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

Recruitment Genius: Photographer / Floorplanner / Domestic Energy Assessor

£16000 - £25000 per annum: Recruitment Genius: A Photographer/ Floor planner /...

Ashdown Group: Front-End Developer - Surrey - £40,000

£30000 - £40000 per annum: Ashdown Group: Front-End Developer - Guildford/Craw...

Recruitment Genius: Customer Service Assistant

£13500 - £15000 per annum: Recruitment Genius: A Customer Service Assistant is...

Recruitment Genius: Sales Executive - OTE £35,000

£16000 - £35000 per annum: Recruitment Genius: An ambitious and motivated Sale...

Day In a Page

Read Next
 

General Election 2015: Ed Miliband hasn’t ‘suddenly’ become a robust leader. He always was

Steve Richards
 

Costa Rica’s wildlife makes me mourn our paradise lost

Michael McCarthy
Not even the 'putrid throat' could stop the Ross Poldark swoon-fest'

Not even the 'putrid throat' could stop the Ross Poldark swoon-fest'

How a costume drama became a Sunday night staple
Miliband promises no stamp duty for first-time buyers as he pushes Tories on housing

Miliband promises no stamp duty for first-time buyers

Labour leader pushes Tories on housing
Aviation history is littered with grand failures - from the the Bristol Brabazon to Concorde - but what went wrong with the SuperJumbo?

Aviation history is littered with grand failures

But what went wrong with the SuperJumbo?
Fear of Putin, Islamists and immigration is giving rise to a new generation of Soviet-style 'iron curtains' right across Europe

Fortress Europe?

Fear of Putin, Islamists and immigration is giving rise to a new generation of 'iron curtains'
Never mind what you're wearing, it's what you're reclining on

Never mind what you're wearing

It's what you're reclining on that matters
General Election 2015: Chuka Umunna on the benefits of immigration, humility – and his leader Ed Miliband

Chuka Umunna: A virus of racism runs through Ukip

The shadow business secretary on the benefits of immigration, humility – and his leader Ed Miliband
Yemen crisis: This exotic war will soon become Europe's problem

Yemen's exotic war will soon affect Europe

Terrorism and boatloads of desperate migrants will be the outcome of the Saudi air campaign, says Patrick Cockburn
Marginal Streets project aims to document voters in the run-up to the General Election

Marginal Streets project documents voters

Independent photographers Joseph Fox and Orlando Gili are uploading two portraits of constituents to their website for each day of the campaign
Game of Thrones: Visit the real-life kingdom of Westeros to see where violent history ends and telly tourism begins

The real-life kingdom of Westeros

Is there something a little uncomfortable about Game of Thrones shooting in Northern Ireland?
How to survive a social-media mauling, by the tough women of Twitter

How to survive a Twitter mauling

Mary Beard, Caroline Criado-Perez, Louise Mensch, Bunny La Roche and Courtney Barrasford reveal how to trounce the trolls
Gallipoli centenary: At dawn, the young remember the young who perished in one of the First World War's bloodiest battles

At dawn, the young remember the young

A century ago, soldiers of the Empire – many no more than boys – spilt on to Gallipoli’s beaches. On this 100th Anzac Day, there are personal, poetic tributes to their sacrifice
Dissent is slowly building against the billions spent on presidential campaigns – even among politicians themselves

Follow the money as never before

Dissent is slowly building against the billions spent on presidential campaigns – even among politicians themselves, reports Rupert Cornwell
Samuel West interview: The actor and director on austerity, unionisation, and not mentioning his famous parents

Samuel West interview

The actor and director on austerity, unionisation, and not mentioning his famous parents
General Election 2015: Imagine if the leading political parties were fashion labels

Imagine if the leading political parties were fashion labels

Fashion editor, Alexander Fury, on what the leaders' appearances tell us about them
Phumzile Mlambo-Ngcuka: Home can be the unsafest place for women

Phumzile Mlambo-Ngcuka: Home can be the unsafest place for women

The architect of the HeForShe movement and head of UN Women on the world's failure to combat domestic violence