dryer,uncertainty in all things is rife, all this is like a kind of cleansing...England is sinking folks, she;s sinking x

Mon, 2011-04-04 11:12 — Richard Blogger (not verified)

I bet I won't be invited to any of the events that Cameron&Clegg are organising to "explain" the Health Bill. In fact, I bet they won't even publicise where these meetings will be, for fear of demonstrations.