David Cameron has just come off the Today Programme with a strong defence of the Government’s now famous NHS ‘listening exercise’. But there is a suggestion around Westminster that the man who came up with the idea was not Mr Cameron but his new spin doctor Craig Oliver.Mr Oliver is said to have persuaded his boss of the merits of the unprecedented legislative pause and round of public listening exercises (Mssrs Cameron and Lansley have to sit through another one this morning) as a way of publically proving that they care about the NHS and are not running rough-shod over health professionals in their reforms.
But concerns are beginning to surface about the strategy.
The Department of Health is understood to have warned Downing Street that if “substantial” changes are made to the content of the Health and Social Care Bill it could be open to a Judicial Review – on the grounds that the legislation is very different from what the House of Commons agreed. That could tie up the bill in the courts for months and cause chaos on the front line.
But another – and more likely scenario – is that little will be changed by the listening exercise leaving all the interested parties feeling hard done by.
If for example – and Mr Cameron hinted at this on the BBC – nurses and hospital doctors are given a slightly bigger role in commissioning and the GP consortiums get renamed to loose the ‘GP’ out of them that may end up antagonising GPs who are the key players in the whole reform process.
But it may still not be enough to appease the nurses – who, after all, have just passed a vote of no confidence in Mr Cameron. They are mainly concerned about the £20 billion worth of savings (or cutbacks) which the NHS has to make over the next four years (and which has been conflated in the minds of many with the Health Bill). And ministers can’t back down on that one.
Equally any changes in the bill which make it more difficult for private providers to get involved in the NHS might push those already there (like the much admired Circle Group) to revise their plans to take over and run failing hospitals.
This would undermine a key part of the bill – but, yet again, is unlikely to be enough to convince the sceptics – who want to see private involvement in the NHS not just well regulated – but rolled back.
All these dilemmas will be played out on the front pages and top of the news programmes when the Government finally unveils its response to the listening exercise later this year.
Mr Oliver got his headlines about listening as desired.
But when the Government gets back to governing and its ‘listened to’ bill goes to the House of Lords both he and Mr Cameron may come to rue the whole idea.
http://blogs.independent.co.uk/2011/04/19/camerons-problem-with-listening/
