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30 May 2011

How much does Cameron want to keep Lansley in the cabinet?

Downing Street has issued a statement of support for the Health Secretary – but the PM has a difficu

By Samira Shackle

Downing Street has moved to refute speculation that Andrew Lansley will quit if wholesale changes are made to his NHS reform bill.

In a statement of support for the Health Secretary, Downing Street said: “The speculation in the papers is nonsense. Andrew Lansley is doing an excellent job.”

This follows reports at the weekend that Lansley had told David Cameron to “back me or sack me“. So for now, the Ptrime Minister is standing by his Health Secretary, publicly at least.

Soon after this month’s local elections, when Nick Clegg stepped up his vociferous attacks on NHS reform, it was speculated that Cameron might be glad of the Lib Dem excuse to rein in the bill. Yesterday, the Daily Mail‘s lipreader purportedly detected Cameron telling Clegg that the reform has “nothing to do with [Lansley] now”, which appears to support the theory that he is being marginalised.

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When the “listening exercise” on the bill draws to a close next month, Cameron will be faced with the difficult situation of having to show that he has actually listened to public and professional concerns, while also striving to keep Lansley in the cabinet.

The Health Secretary and his supporters believe that much of the public discomfort with the bill comes from misunderstanding, and that the necessary reassurance can be provided without making fundamental changes. The main cornerstone of the proposed law, GP commissioning, is highly likely to survive, but the debate rages over levels of competition and the involvement of private service providers.

Yet, in addition to the question of how much change Lansley is willing to take before he walks out of his role, there is the matter of how much Cameron wants to keep him in the cabinet. Lansley is certainly very knowledgeable: he spent five years in opposition preparing for this role. But is he indispensable?

Cameron is likely to continue holding his own views on the NHS bill close to his chest, but, given the huge support for Lansley among Tory backbenchers, he has a difficult path to tread.