I was surprised yesterday to wake to the news that 38 Conservative MPs led by Dan Poulter had signed a short letter to the Sunday Telegraph declaring that they suported the Health Bill. The spin said these were loyalist MPs who wanted to show their support for the Prime Minister’s Health reforms.
I was surprised because at last count around 300 Conservative MPs supported the Health Bill. I had not heard rumours of large groups of disloyal MPs seeking to change the Bill radically or get it droppped. There have been no angry meetings about this, no letters signed by 100 potential rebels, no attempt to table unhelpful backbench motions through the backbench business committee, no pre-emptive summons of Health Ministers to the 1922 Committee to explain themselves. This is no referendum on the EU or powers back from Brussels issue within the Conservative party, where all of these things have been happening, including from some of the same people who signed this letter.
I was surprised because many MPs had not been shown the letter or invited to sign it, so clearly there was no wish to maximise the numbers of signatures. As a result a letter went out with just 38 names on it, running the risk of implying there are almost a couple of hundred Conservative backbench MPs who would not sign it, when I guess most had not been asked. Let me reassure you all further, those who like the reforms or are relaxed about them. As far as I know Conservative MPs will continue to vote for this legislation if asked to so so. If you are against the Bill , you will be relying on Labour and Lib Dem votes in the Lords to force the changes.
The letter makes the fair general point that the aim of the Health Bill reforms is to improve the quality of patient care, partly by offering more control over that care to medical practitioners within the service. The aim presumably was the worthy one to try to get across the high level messages about this reform – that quality and choice are the drivers of the reforms with the aim of better patient care. One of the means of doing this is cutting bureaucracy and leaving more direct control to medics. Unfortunately the absence of any praise for Mr Lansley in the text left the media with the story that the loyal MPs were loyal to the PM but not to the Health Secretary, which no-one seemed to move rapidly to deny. The original White Paper in 2010 was co signed by Mr Cameron, Mr Clegg and Mr Lansley. All three were completely united in recommending their chosen course of action to the public.
What is my view? I favour more choice and more patient power in the NHS. I am happy about effective cuts in overall bureaucracy, as long as the replacement offers better management for less cost. I did not advocate the Bill, but will support the government if they tell me that is the best way of bringing about these general aims. I was asked at the beginning of the government what I thought about proceeding with it. I suggested it would prove difficult as I expected the Lib Dems enthusiaism for it to wane if it ran into criticism. They do need to be careful lest the Bill becomes a very expensive complex measure, with all sorts of new duties and functions for the NHS built into it to seek agreement to it in the Lords. They need to concentrate on achieving that better quality care with more choice that is at the heart of the original proposals.
I would be interested to hear your views on this Bill, and on the government’s approach to it. I have delayed the schools piece until tomorrow, as this is topical today.