NHS reform: bill stalled as ‘listening’ exercise begins

I can’t remember the last time a Government launched a consultation in the middle of a bill’s progress through Parliament. It’s not a good sign and it certainly wasn’t part of the plan. In the Commons just now, Andrew Lansley has been careful to call it a “listening” exercise not a “consultation” – I’m told this is because the latter term has legal weight and leaves you open to judicial review if you are not carrying it out to the letter of prescribed practice.

To say that Andrew Lansley sounded hugely impressed by his critics and sees the shortfalls of his brainchild would be a little wide of the mark. This statement was no mea culpa. The Health Secretary is said to be frustrated by the headlines of recent days promising a lengthy pause in reforms and a serious re-think, and it showed.

Mr Lansley is said to be making the point in government that changing NHS reform is not like changing something like the forestry policy … even small changes in the NHS (still the third largest employer in the world after the Red Army and the Indian Railways?), send multi-million pound ripples through the entire organisation and cost you lots more than you might like. So he promised “democratic accountability” would improve through health and well-being boards – not sure that will satisfy critics like Evan Harris. There was nothing about putting the brakes on the whole policy.

It was the end of last year that No. 10 started getting very nervous about the progress of NHS reform. There was a bit of internal blame parked with Andy Coulson for not “rolling out the pitch” before the Bill was published and preparing public opinion.

There was an acknowledgement that No. 10 hasn’t had the personnel to scrutinise the Health and Social Care White Paper in the summer of 2010 – that’s played a big role in leading to the beefing up of No. 10’s policy team. One former No. 10 aide said to me that No. 10’s scrutiny of the White Paper last summer amounted to little more than “a spell check” – no doubt he exaggerated for effect, but you get the point.

Interesting interventions from elsewhere in this debate today saying that the Lansley pace of reform threatens to add to costs because of expensive mistakes:
– David Cameron’s favourite think tank, Policy Exchange, says slow down – the pilots prove you can’t rush this (http://www.policyexchange.org.uk/)
– Norman Tebbit says in The Mirror that the policy is being rushed (Andrew Lansley when he was a civil servant was Principal Private Secretary to Norman Tebbit when the latter was a minister)
– Ed Miliband clearly thinks this is an Achilles Heel and lays into the policy in a speech at the RSA
– The Daily Telegraph leader calls the policy a “mess” and questions whether Andrew Lansley should be sacked

Future interventions on the way:
– the Health Select Committee weighs in again tomorrow
– perhaps more grabbily, Tony Blair, whose name is much invoked by the PM when he defends the NHS reforms, is planning to make a speech at the end of next month which will try to distance himself from the Tories’ reforms of the NHS (and their free schools reforms, I hear). The “not in my name” speech, depending on how strongly it is made, could be another significant moment.

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