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.

Show Hide image

Michael Gove definitely didn't betray anyone, says Michael Gove

What's a disagreement among friends?

Michael Gove is certainly not a traitor and he thinks Theresa May is absolutely the best leader of the Conservative party.

That's according to the cast out Brexiteer, who told the BBC's World At One life on the back benches has given him the opportunity to reflect on his mistakes. 

He described Boris Johnson, his one-time Leave ally before he decided to run against him for leader, as "phenomenally talented". 

Asked whether he had betrayed Johnson with his surprise leadership bid, Gove protested: "I wouldn't say I stabbed him in the back."

Instead, "while I intially thought Boris was the right person to be Prime Minister", he later came to the conclusion "he wasn't the right person to be Prime Minister at that point".

As for campaigning against the then-PM David Cameron, he declared: "I absolutely reject the idea of betrayal." Instead, it was a "disagreement" among friends: "Disagreement among friends is always painful."

Gove, who up to July had been a government minister since 2010, also found time to praise the person in charge of hiring government ministers, Theresa May. 

He said: "With the benefit of hindsight and the opportunity to spend some time on the backbenches reflecting on some of the mistakes I've made and some of the judgements I've made, I actually think that Theresa is the right leader at the right time. 

"I think that someone who took the position she did during the referendum is very well placed both to unite the party and lead these negotiations effectively."

Gove, who told The Times he was shocked when Cameron resigned after the Brexit vote, had backed Johnson for leader.

However, at the last minute he announced his candidacy, and caused an infuriated Johnson to pull his own campaign. Gove received just 14 per cent of the vote in the final contest, compared to 60.5 per cent for May. 


Julia Rampen is the editor of The Staggers, The New Statesman's online rolling politics blog. She was previously deputy editor at Mirror Money Online and has worked as a financial journalist for several trade magazines.