Friday, February 29, 2008

Telegraph Column: The Consequences of Mr Lansley



Click HERE to read my latest Telegraph column on Andrew Lansley and NHS funding. Here are a couple of tasters...

I suppose that compared with Labour's £110 billion commitment to Northern Rock, the Conservatives should find it relatively easy to uncover an extra £28 billion to spend on the National Health Service. This is what shadow health secretary Andrew Lansley appeared to commit the party to in an interview yesterday. The truth, however, was a little different, and once we ''small state" Tories had picked up our jaws from the floor we were told that Mr Lansley had actually said nothing new and it was all a storm in a teacup. Those of us with memories of longer than six months recall the same thing being said of David Willetts' speech on grammar schools...

What was he suggesting? That the defence budget be slashed? That the Home Office should fund fewer policemen? Tory spokesmen point out that no spending pledge has been made and any suggested cuts are included in Labour's spending plans, which the Tories are committed to shadowing until 2011. But the damage had been done...

Some of Mr Lansley's detractors have long believed that David Cameron would come to regret publicly guaranteeing him the position of health secretary in a Conservative government. It seemingly gave him a licence to speak out in a manner they did not enjoy. They now feel vindicated...

The Conservatives are polling narrowly ahead of Labour on the economy and NHS. This interview may help improve the latter, but not the former. During Labour's period in opposition, between 1992 and 1997, Gordon Brown instilled an iron discipline on spending pledges. Shadow cabinet members were banned from making any pledge without his explicit approval. They were even banned from talking about money, in case anyone should misinterpret their remarks. I trust George Osborne will impose a similar discipline on Mr Lansley and his colleagues in future.

19 comments:

  1. There appears to be an "agenda" against Andrew Lansley here. What is your real beef with him?

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  2. Lansley did not need to say anything, just like Willets did not need to.

    But they did.

    Willets stupidity was part of a massive decline in our poll ratings. Lansley has tried to patch it up, butis it too much to ask them to engage their brains before they open their mouths?

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  3. Oh for goodness sake. Can one now not argue a reasoned case without being accused of having an 'agenda'?! I have always liked andrew and still do. I think he has done a tremendous job but on this I believe he got it wrong. What is so terrible about saying so? It wouild be so much easier to pretend oit were otherwise.

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  4. It's self-defeating to continue to describe £110bn support as spending. It's loans plus guarantees, not spending. There's no evidence yet that the taxpayer will make a loss on Northern Rock, even after the transaction costs are taken into account.

    The NHS is funded by actual spending, not guarantees.

    The principle of keeping the shadow cabinet quiet on spending commitments is correct, though.

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  5. You know, there is very little coverage of this. The only way this will have legs is if the blogs keep picking at it, like the Grammar school "row."

    A friend of mine believes that the single thing standing in the way of a Tory victory is the blogs. I think he's right. They act as an echo chamber for the most ideologically committed, and in particular with Tim Montgomerie trying to boost his career (I've no problem with him wanting to become a big media shot, but it's laughable to hear him claim he's doing it for the Party-he's doing it for himself) by claiming he speaks for the grass roots, it makes it difficult for the party to move to the centre to appeal to a broader range.

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  6. While everyone may be able to see the point of not voting Labour, what is now the point of voting Tory?

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  7. Andrew Lansley, Teresa May, Ed Vaizey (i could go on) all fall into the 'nice- but don't cut the mustard' category. Do they kick the living crap out of Lying Labour or the Limp Libbies on a regular basis? Nope, they are too busy trying to be 'media friendly'(trying not to offend anyone) with the effect being they have the overall effectiveness of a chocolate fireguard. WHO authorised Lansley to claim the figure that an incoming conservative govt would waste/spend on the EU&therestoftheworld health service? He wouldn't have just blurted out any old figure. I do credit Lanners with SOME sense.

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  8. Iain.

    This all comes down to leadership.

    Cameron's video is excellent BUT then on the same day this twerp announces this!

    Left hand and right hand?
    A leader LEADS knows what is going on and who is going to say what. I can only suspect that he knew Lansley was going to say this and therefore agrees.

    If so, it is a madness. What is the use of looking at the way other countries operate their health services and never learn anything from them.

    The NHS cannot go on the way it is.There has to be a root and branch examination before extra money is guaranteed.

    There is, for example, much money to be saved from the great many publications produced within the NHS at great cost!

    There is, for example, much money to be saved by culling so many quango's.

    There is, for example, much money to be saved by culling the Departments of Health in London and the Leeds HQ.

    If Cameron truly believes, as the video stated,in local direction. He should make that a theme for the Health Service and call it Local Health for Local People. Based on the needs of the people. NOT on the views from London or Leeds.

    Lansley has failed. Time to offer his resignation.

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  9. What a twit Lansley is to mix up NR and NHS.

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  10. Inept, Mt Lansley. Inept.

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  11. Iain I thought you cooked your article so carefully it was , if anything, a little underdone .

    The fear is surely that Cameron has always intended to sell out the Party and he is using his recent high polls to slip a dagger into the heart of the faithful.
    Brown has done enough whilst in office to tell us all that he is heading off into authoritarian left wingery and so Cameron will feel that he can head deep into Labour’s territory losing only excess votes in Seats he cannot lose. Blair if you recall came to power promising to reform welfare and Cameron will feel that he similarly has to attract those who would vote for him only with great misgivings.

    The reason Brown funked his election was alarming news about Tory polling in the marginals . These marginal votes are the newly wealthy Liberal Public sector professional votes . The NHS is their castle . It is this constituency that will decide the election result and one hopes Cameron is making a pawn sacrifice .
    I think you also have to use political discounting before you count . Liberals talk about tax readjustment and we read tax rise. Conservatives talk about sharing growth and cuts are read. Promises like this are nothing like as ,meaningful as they appear over time and in power.
    I `ve thought about it a lot and in the end it comes to this . Do you or do you not want to get rid of Brown. To do so the Conservative party has to become something many Party ,members will not altogether like , including me . I hope there will some reassurance soon that we are still , beneath it all, simpatico .

    I`m still on board but I do not need to be lectured by prattling smarmy Liberals who believe in nothing and live from the efforts of others .

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  12. Are you sure that Osborne didn't know about this already? I find it very hard to believe that a policy announcement of this magnitude wasn't signed off by the Chancellor, at least in passing.

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  13. Iain, why don't you engage Mr brain for just one moment.

    Lansley is excellent. He really knows his stuff, and is respected by all parties. It's probably thanks to him that tories are even close to labour on health.

    The NHS will be one of the REALLY big themes of the next election. Particularly in marginal seats.

    Ultimately people fear the bad old days of the tory NHS in the 80's & 90's - many doctors (natural tory voters) still haven't forgiven Clarke et al for this.

    By sounding as though he was promising bucket loads of cash it will be a reassurance to anxious voters who want to be rid of labour but don't (yet) trust the tories. The fact that he didn't actually promise more cash is all the more cunning.

    This is only an issue in the Westminster community who have nothing in common with undecided voters in marginal constituencies.

    I quite agree that the real priority is to stop the astonishing waste in the NHS - and the tories are the ones to do this. This message doesn't resonate and doesn't win votes. Most voters are thick and/or apathetic - you have to keep the message simple.

    In summary - Lansley is doing a sterling job and the old guard of tory muppets should leave him be.

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  14. Until we hear the words "Brown Brown Brown, Out Out Out" from the electorate, Cameron has a mountain to climb. It's coming loud and clear on sites like this - where to be anything to the left of extreme right is to be vilified as a "smarmy liberal" by semi-literate pajama wearers, but the majority of people? Not angry enough by far.

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  15. Sorry to see you can't distinguish between a loan guarantee and actual expenditure. I hope you've got a more competent businessman helping you with your new venture. Perhaps it comes of having no children whose rent or mortgage needs a guarantor...

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  16. For the cohort of Labour trolls spitting bile at Daily Mail readers yesterday here is some news to gladden their hearts - Gordon describes himself as a Mail reader in today's Daily Mail - writing about his audacious policy to ban... erm ... plastic bags. As I posted yesterday - it's not so much that Gordon Brown thinks what Paul Dacre is thinking. More like Gordon doesn't know what to think until he's asked Paul Dacre.

    (see Guido's post Labour were thinking what the Tories were thinking)

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  17. I think the commentators here pointing out the political reasoning for the announcement are right - and the (predictable) reaction from the Right also helps the perception that Cameron is moving away from the Tories' past.

    Moreover, Lansley clearly understands the problem we face on health - even with reform (incl. going the whole hog to social or private insurance), we (and all other countries) will have to spend more on health: ageing population, higher-than-average cost inflation for medicines, etc. Where he can add value is by reforming the supply side to get more for our money by introducing competition and tackling public and private (e.g. GPs, pharma companies) sector monopolies. On the demand side, it will eventually be necessary to introduce some form of charging, but there is no way that this is politically possible at the moment - this needs to wait for more financial pressures to build. In the meantime, supply-side reform to prepare for that day is the best way forward.

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  18. vilified as a "smarmy liberal" by semi-literate pajama wearers, but the majority of people? Not angry enough by far.


    If you mean me I am working in a suit and I have a degree in Literature ..( albeit long forgotten).
    I wonder if this is the moment when Cameron decides he needs to dump some of those his new Liberal friends find offensive. Could this be a deliberate ploy to fumigate the Party of what would consider its "regressive " elements ?
    I agreed with him on education but actually planning to expand the state takes away the whole point of being a Conservative.

    The more I think about this the more it seem to me to be potentially a catastrophic misjudgment by Lansley . What he says he might have meant afterwards is not the point . the point is the political position it implies .
    The point is the foul cankered ghost of Edward Heath rising from his grave and shrieking with glee. "I `ve won I`ve won ,,,....I `ve beaten her in the end ...!"

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  19. Iain,

    I think you are missing Andrew Lansley's real point. With increasing population, longer life spans and more advanced medical technology if the NHS bumbles on in its current inefficient way then it is probable that NHS spending will rise to about 14% of GDP. Not for massive improvements, just more of what we are currently getting. His key point is that to keep the growth to only 11% will require structural change and more effective delivery.

    The dual case needs to be made, that there has to be more funding in line with increases in demand, but there needs to be incentives to reduce demand and massive improvement of the delivery of treatment. Just wishing the problem away won't make it go. Its better that the Conservatives present realistic solutions, but they will only be credible if they are honest with the public about the scale and nature of the problem.

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