Andrew Lansley - Not a t****r
Contrary to popular internet speculation, the Secretary of State for Health is not a ‘tosser’. Nor is he attempting to ‘sell’ the NHS. But nonetheless it looks this morning as though his flagship bill on NHS reorganisation will suffer an incongruous death at the hands of his suddenly outraged Lib Dem colleagues.
The politics of this are bizarre in themselves – a party loses local elections and a referendum, thus giving them the capital to strangle a key Government reform – but it is the broader narrative that is most fascinating here. Think tanks, policy wonks and campaigners are prone to decrying ‘ministerial churn’. Demos published a report looking at the high turn-over of Ministers and Secretaries of State and calling for longer term appointments. The problem, we argued, was that short-term Ministers lead to short-term decision making, lack of specialist knowledge and over-mighty vested interests in the civil service and public sector. Those arguments are as true today as they were two years ago and yet we need only look at Andrew Lansley to see what happens to those senior politicians who actually bother to become experts in their field.
No-one could accuse Lansley of being a fly-by-night Minister. He shadowed the health brief for six years before getting his hands on the shiny red box post-election. During that time he built a vast understanding of the NHS – of what works and what doesn’t, of how the systems produce outcomes, of what might be done to improve it. Having conducted six long years of field research Mr. Lansley wanted to implement what he had found, to make the changes he saw were necessary and to reform in favour of patients. But he now stands forlorn with a Bill killed for expediency’s sake, a media scenting blood and a very bleak future indeed. Because the truth is that British politics is grotesquely unforgiving to politicians who actually know what they’re talking about. This rare breed takes an interest in a particular area, studies it, makes decisions based on facts rather than either gut or biased briefings – then they seek to act. And because they know how bad the problems really are, because they understand that surface change is insufficient, they tend to try to act big and act bold. It is then that the full force of Britain’s public management class comes hammering at their door demanding their head on a platter. It is happening to Andrew Lansley, it happened to Frank Field, Lord only knows which politician will be foolish enough to get on top of his brief next but we know what fate awaits them.
Ministerial churn is a problem. It leaves us with automaton politicians remotely controlled in the interests of their Department rather than their public. But it will not be solved so long as we allow those who stay, learn and then attempt to act radically to be hung, drawn and quartered in revenge. The Prime Minister claims to want to lead a radical Government – he can achieve that but he must allow his Ministers to embrace that radicalism and to take it forward. That means signalling that he will protect them when their pursuit of reform leaves them open to attack. David Cameron must save Andrew Lansley, and his Bill, or risk sending the message to his Cabinet that short-termism, political expediency and blandness will be rewarded whilst expertise and bravery will not.