Finance fears over NHS plans

For, if the Tories were governing as a single party, there would – in all probability – have been no concessions over student tuition fees, and no review of NHS reforms. They would have carried on regardless.

That David Cameron has, thankfully, halted Andrew Lansley’s ill-conceived plans to give unprecedented financial powers to GPs is, largely, because of the concerns expressed forcibly – privately and in public – by Liberal Democrat Ministers and MPs.

They are concerns that are reinforced by today’s savage Parliamentary report which suggests that Mr Lansley’s doctrine will not accrue the anticipated financial savings – the primary justification for this reform.

Few will be surprised, given the two constants that have accompanied every single NHS shake-up in recent times. They have never achieved the expected efficiencies. And they have all cost considerably more money than anticipated.

It is odds-on that the coalition’s reforms will suffer the same fate. For, at a time when certain parts of the healthcare industry are struggling to meet foundation status, the benchmark of excellence, Mr Lansley hopes to rectify this by devolving power to GPs.

He is mistaken. Sub-standard care is unlikely to improve because a tier of bureaucracy has been stripped away and control passed from primary care trusts to GP surgeries. Precisely the opposite is likely to happen as Ministers, and others, lose the scope to exert quality control.

Yet the consequences do not end here. If the reforms do not accrue savings worth £20bn, the shortfall will have to be found elsewhere – and that means jeopardising Mr Cameron’s pledge to increase health spending on his watch.

It may be politically uncomfortable – but the Lib Dems have, at least, halted Mr Lansley’s reforms. Their challenge now is devising an alternative which enhances patient care, and also achieves the necessary efficiencies.