Jeremy Laurance: We may not agree with Lansley, but we should listen to what he says

Medical Life

It is time to pause, listen and engage with Andrew Lansley. After the most bruising 14 days of his career, the beleaguered Health Secretary is in a lonely place. He has seen his NHS reform plans mauled by the Liberal Democrats, the Royal College of Nursing, the British Medical Association and just about every think-tank. Now, the Prime Minister has called a temporary halt. Leave my man alone, he says.

Mr Lansley is from a public service background. His father worked in a pathology department, one brother is a policeman and another trained as a teacher. His first wife was a doctor. He is a public servant who spent six years as opposition health spokesman, honing his NHS plans.

In an interview to The Spectator in 2006, he used an arresting joke to warm up audiences. "People imagine politicians are a bit brain dead," he would say. "Well I am – and I have the MRI scan to prove it."

In a freak medical accident, he suffered a stroke while playing cricket in Kent in 1992. He was 36. But he got proper treatment only because his wife, then a junior doctor, bullied his GP to send him for a scan. The GP thought his collapse was due to an infection.

Lansley recovered because he got swift treatment. Many stroke victims are not so lucky. The NHS's failure to catch up with other countries, he told The Spectator, was indicative of its bureaucratic culture. "Nobody is rewarded for being enterprising; you just do your thing and travel in the middle with everyone else. You don't want to be an out-rider, you just keep your head down. And I think that's a real shame," he said.

That encapsulates the challenge as he saw it – how to create a more responsive, innovative, less bureaucratic NHS. Lansley's answer was to shift control of 60 per cent of resources to GPs (responsiveness), open the NHS to competition (innovation), and cut out two layers of management – primary care trusts and strategic health authorities (bureaucracy).

The battle to modify his changes is now under way. But on one thing Cameron, Clegg and Lansley are agreed – no change is not an option. An NHS crisis is coming whatever happens, they say, as the population ages and medicine advances. This is the bedrock of the reforms argument. But is it true? Claims that the NHS is facing a crisis from escalating demands have been heard ever since it was founded. Yet it still survives. As wealth increases, health may be the one area where people are prepared to spend more.

Lansley's first wife saved his life by getting him access to a brain scan. Finding the cash to provide extra MRI scanners might have achieved the same end.

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