Andrew Grice: Cameron could live to regret his reluctance to kill the Bill

Inside Westminster

Share
Related Topics

"I hope I backed Andrew [Lansley] enough," David Cameron said after PMQs on Wednesday.

When Ed Miliband gave him a torrid time over his NHS reforms, Mr Cameron had meant to defend his troubled Health Secretary. He told Mr Miliband that Mr Lansley's career prospects were "a lot better" than the Labour leader's – hardly the most ringing endorsement.

That the Prime Minister intended to give Mr Lansley his full support is revealing. He is not going to be thrown overboard – not yet, anyway. Nor, it seems, is the Health and Social Care Bill. Mr Cameron, right, has a difficult dilemma. There are plenty of voices, including some Downing Street advisers and cabinet ministers, who want him to cut his losses, dump most of the Bill and salvage the elements that could be agreed with Labour. That would take most of the politics out of the NHS, giving Mr Cameron a valuable insurance policy at the next general election.

It looks tempting, because the Prime Minister has an aversion to retoxifying his party. But he has also developed an aversion to U-turns. Dropping the Bill at this late stage would be the mother of all retreats. Having gone through the pain barrier of a full-scale review last year to lose his nerve now would suggest he is being buffeted around by events. So the most likely course is for Mr Cameron to repeat the "sell-it-yourself" solution he adopted during last year's storm. Expect lots of TV pictures of the PM visiting hospitals, sleeves rolled up, with poor Mr Lansley following behind.

The latest wobble over the Bill has surprised ministers because it was filleted during last year's much-vaunted "pause". Many of the criticisms that have resurfaced in recent weeks were fully aired then. So what has changed? Crucially, most of the professional bodies representing those who work in the NHS have come out against the shake-up.

This is toxic for the Tories. As Mr Cameron knows, the public normally takes its cue not from what politicians say about the NHS but what the professionals say. That's why he and Mr Lansley cuddled up to them in opposition – reassuring them, by the way, that there would be no more top-down reorganisations like the one they are now trying to push through.

The latest wobble also poses a dilemma for the Liberal Democrats. They trumpeted the surgery given to the Bill last year as a great victory. In fact, George Osborne played an equally important role but was happy to let Nick Clegg get the plaudits after his defeat in the referendum. So it is hard for the Liberal Democrats to say the NHS changes are a disaster. Mr Clegg cannot easily join Labour in trying to "kill the Bill".

Last year's battle between the Coalition parties over the NHS reforms was the most public since the 2010 election – though it was rather stage-managed, a revolt by the smaller party licensed by the major one. Recently, the Liberal Democrats decided that they need to do more of what they call "differentiation" to show the voters they are not Tories. That is why Mr Clegg took the unusual step of making his demand for tax cuts in a speech rather than a private submission to the Chancellor.

Like the NHS row, that made headlines, but is the public getting the Liberal Democrat message? Party strategists admit they need to differ more loudly, that even the great NHS revolt passed many voters by. Mr Clegg has a difficult balancing act; he also needs to show that "coalition works".

So the Liberal Democrat plan is to set out some key disagreements in public so that, even if they don't get their own way, the public knows they are not Tories. At the same time, the two parties are discussing plans to set out the policies on which they do agree in an updated Coalition Agreement.

One of those areas will be health. But that has big dangers for both parties. The pressures for hospital closures in the run-up to the 2015 election will be enormous. A proper solution to the looming social-care crisis would require even more money to be taken out of hospital budgets so that more people can remain in their own homes. Waiting times for treatment will become a major issue again. The cuts will be blamed on the reforms, and will be laid at Mr Cameron's door. The man who described his top priority in three letters – "NHS" – might well look back on 2012 and wish he had "killed the Bill" after all.

React Now

  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

Recruitment Genius: Project Implementation Executive

£18000 - £23000 per annum: Recruitment Genius: They work with major vehicle ma...

Recruitment Genius: Chiropractic Assistant

£16500 per annum: Recruitment Genius: A Chiropractic Assistant is needed in a ...

Recruitment Genius: Digital Account Executive - Midlands

£18000 - £26000 per annum: Recruitment Genius: They work with major vehicle ma...

Recruitment Genius: Web Developer

£28000 - £30000 per annum: Recruitment Genius: This company provides coaching ...

Day In a Page

Read Next
 

Errors & Omissions: how to spell BBQ and other linguistic irregularities

Guy Keleny
 

South Africa's race problem is less between black and white than between poor blacks and immigrants from sub-Saharan Africa

John Carlin
NHS struggling to monitor the safety and efficacy of its services outsourced to private providers

Who's monitoring the outsourced NHS services?

A report finds that private firms are not being properly assessed for their quality of care
Zac Goldsmith: 'I'll trigger a by-election over Heathrow'

Zac Goldsmith: 'I'll trigger a by-election over Heathrow'

The Tory MP said he did not want to stand again unless his party's manifesto ruled out a third runway. But he's doing so. Watch this space
How do Greek voters feel about Syriza's backtracking on its anti-austerity pledge?

How do Greeks feel about Syriza?

Five voters from different backgrounds tell us what they expect from Syriza's charismatic leader Alexis Tsipras
From Iraq to Libya and Syria: The wars that come back to haunt us

The wars that come back to haunt us

David Cameron should not escape blame for his role in conflicts that are still raging, argues Patrick Cockburn
Sam Baker and Lauren Laverne: Too busy to surf? Head to The Pool

Too busy to surf? Head to The Pool

A new website is trying to declutter the internet to help busy women. Holly Williams meets the founders
Heston Blumenthal to cook up a spice odyssey for British astronaut manning the International Space Station

UK's Major Tum to blast off on a spice odyssey

Nothing but the best for British astronaut as chef Heston Blumenthal cooks up his rations
John Harrison's 'longitude' clock sets new record - 300 years on

‘Longitude’ clock sets new record - 300 years on

Greenwich horologists celebrate as it keeps to within a second of real time over a 100-day test
Fears in the US of being outgunned in the vital propaganda wars by Russia, China - and even Isis - have prompted a rethink on overseas broadcasters

Let the propaganda wars begin - again

'Accurate, objective, comprehensive': that was Voice of America's creed, but now its masters want it to promote US policy, reports Rupert Cornwell
Why Japan's incredible long-distance runners will never win the London Marathon

Japan's incredible long-distance runners

Every year, Japanese long-distance runners post some of the world's fastest times – yet, come next weekend, not a single elite competitor from the country will be at the London Marathon
Why does Tom Drury remain the greatest writer you've never heard of?

Tom Drury: The quiet American

His debut was considered one of the finest novels of the past 50 years, and he is every bit the equal of his contemporaries, Jonathan Franzen, Dave Eggers and David Foster Wallace
You should judge a person by how they peel a potato

You should judge a person by how they peel a potato

Dave Hax's domestic tips are reminiscent of George Orwell's tea routine. The world might need revolution, but we like to sweat the small stuff, says DJ Taylor
Beige is back: The drab car colours of the 1970s are proving popular again

Beige to the future

Flares and flounce are back on catwalks but a revival in ’70s car paintjobs was a stack-heeled step too far – until now
Bill Granger recipes: Our chef's dishes highlight the delicate essence of fresh cheeses

Bill Granger cooks with fresh cheeses

More delicate on the palate, milder, fresh cheeses can also be kinder to the waistline
Aston Villa vs Liverpool: 'This FA Cup run has been wonderful,' says veteran Shay Given

Shay Given: 'This FA Cup run has been wonderful'

The Villa keeper has been overlooked for a long time and has unhappy memories of the national stadium – but he is savouring his chance to play at Wembley
Timeless drama of Championship race in league of its own - Michael Calvin

Michael Calvin's Last Word

Timeless drama of Championship race in league of its own