ConservativeHome calls for health bill to be scrapped

Three Tory cabinet ministers "almost instructed" influential website to come out against NHS reform.

It has been a bad week for Andrew Lansley. David Cameron may have said this week that the Health Secretary has his "full support", but evidently not everyone in the cabinet feels the same. The influential website ConservativeHome has published an editorial calling for the bill to be scrapped. It claims that it was urged to do so by three Tory cabinet ministers.

This comes off the back of Rachel Sylvester's article in the Times (£) on Tuesday, which revealed deep concern about the NHS bill from the inner circles of government. She quoted a Downing Street insider who said that Lansley "should be taken out and shot."

Cameron moved to squash speculation that the Health Secretary is on his way out, throwing his weight behind efforts to get the bill on the statute books in the next few months. (It was defeated in the Lords this week). The Sylvester piece also made the point that the Prime Minister is remarkably loyal to Lansley, who was once his boss at the Conservative Research Department.

Yet it appears that some in the cabinet do not share Cameron's conviction for pressing ahead with the bill. In today's editorial, Tim Montgomerie writes:

Speaking to ConservativeHome, three Tory Cabinet ministers have now also rung the alarm bell. One was insistent the Bill must be dropped. Another said Andrew Lansley must be replaced. Another likened the NHS reforms to the poll tax. The consensus is that the Prime Minister needs an external shock to wake him to the scale of the problem.

The intervention from ConservativeHome is significant for several reasons. First and foremost is the fact that it was urged to make this intervention by members of the cabinet who feel that Cameron is not listening. A source at the website told the Guardian: "We have almost been instructed to write this." If this is indeed the case, it is remarkable that cabinet members have reached such a level of frustration with Cameron's refusal to ditch the bill.

Secondly, the website is generally taken as a good bellwether of grassroots Conservative opinion and is thus far more significant for the government than the on-going clamour from Liberal Democrat and Labour supporters. Montgomerie articulates the growing sense that the bill is, essentially, more trouble than it's worth and "potentially fatal to the Conservative Party's electoral prospects":

By 'succeeding' in enacting a contentious Bill every inevitable problem that arises in the NHS in the years ahead will be blamed on it. That's a heavy price to pay for a Bill that is neither transformational nor necessary.

Guido Fawkes notes that this may not be the majority view of Tory voters, who still tend to support NHS reform. He makes the point that "cabinet ministers are hardly the grassroots". That may be the case, but this is still a highly significant intervention, reflecting the fact that the political pressure on this issue is not going anywhere.

Samira Shackle is a freelance journalist, who tweets @samirashackle. She was formerly a staff writer for the New Statesman.

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Is anyone prepared to solve the NHS funding crisis?

As long as the political taboo on raising taxes endures, the service will be in financial peril. 

It has long been clear that the NHS is in financial ill-health. But today's figures, conveniently delayed until after the Conservative conference, are still stunningly bad. The service ran a deficit of £930m between April and June (greater than the £820m recorded for the whole of the 2014/15 financial year) and is on course for a shortfall of at least £2bn this year - its worst position for a generation. 

Though often described as having been shielded from austerity, owing to its ring-fenced budget, the NHS is enduring the toughest spending settlement in its history. Since 1950, health spending has grown at an average annual rate of 4 per cent, but over the last parliament it rose by just 0.5 per cent. An ageing population, rising treatment costs and the social care crisis all mean that the NHS has to run merely to stand still. The Tories have pledged to provide £10bn more for the service but this still leaves £20bn of efficiency savings required. 

Speculation is now turning to whether George Osborne will provide an emergency injection of funds in the Autumn Statement on 25 November. But the long-term question is whether anyone is prepared to offer a sustainable solution to the crisis. Health experts argue that only a rise in general taxation (income tax, VAT, national insurance), patient charges or a hypothecated "health tax" will secure the future of a universal, high-quality service. But the political taboo against increasing taxes on all but the richest means no politician has ventured into this territory. Shadow health secretary Heidi Alexander has today called for the government to "find money urgently to get through the coming winter months". But the bigger question is whether, under Jeremy Corbyn, Labour is prepared to go beyond sticking-plaster solutions. 

George Eaton is political editor of the New Statesman.