Leading article: Doctors to the rescue

 

Share
Related Topics

The Health and Social Care Bill will be a case study for decades to come in how not to reform public services and how not to legislate. Students of modern government will start with the textbook Failure in British Government: Politics of the Poll Tax, before moving on to the design of railway privatisation and then to the coalition Government's attempt to reform the National Health Service.

The faults of the reform are well known. David Cameron promised before the election that "there will be no more of the tiresome, meddlesome, top-down restructures that have dominated the last decade of the NHS". This pledge was repeated in the coalition agreement with the Liberal Democrats after the election: "We will stop the top-down reorganisations of the NHS."

Andrew Lansley, the Secretary of State for Health, then suddenly announced that he would abolish primary care trusts and give the power to spend £60bn a year of the NHS budget to family doctors.

Mr Lansley said that he had been explaining the rationale for the plan for six years as opposition health spokesman, and that it was our fault that we had not noticed. But now that we had noticed, we still could not understand his explanation. Not least because it contradicted itself. The localism was to be imposed by central diktat. The bureaucracy – it became clear – was to be replaced by a new bureaucracy. Targets were to be replaced by benchmarks.

Mr Cameron realised a year ago that he had a problem. He had been paying attention when Mr Lansley explained it all to him, which was quite often. But it was like asking someone who works in the City what a hedge fund is. They explain; you nod; you think you understand; but five minutes later you realise that you have no idea. So Mr Cameron got George Osborne, his chief political adviser, to look at it for him. In February last year, the Chancellor leaned back in his chair and asked: "Does anybody else think this is a bad idea?"

They should have dropped the Bill then. But, instead, they decided to save it. Mr Cameron ordered a "pause", so that Mr Lansley could have another go at explaining it, and so that his Liberal Democrat coalition partners could devise some cosmetic amendments, which would make it look as if the Government had listened. The pause had the remarkable effect of making the doctors even more opposed to the Bill. The Liberal Democrat amendments made the Bill even more confused and contradictory. And the chief apologist for the whole sorry mess at the Liberal Democrat spring conference in Gateshead last weekend was Baroness Williams, whose status as guardian of her party's principles has now been Clare Shorted.

The Bill is now in injury time in the House of Lords. Tomorrow, peers have their last chance to stop it when they vote on a delaying amendment tabled by Lord Owen, Lady Williams's co-founder of the Social Democrats.

As we report today, a group of hundreds of doctors, representing thousands more, is launching a last attempt to persuade peers to drop the Bill. They intend to stand as candidates at the next election against Liberal Democrat and Conservative MPs on a Save the NHS platform. This is no mere revenge against the Liberal Democrats for betraying another policy for which the party purported to stand, but a serious attempt to persuade the party's peers to do the right thing tomorrow.

It is nearly too late for Nick Clegg to try to save some of his party's reputation. As John Rentoul writes, Clegg has led his party into a coalition government that has gone against fundamental Liberal Democrat principles on student finance and Europe in return for very little: a referendum on a change to the voting system that the party did not really want and the right to claim credit for raising the income tax threshold. This week's Budget will no doubt raise the threshold further, but that is a tax cut the Conservatives want too, and it would be no compensation for setting back much-needed reform of the health service.

We suspect that tomorrow's vote in the House of Lords has already been decided, but The Independent on Sunday wishes the campaign well. If the Bill passes, we hope that the doctors can, by targeting Liberal Democrats – and Conservatives too – in marginal seats, hold the NHS reforms to democratic account over the next three years. If the Government's botched changes damage the NHS, the MPs who supported it must pay the price.

React Now

Latest stories from i100
iJobs Job Widget
iJobs General

Maths Teacher

£110 - £200 per day: Randstad Education Leeds: Secondary Maths Teacher for spe...

Business Analyst - Surrey - Permanent - Up to £50k DOE

£40000 - £50000 Per Annum Excellent benefits: Clearwater People Solutions Ltd:...

***ASP.NET Developer - Cheshire - £35k - Permanent***

£30000 - £35000 Per Annum Excellent benefits: Clearwater People Solutions Ltd:...

***Solutions Architect*** - Brighton - £40k - Permanent

£35000 - £40000 Per Annum Excellent benefits: Clearwater People Solutions Ltd:...

Day In a Page

Read Next
Women are working in some of the lowest-paid sectors such as cleaning, catering and caring  

Women's wages have gone backwards. Labour would give women the pay they deserve

Gloria de Piero
 

Taking on Ukip requires a delicate balancing act for both main parties

Andrew Grice
Wilko Johnson, now the bad news: musician splits with manager after police investigate assault claims

Wilko Johnson, now the bad news

Former Dr Feelgood splits with manager after police investigate assault claims
Mark Udall: The Democrat Senator with a fight on his hands ahead of the US midterm elections

Mark Udall: The Democrat Senator with a fight on his hands

The Senator for Colorado is for gay rights, for abortion rights – and in the Republicans’ sights as they threaten to take control of the Senate next month
New discoveries show more contact between far-flung prehistoric humans than had been thought

New discoveries show more contact between far-flung prehistoric humans than had been thought

Evidence found of contact between Easter Islanders and South America
Cerys Matthews reveals how her uncle taped 150 interviews for a biography of Dylan Thomas

Cerys Matthews on Dylan Thomas

The singer reveals how her uncle taped 150 interviews for a biography of the famous Welsh poet
DIY is not fun and we've finally realised this as a nation

Homebase closures: 'DIY is not fun'

Homebase has announced the closure of one in four of its stores. Nick Harding, who never did know his awl from his elbow, is glad to see the back of DIY
The Battle of the Five Armies: Air New Zealand releases new Hobbit-inspired in-flight video

Air New Zealand's wizard in-flight video

The airline has released a new Hobbit-inspired clip dubbed "The most epic safety video ever made"
Pumpkin spice is the flavour of the month - but can you stomach the sweetness?

Pumpkin spice is the flavour of the month

The combination of cinnamon, clove, nutmeg (and no actual pumpkin), now flavours everything from lattes to cream cheese in the US
11 best sonic skincare brushes

11 best sonic skincare brushes

Forget the flannel - take skincare to the next level by using your favourite cleanser with a sonic facial brush
Paul Scholes column: I'm not worried about Manchester United's defence - Chelsea test can be the making of Phil Jones and Marcos Rojo

Paul Scholes column

I'm not worried about Manchester United's defence - Chelsea test can be the making of Jones and Rojo
Frank Warren: Boxing has its problems but in all my time I've never seen a crooked fight

Frank Warren: Boxing has its problems but in all my time I've never seen a crooked fight

While other sports are stalked by corruption, we are an easy target for the critics
Jamie Roberts exclusive interview: 'I'm a man of my word – I'll stay in Paris'

Jamie Roberts: 'I'm a man of my word – I'll stay in Paris'

Wales centre says he’s not coming home but is looking to establish himself at Racing Métro
How could three tourists have been battered within an inch of their lives by a burglar in a plush London hotel?

A crime that reveals London's dark heart

How could three tourists have been battered within an inch of their lives by a burglar in a plush London hotel?