Lansley fights another day as Cameron backs NHS reform

The PM moves to squash speculation about the Health Secretary's future as the Lords prepare to debat

The Health and Social Care Bill has had anything but an easy ride. A year on from its introduction, the bill -- more controversial than ever -- is returning to the House of Lords.

Yesterday saw intense speculation about the future of the bill, and of its creator, Andrew Lansley. Writing in the Times (£), Rachel Sylvester quoted an anonymous Downing Street source saying that the Health Secretary should be "taken out and shot". She also discussed rumours that the former Labour health secretary, Alan Milburn, could be given a peerage and parachuted into the cabinet.

Rather provocatively, the Times (£) has followed up today with a piece by Milburn, in which he issues a stinging criticism of the bill:

The Health and Social Care Bill is a patchwork quilt of complexity, compromise and confusion. It is incapable of giving the NHS the clarity and direction it needs. It is a roadblock to meaningful reform.

The article is an edited extract of an essay Milburn has written for Reform's The Next Ten Years, published at the beginning of next month, and as such makes no reference to the current speculation. While arch-moderniser Milburn reiterates his belief in the urgency of reform, he also states that he does not "believe that the current government can or will make these changes". Perhaps he will not benefit from a cabinet reshuffle after all.

Indeed, David Cameron is reportedly keen to squash rumours of the imminent demise of Lansley and his bill. Public and professional hostility remain: 90 per cent of respondents in a British Medical Journal poll said the reform should be scrapped, while 50,000 people (including celebrities such as Stephen Fry and Jamie Oliver) have signed a petition to drop it. But it appears that rather than back-tracking, Cameron will throw his weight behind the reforms to get them on the statute book sooner rather than later.

And this might just be possible, as Liberal Democrat peers have indicated that they will end their war on the reform, saying that the changes they secured -- the bill has had more than 1,000 amendments over the last 18 months of battle -- will safeguard the NHS and regulate competition.

So it looks like full steam ahead. But Cameron has some serious work to do if he wants to get the public on board and convince voters that, after his careful work detoxifying, this is not a return to business as usual for the Tories and the NHS.

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

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For a mayor who will help make Londoners healthier, vote for Tessa Jowell

The surgeon, former Labour health minister and chairman of the London Health Commission, Ara Darzi, backs Tessa Jowell to be Labour's candidate for London mayor.

London’s mayor matters. As the world’s preeminent city, London possesses an enormous wealth of assets: energetic and enterprising people, successful businesses, a strong public sector, good infrastructure and more parks and green spaces than any other capital city.

Yet these aren’t put to work to promote the health of Londoners. Indeed, quite the opposite: right now, London faces a public health emergency.

More than a million Londoners still smoke tobacco, with 67 children lighting up for the first time every day. London’s air quality is silently killing us. We have the dirtiest air in Europe, causing more than 4,000 premature deaths every year.

Nearly four million Londoners are obese or overweight – and just 13% of us walk or cycle to school or work, despite half of us living close enough to do so. All Londoners should be ashamed that we have the highest rate of childhood obesity of any major global city.

It’s often been said that we don’t value our health until we lose it. As a cancer surgeon, I am certain that is true. And I know that London can do better. 

For that reason, twice in the past decade, I’ve led movements of Londoners working together to improve health and to improve the NHS. Healthcare for London gave our prescription for a better NHS in the capital. And Better Health for London showed how Londoners could be helped to better health, as well as better healthcare.

In my time championing health in London, I’ve never met a politician more committed to doing the right thing for Londoners’ health than Tessa Jowell. That’s why I’m backing her as Labour’s choice for mayor. We need a mayor who will deliver real change, and Tessa will be that mayor.  

When she invited me to discuss Better Health for London, she had the courage to commit to doing what is right, no matter how hard the politics. Above all, she wanted to know how many lives would be saved or improved, and what she could do to help.

In Tessa, I see extraordinary passion, boundless energy and unwavering determination to help others.

For all Londoners, the healthiest choice isn’t always easy and isn’t always obvious. Every day, we make hundreds of choices that affect our health – how we get to and from school or work, what we choose to eat, how we spend our free time.

As mayor, Tessa Jowell will help Londoners by making each of those individual decisions that bit easier. And in that difference is everything: making small changes individually will make a huge difference collectively.  

Tessa is committed to helping London’s children in their early years – just as she did in government by delivering Sure Start. Tessa will tackle London’s childhood obesity epidemic by getting children moving just as she did with the Olympics. Tessa will make London a walking city – helping all of us to healthier lifestyles.

And yes, she’s got the guts to make our parks and public places smoke free, helping adults to choose to stop smoking and preventing children from starting.   

The real test of leadership is not to dream up great ideas or make grand speeches. It is to build coalitions to make change happen. It is to deliver real improvements to daily life. Only Tessa has the track record of delivery – from the Olympics to Sure Start.   

Like many in our capital, I am a Londoner by choice. I am here because I believe that London is the greatest city in the world – and is bursting with potential to be even greater.

The Labour party now has a crucial choice to make. London needs Labour to choose Tessa, to give Londoners the chance to choose better health.