Leading article: The Coalition will listen, but will it learn?

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It is probably fair to say that not one of this trio – not David Cameron, not Nick Clegg, and not Andrew Lansley – expected to spend the first day of the Easter recess sharing a platform at Frimley Park Hospital in Surrey. Still less, that at this late stage, they would be having to explain to a sceptical public what the reforms were and, far more to the point, what they were not. That this show of coalition unity was being mounted at all, however, and with the purpose of denying that the NHS was to be cut, cherry-picked or even privatised, is a measure of how far the Government has failed to get its message out.

On the one hand, what has happened offers a lesson to all governments in the imperative of controlling the agenda, especially when, as with the medical profession, long-standing vested interests may be threatened. On the other, however, as was clear from what Mr Cameron and Mr Clegg said yesterday, the public have still not "bought" the idea that the NHS needs such root and branch change at all. They may not be entirely happy with all aspects of the service they receive, but there is clearly widespread apprehension that, after a period of improvement, particularly where waiting lists were concerned, different will mean worse, less fair and distorted by commercial considerations.

The question – which remained open yesterday – was whether the next two months of "listening" on the Government's part will be anything more than a cosmetic exercise. Although many GPs are already preparing to take over the proposed budgetary responsibilities, for some the 2013 deadline will not be feasible, and there are real concerns about transparency and accountability. That a former chairman of the Royal College of GPs has been named head of an expert panel, the NHS Future Forum, to help lead the "listening" process suggests that ministers are concerned to keep GPs in the driving seat, even if the proposed consortiums are eventually supplemented by hospital doctors and local councillors. For the listening exercise to mean anything, however, the Government must be ready to hear what is said, and then defend, convincingly, the conclusions it reaches.

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