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31 March 2011

Cameron slows down the NHS revolution

PM prepares to water down Andrew Lansley’s reforms after a political backlash.

By George Eaton

David Cameron’s political survival instincts finally appear to be asserting themselves. The PM, who was surprised by the level of opposition to the coalition’s NHS reforms, is planning to put the brake on Andrew Lansley’s revolution.Today’s Times (£) reports that, instead of transferring 80 per cent of the NHS budget to GPs within two years, Downing Street now favours a slower pace of change, with 2013 “a goal rather than a deadline”.

It’s not hard to see why. Cameron worked hard in opposition to convince the public that the Tories could be trusted with the NHS. But the coalition’s reckless reforms (likened by the Conservative MP Sarah Wollaston to tossing a “grenade” into the health service) have had the reverse effect.

Lansley is reportedly insisting that there should be no change to the scale and speed of the reforms. But he has already performed a U-turn on price competition and that weakens his hand. If the reforms can be amended once, they can be amended twice.

The “mad” decision (in the words of the British Medical Journal) to introduce the biggest upheaval in the service’s history, just when the NHS is required to make unprecedented savings of between £15bn and £20bn, was never likely to bear scrutiny. I’d wager that the coalition will look again at the “any willing provider” rule and at the decision to place the NHS under EU competition law for the first time (something Cameron seemed only dimly aware of at a recent PMQs).

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Cameron will reportedly sit down with Nick Clegg, George Osborne and Danny Alexander – “the quad” – to thrash out a solution in the next two weeks.

The PM is clearly determined to blunt Labour’s sharp attack on his handling of the NHS. As I noted yesterday, he moved at PMQs to insist that the coalition will not break its pledge to increase NHS spending in real terms. But this expensive promise on its own won’t be enough to win back goodwill.