Closed doors

Already committed to wholesale changes to education and welfare, it had been accepted within the party that the Conservatives would postpone NHS reform until a possible second term, hence David Cameron’s pre-election promise of “no top-down reorganisation of the NHS”.

Once in power, however, Mr Cameron thought again and unleashed Health Secretary Andrew Lansley’s vision of the future.

This apparent breaking of a promise, however, has made the Prime Minister appear shifty and unreliable, which has hardly helped Mr Lansley in his stumbling attempts to explain his policy to the public and sell it to the people whose support he most needs, NHS staff.

The consequence is an absurd situation in which Downing Street can host a meeting on the Health Bill which excludes all its major critics. It is palpably ridiculous that this is a plan which centres on devolving power to NHS staff, yet the Royal College of Nursing and the British Medical Association are not invited to discuss its implementation.

The Government protests that it is talking to those who want to implement the changes, not those who would obstruct them. Yet if these organisations cannot be trusted to behave constructively at a meeting, how can they be relied on to carry out major healthcare reforms?

It is clearly the case that the NHS needs reform in order to adapt to a changing society, just as it is clear that there are powerful vested interests within the NHS who will always resist change that does not suit them. Yet this makes it all the more important that the Government gets its policy right and takes time to do so. Mr Lansley’s already much diluted Bill is not the answer.