The NHS is toxic for the Tories and they know it

An increasing number of Conservative MPs are starting to think the unloved health reforms ought some

David Cameron was rattled in the Commons today by an attack on his health reforms - and with good reason. The NHS reorganisation is a disaster on many fronts. It is unloved by doctors, poorly understood by the public and, after a series of mangling amendments in parliament, barely even resembles the vision first outlined by Health Secretary Andrew Lansley. The likeliest outcome from the whole thing is protracted chaos and worse services. This time it will be very hard for the Tories to blame the mess on Labour's legacy.

Opinion polls traditionally show Labour well ahead of Conservatives in terms of who is trusted to look after the NHS. Crucially for Ed Miliband, this is also an issue that is personally associated with David Cameron. The pledge to avoid "top down reorganisations" came from Conservative leader's lips. So did the promise to protect health spending in real terms. That will be very hard to achieve even if inflation comes down - at least not without imposing harsher cuts elsewhere. The Labour front bench think the NHS is one policy area where they might be able to puncture Cameron's famous Teflon coating. I have even heard it said by MPs, and not just from Labour ones, that the NHS alone could cost the Tories a majority at the next election

Crucially, Tory MPs are starting to get worried. They are as baffled as anyone else as to how the government got itself into this mess. Questions are increasingly being asked about Lansley's future. It is recognised that he would have to resign if the reforms were shelved. That is hard to do in practice because some of the structural changes are already under way. But as an exercise in political damage limitation it might still be worth slamming on the brakes and, if need be, losing Lansley. Very senior Tories recognise now that the NHS is their point of greatest vulnerability. So much so, in fact, that one source familiar with the Prime Minister's feelings about the subject recently told me Downing Street wished the Lib Dems had killed the thing off last year instead of insisting on a legislative "pause".

Back then Nick Clegg didn't want to be seen to be too obstructive. The Lib Dem priority was still being seen to make coalition work. With hindsight, Clegg's team now say they should have been bolshier and insisted that the NHS reforms be dropped. It is testimony to how politically toxic the whole thing has come that an increasing number of Tories on front and back benches agree.

Rafael Behr is political columnist at the Guardian and former political editor of the New Statesman

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Nicola Sturgeon is betting on Brexit becoming real before autumn 2018

Second independence referendum plans have been delayed but not ruled out.

Three months after announcing plans for a second independence referendum, and 19 days after losing a third of her Scottish National Party MPs, Scotland’s First Minister Nicola Sturgeon booted the prospect of a second independence referendum into the heather. 

In a statement at Holyrood, Sturgeon said she felt her responsibility as First Minister “is to build as much unity and consensus as possible” and that she had consulted “a broad spectrum of voices” on independence.

She said she had noted a “commonality” among the views of the majority, who were neither strongly pro or anti-independence, but “worry about the uncertainty of Brexit and worry about the clarity of what it means”. Some “just want a break from making political decisions”.

This, she said had led her to the conclusion that there should be a referendum reset. Nevertheless: "It remains my view and the position of this government that at the end of this Brexit process the Scottish people should have a choice about the future of our country." 

This "choice", she suggested, was likely to be in autumn 2018 – the same time floated by SNP insiders before the initial announcement was made. 

The Scottish Lib Dem leader Willie Rennie responded: “The First Minister wishes to call a referendum at a time of her choosing. So absolutely nothing has changed." In fact, there is significance in the fact Sturgeon will no longer be pursuing the legislative process needed for a second referendum. Unlike Theresa May, say, she has not committed herself to a seemingly irreversable process.

Sturgeon’s demand for a second independence referendum was said to be partly the result of pressure from the more indy-happy wing of the party, including former First Minister Alex Salmond. The First Minister herself, whose constituency is in the former Labour stronghold of Glasgow, has been more cautious, and is keenly aware that the party can lose if it appears to be taking the electorate for granted. 

In her speech, she pledged to “put our shoulder to the wheel” in Brexit talks, and improve education and the NHS. Yet she could have ruled out a referendum altogether, and she did not. 

Sturgeon has framed this as a “choice” that is reasonable, given the uncertainties of Brexit. Yet as many of Scotland’s new Labour MPs can testify, opposition to independence on the doorstep is just as likely to come from a desire to concentrate on public services and strengthening a local community as it is attachment to a more abstract union. The SNP has now been in power for 10 years, and the fact it suffered losses in the 2017 general election reflects the perception that it is the party not only for independence, but also the party of government.

For all her talk of remaining in the single market, Sturgeon will be aware that it will be the bread-and-butter consequences of Brexit, like rising prices, and money redirected towards Northern Ireland, that will resonate on the doorstep. She will also be aware that roughly a third of SNP voters opted for Brexit

The general election result suggests discontent over local or devolved issues is currently overriding constitutional matters, whether UK-wide or across the EU. Now Brexit talks with a Tory-DUP government have started, this may change. But if it does not, Sturgeon will be heading for a collision with voter choice in the autumn of 2018. 

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

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