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?

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.

George Eaton is political editor of the New Statesman.

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Autumn Statement 2015: George Osborne abandons his target

How will George Osborne close the deficit after his U-Turns? Answer: he won't, of course. 

“Good governments U-Turn, and U-Turn frequently.” That’s Andrew Adonis’ maxim, and George Osborne borrowed heavily from him today, delivering two big U-Turns, on tax credits and on police funding. There will be no cuts to tax credits or to the police.

The Office for Budget Responsibility estimates that, in total, the government gave away £6.2 billion next year, more than half of which is the reverse to tax credits.

Osborne claims that he will still deliver his planned £12bn reduction in welfare. But, as I’ve written before, without cutting tax credits, it’s difficult to see how you can get £12bn out of the welfare bill. Here’s the OBR’s chart of welfare spending:

The government has already promised to protect child benefit and pension spending – in fact, it actually increased pensioner spending today. So all that’s left is tax credits. If the government is not going to cut them, where’s the £12bn come from?

A bit of clever accounting today got Osborne out of his hole. The Universal Credit, once it comes in in full, will replace tax credits anyway, allowing him to describe his U-Turn as a delay, not a full retreat. But the reality – as the Treasury has admitted privately for some time – is that the Universal Credit will never be wholly implemented. The pilot schemes – one of which, in Hammersmith, I have visited myself – are little more than Potemkin set-ups. Iain Duncan Smith’s Universal Credit will never be rolled out in full. The savings from switching from tax credits to Universal Credit will never materialise.

The £12bn is smaller, too, than it was this time last week. Instead of cutting £12bn from the welfare budget by 2017-8, the government will instead cut £12bn by the end of the parliament – a much smaller task.

That’s not to say that the cuts to departmental spending and welfare will be painless – far from it. Employment Support Allowance – what used to be called incapacity benefit and severe disablement benefit – will be cut down to the level of Jobseekers’ Allowance, while the government will erect further hurdles to claimants. Cuts to departmental spending will mean a further reduction in the numbers of public sector workers.  But it will be some way short of the reductions in welfare spending required to hit Osborne’s deficit reduction timetable.

So, where’s the money coming from? The answer is nowhere. What we'll instead get is five more years of the same: increasing household debt, austerity largely concentrated on the poorest, and yet more borrowing. As the last five years proved, the Conservatives don’t need to close the deficit to be re-elected. In fact, it may be that having the need to “finish the job” as a stick to beat Labour with actually helped the Tories in May. They have neither an economic imperative nor a political one to close the deficit. 

Stephen Bush is editor of the Staggers, the New Statesman’s political blog.