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Cameron’s new NHS position leaves health professionals more confused than ever

Posted on 8 June 2011 | 12:06pm

There was a fascinating discussion on Newsnight of the latest twist in the tale of David Cameron and the NHS last night.

On one side of Jeremy Paxman sat Nick Clegg’s chief of staff, Norman Lamb, and a Tory MP I had never seen before but who was clearly on the right of his Party. And on the other sat a BMA representative and a consultant keen on the private sector being more involved in healthcare.

The two politicians, from totally different political perspectives, said that they were now happy with the position as set out by the Prime Minister yesterday. The two professionals, from their totally different perspectives, said they were now more confused than ever about what the Prime Minister’s position was. Cue Paxo’s sneery-faced, arms-folded, tongue-lolling, eyebrow-raising,what-the-hell-is-a-Nick-Clegg-chief-of-staff-anyway? look!

The discussion brought home the realities of the situation now that the coalition is well through the Rose Garden honeymoon period. The politicians seemed to see everything in terms of whether their own political view had been properly expressed – so Lamb was claiming the policy had shifted in a Lib Dem direction, and the Tory was claiming all the proper Tory principles had been protected. Paxman always does a good bemused look, but so did his healthcare guests.

David Cameron is said to have taken charge of sentencing policy as well as NHS policy. I wonder on both issues whether deep down he wonders why – and how – he started out on the road the coalition has taken.

On the NHS there is the particular problem of Cameron having been so clearly on the record that there would be ‘no more top-down reorganisations of the NHS’, that it was in neither manifesto not the coalition agreement. There is the problem too of Andrew Lansley’s credibility as Health Secretary now that Mr Cameron appears to have taken over much of his job.

Cameron has gone through the pain of the ridicule which greeted the ‘pause’ in the Parliamentary process. He has gone through the additional grief of a listening process which showed most parts of the NHS did not support the policy. And he has further pain ahead when the new position is fleshed out in detail.

Is it really too late to go the whole hog, say that actually much of what they wish to do could be done without legislation, and drop the Bill?

As for sentencing, as I have said before, I hope Ken Clarke does manage to get a changed approach on prisons and sentencing. He looked like he had swallowed the PM’s medicine for the time being. But I don’t think he will let Mr Cameron take over the whole process in the way he has seemingly done with Mr Lansley.

  • Watoop

    The crass list of ineptitude goes on.
    Tuition fees, aborted forestry sell off, failed Project Merlin, lack of any economic growth policy, schools sports u-turn, school buillding programme mess, rushed defence review, botched quango “bonfire”, child benefit removal, Bookstart u-turn, ineffectual “green” policies, banker bonus climbdown etc.
    Now add NHS reform and prison sentencing to the list. 
    Regardless of the rights and wrong of ideology, they are simply JUST NOT UP TO THE JOB OF GOVERNMENT! (sorry to shout but it makes me angry).

  • Richard

    Red Leader magnificent again today at PMQ’s. All agree?
    However, please advise how, after Labour discounted sentencing by 33 1/3 % for early guilty pleas, the thought of raising it to 50% is anathema. The principle is excellent: is 35% too much? 38%? 41%?
    As in the Balls argument of 50% reduction of current account debt over 5 years = Good, 100% Bad, Labour stubbornly gets a % figure in it’s head, and the mantra never shifts.
    Are these % figures handed to Ed M written in tablets of stone, at the top of a mountain in the near east?
    If so, when is he to visit again to collect some policies for the future?

  • Gilliebc

    “Is it really too late to go the whole hog, say that much of what they wish to do could be done without legislation, and drop the Bill?”   If they have any sense that’s what they should do. They have no mandate to do any more than that.

    Ken Clarke, that seasoned old pro. I think he will simply see this as a temporary blip and carry on regardless.  I hope that’s what will happen because prison and sentencing reform is an important issue and well overdue for change and up-date.  Time is no longer on KC’s side.  It is probably his last chance to achieve real change in an archaic system and less importantly (to most) ensure his place in the history books as a great reformer.

    Regarding today’s PMQ’s.  I could not help but feel slightly sorry for “little” Ed.
    The poor chap is way out of his depth. He comes across as a petulant sixth form schoolboy.  Meanwhile Cameron is becoming more and more confident
    and every inch the PM.  If he styled himself on TB he has done a good job.
    But, he totally lacks the effortless charm of TB.

  • Paul M

    You forgot to mention Pickles forcing Corby to accept nuclear waste. All part of his returning power to local people.

  • Sarah Dodds

    I’m just increasingly angry with all 3 main political parties when it comes to the other great privatisation issue of the day. We are watching the wholesale privatisation of our education system without so much as a eyelid being batted from any of the parties.
    Where is the debate from Labour about it?
    The debate is being had, but not on a party level. 
    As a Labour councillor, a teacher, a parent, and an active campaigner trying to protect state education as we know it, I find the silence from Labour dispiriting to say the least.  
    Look what mass opposition to the health proposals achieved. Have Labour decided not to fight a battle on two fronts? Because if that is the case, they have failed in realising that the debates are really one and the same.
    If Gove has his way, and we do end up with a privatised education system, (and in many parts of the country it is almost complete in the secondary sector)  the current Labour front bench will be as much to blame as the Tories and the Libs.
    Shame on them.

  • Gilliebc

    “Magnificent” that’s certainly one word for his performance today, Richard.
    Excruciating, might be another.  Poor chap.  Why on earth did he put himself up for the job as leader. Even the unions who voted him in are having second thoughts. When a leader begins to be pityed, it’s time to go.

  • MicheleB

    Most if the furore about 50% sentence reductions furore seems to have settled around rape, as if it’s the only crime it was being thought about (having coincided with his verbal accident with ‘serious rape’).

    I’m not sure how convinced criminals would be about the value of an early ‘guilty’ plea and a halved sentence as a result of it.  They don’t know, at the start of their trial, what 100% of their sentence would be guilt is proved anyway.  I doubt many crims are trusting souls.

    Re NHS changes, I put a post on the wrong thread the other day and will re-enter it here, it’s from the fab i paper of last Wednesday :

       “In a remark that infuriated 
    … Shirley Williams, Mark Britnell, a member of
    the kitchen cabinet
    appointed to advise the Prime Minister on the reforms,
    was reported to
    have told private sector executives in October that the
    reforms would
    offer a ‘big opportunity to the private sector’.”

    WHOSE NHS ?  
    Ours or investors from home OR abroad?

  • Robert

    And the latest cash saving wheeze for care home company Southern Cross?

    Sack 3000 non-frontline staff such as cleaners.

    Is that wise?

    Will fewer cleaners encourage increased occupancy – one of your cash problems?

    The first thing any daughter or son looking for a good care home for their parent does is walk in the front door and smell the place.

    When my sister and I were looking for care for mom in 2005 we went to four places that stank so we walked out without further ado – mom went into one that had no smell at all and the home stayed that way until she died from her fall in March. Whenever we went to the home to take mom out for the day and when dropping her back the cleaners were there – and no smell.

    Sacking cleaners in care homes for the elderly is NOT the way to go.

  • ambrosian

    I watched the full PMQs live and agree that it wasn’t one of Miliband’s best performances.
    Yet in the 10 second soundbites on the BBC News, Miliband looked fine and appeared to have Cameron on the ropes over the current policy chaos. So Team Miliband will probably think ‘job done’.
    Fact: 300,000 people watch PMQs live. 4 million people watch the 6 O’Clock News.

  • MicheleB

    KC’s main argument about the 50% bartering was that it would save £130m in costs but it was insane to see it in such a way if, as it sounded, it would have gone in to the Govt’s general pot. 
    Anything saved from prisoner accommodation should be specifically to make it available to the same dept’s budget for prisoner education, counselling and re-development in preparation for release. 

    I don’t think Camsham has achieved even 10% of TB’s skill; to drop so many of his team in the poo, to humiliate them as he does (after giving them free rein then pulling them back in) is shocking.  He doesn’t have a grasp of diplomacy (or loyalty – except that to mouth breather LittleO).


  • MicheleB

    “However, please advise how, after Labour discounted sentencing by 33 1/3
    % for early guilty pleas, the thought of raising it to 50% is anathema”.

    Difference between giving a third off for an early plea when the reasoning for it is genuinely to shorten trials vs giving half off simply to save prison costs is clear to me. 

  • Quinney

    Poor Teflon Dave had to get back from his break with  da yoof on Club Ibiza and to become the de facto Health Secretary and Home Secretary.He’s had to promise voters that Teflon Dave will save the NHS from David Cameron!
    Dr Fox (not the Club Ibiza Dr Fox) has had to borrow an American anti submarine plane to look after the navy off Libya, after he orderded our £4 billions worth state of the art Nimrods to be cut up.
    We also have Oxbridge telling Willets they have no confidence in him and more and more universities charging the £9k a year this lot said wouldn’t.

    And, reverting to type the cause of the nations woes are…. you guessed it….the trade unions. Bumbling Vince who catches all the crap that slips off Teflon Dave (Clegg just takes all the bullets) warns the unions to behave themselves or he’ll introduce yet more anti union legislation.
    It’s a pity that this fool dosen’t use his nuclear option to stop firms decamping abroad and tax avoidance by the mega rich.

  • Watoop

    The Goverment’s localism reminds me greatly of the old management chestnut of “empowerment”. We empower local people to make decisions, as long as it’s exactly what we tell you to do. And if it goes wrong, it’s nothing to do with us.

  • Anonymous

    I’m afraid I don’t.

    Health is an issue on which the Tories are spectacularly failing, but today Ed Mili used a hammer where a scalpel would have been more appropriate.  We all know the government’s health policy is a mess, but merely to call it that doesn’t get us very far.  I preferred his reference to Cameron as a shameless person who will say anything.  Miliband ought to have the moral authority to crush the party opposite on issues as big as this.  I’m finding it frustrating when he doesn’t manage it.  

  • Yonks

    One of Cameron’s problems is that he appears to be too easily swayed by media opinion; the coalition proposes something, the media and some experts moan, the coalition changes its mind.
    They haven’t learnt that if you’re going to be a ‘bastard’ then be one, this trying to appeal to everyone simply has the opposite effect.
    And little Ed has no idea on how to take advantage of the confusion.

  • DM

    I very much liked the post Watoop and a good point Paul M.  But I also think Teresa May should get a mention as she has done nothing constructive.  She is a terrible communicator as she clearly has to talk at people rather than to them, and yet she comes across as being all mouth, posture and pomp and I personally wouldn’t follow her out of curiosity.  So I would add her thrashing around with great ceremony to simply rebrand a load of stuff we already have (ASBO’s, SOCA, Prevent) as wasteful, costly and ultimately pointless.  She’s obviously been taking a few pointers from that clown Letwin – announce something with great fanfare and then slide away while absolutely nothing useful materialises. 
    So there’s a long list of moronic policies and stances from this shambolic bunch and I think that needs to be emphasised by Labour at every opportunity.  While the Tories want to use every interview to squeeze in the lie that “it’s all because of the financial mess labour left”, Labour need to start hitting back hard and consistently with clear messages and responses.  If that means messing up some poor radio or TV interviewer’s slot, so be it.  The Tories seem to figure that repeating the same lies has taken hold, but their list of truly shambolic achievements in just 13 short months is very useful ammunition to fire back time, after time, after time.  The interviewers, producers and hacks will soon tire of not getting their way, particularly the lightweight ones, but it will also drive home the fact that collectively they are not scrutinising this bunch of phoneys and charlatans and holding them to account. Too many in the media still want to give the ConDems an easy ride and move on to something else and it should be made clear that a supine regurgitation of the Tory line by the media will only make those segments of the media look increasingly unprofessional and irrelevant.   For me, the key word for the ConDems is shambolic.  As AC points out, Paxman looked bemused and despite changes to the ‘team’ at Drowning St, the ConDems are all over the place on virtually everything they’ve touched.  Clegg’s an expensive irrelevance, Cable is an impotent busted flush and Osborne is clearly far too sensitive and tightly wrapped to be outside without nanny.  To cap it all, Cameron’s at the top and despite all the effort he puts into the ‘image thing’, it’s quite obviously all bluff and bluster and he’s somehow mastered the reverse midas touch.

  • Sarah Dodds

    Just found this girl on Facebook.
    I can hardly see for crying. Thought you would want to share it too.

  • Dave Simons

    Absolutely spot on, Watoop. I remember ’empowerment’ well, and other chestnuts like ‘make a difference’. I tried the latter policy at work once and ended up being reprimanded by management. No wonder the acronym was ‘MAD’. We live in an age of double-speak.

  • Richard

    Your theory on motivation for the move is interesting.
    You have forgotten that when the 33% discount was introduced it was to reduce the numbers in prison as they were full and new ones were being built but not due for completion for some time.
    Any % suggested by Labour is science, any suggested by anyone else is cynical and wrong!
    In a recent press release it was suggested that 110% of voters thought that Red Ed was doing a brilliant job.

  • Watoop

    Thanks DM – nice analysis here too and absolutely agree that the Labour attack line has to be on the amateurism and shambolic nature of the outfit.
    Lord I couldn’t stand Thatcher but she was at least brutally efficient in going about her nasty agenda.

  • Gilliebc

    Thank you for the link Sarah. It doesn’t feel right to tick your “like” box
    for obvious reasons. That poor young girl Alice, just heart-breaking.
    These young people that are stricken in this and similar ways always seem so brave. It is quite remarkable.

    Are you back teaching again Sarah? Or perhaps you have your hands full
    with your council work.

  • Gilliebc

    “the current Labour front bench will be as much to blame as the Tories and the Libs.”
    That’s pretty much sums it up Sarah.  Disappointing doesn’t really cover it.
    There are so few MP’s that genuinely represent the people.  So few, that they are easily ignored by their party’s.

  • Dave Simons

    I’ve just lost my youngest niece and am about to lose a young colleague, both stricken in similar ways to Alice. I can’t help thinking what I was like when I was the age at which they have been stricken – half mine or less  –  and then thinking:  if it had happened to me would I have been able to attain the level of bravery and spiritual awareness that they have shown or are still showing? I don’t think so.

  • Gilliebc

    I was very sorry to hear about the loss of your niece Dave and the impending loss of a colleague. Life can be so very cruel at times.

    When I was about 11 years old, I had a “mysterious” illness.  My parents were worried sick, but I was well happy being off school for 3 months and not actually feeling too bad at that time. 

    The point I’m trying to make though is that children and teenagers see things differently.  I know when I was poorly I didn’t grasp for a single second the magnitude of what could happen to me.  Whether this a self-protection mode that kicks in at  such a time or what, I really don’t know.
    But whatever it is, it certainly helps the young person concerned.

    Older people are only too well aware of what may happen to a young person who is terminally ill.  But the young person themself even though they have been told they may not live for much longer and outwardly seem to accept it.  I don’t think in their heart of hearts really believe it.
    This is probably a good thing, all in all.