Bill will survive; Andrew will not

I said Andrew Lansley may not be long for this Cabinet in The Independent on Sunday a fortnight ago, so in today’s newspaper I repeat myself at greater length.

Last week’s “Kill the Bill” fuss was displacement activity and posturing by Labour and the royal colleges of NHS vested interests. The health Bill will complete its final stages soon, because David Cameron thought about killing it last summer and decided not to. Since then the vested interests have postured harder against it, but it has acquired the solid(ish) support of the Liberal Democrats in the House of Lords, so it will go through.

But Lansley is likely to be reshuffled after that because he has shown himself to be a poor communicator. In my article today I cite Sam Coates’s great report in The Times on Wednesday (pay wall) which recounted how No 10 wrote a speech for him all about how his family loved the NHS, but to which Lansley added his impenetrable speaking notes:

Outcomes depend on integration across services. Opportunity of NHS/public health/and local authorities together.  Like they do in Sheffield.

This will be the first opportunity in new system to demonstrate how we can bring together services.

GP/community/acute/LAs/safeguarding/children’s trusts.

Not structural integration but integration around familes and children.

Marmot (universal proportionalism) – early intervention.

Strengthening GP practice expertise and delivery of children’s services.

Bring expertise out of hospitals into design and delivery of community paediatric services.

Poor communication is not a trivial flaw in a politician, as someone recently explained:

It’s like when people say to me: “Oh, So-and-So, they don’t believe in anything, they’re just a good communicator.” As a statement about politics, it’s close to being an oxymoron.

(Tony Blair, A Journey, p73.)

These things are not always simple. James Forsyth has a good story in today’s Mail on Sunday about how Andrew Lansley was taken by Andrew Cooper, No 10’s pollster, to a focus group to watch its reaction to clips of him on television. To Cooper’s chagrin, the group warmed to Lansley and took against his Labour opponent, Andy Burnham.

But that does not obviate the problem that Lansley has been unable to explain what his policy for the NHS is. Cameron has noted the contrast with Michael Gove at Education, where many of the vested interests don’t like his free schools, converter academies and continued expansion of sponsored academies, and he is mocked for archaisms such as Dickens and free Bibles, but everyone understands what he is about and parents mostly like it.

I suspect that Gove would not want to move to Health, but sometimes duty calls.

Photograph: Steve Back/Rex Features

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