'NHS reform is Cameron's Waterloo'

Under pressure: Some believe the NHS bill could lose the Tories the election
Under pressure: Sme believe the NHS bill could lose the Tories the electiono

By Ian Dunt

NHS reform has been branded David Cameron's Waterloo, as the bill threatened to erupt into a political disaster for the coalition.

The comment, from health committee member Grahame Morris, comes as ministers break ranks to brief against health secretary Andrew Lansley.

“I think it could be Cameron’s poll tax, it could be his Waterloo - his part being Napoleon,” Mr Morris told Journal Live.


The bill's tortured passage through parliament hit another obstacle last Friday after the influential ConservativeHome website reported that three Cabinet secretaries were against the bill.

That intervention triggered a brutal counter-briefing against the author of the report, Tim Montgomerie, and a table-thumping Downing Street meeting in which the prime minister reiterated his plan to push ahead with the reforms.

"We’ve not shed blood on these proposals not to go through with them," the prime minister reportedly told colleagues.

Mr Cameron dared any minister briefing against Mr Lansley to repeat their views to him as well, according to reports.

"The prime minister is quite clear – the collective responsibility of the Cabinet means that Mr Lansley has its full support," Downing Street said.

That warning did not prevent Liberal Democrat deputy leader Simon Hughes admitting he thought Mr Lansley should be reshuffled on the BBC today.

"I'm clear we need to move on from this bill," he said.

"We need to be careful about the political sensitivities of this coalition."

Shadow health secretary Andy Burnham said: ""The Tory-led government seems to be in meltdown over the health bill.

"Not only do we have senior Tory Cabinet ministers calling if for it be dropped, we also have senior Liberal Democrats calling for the removal of the health secretary on national television."

No 10 fears developing a reputation for U-turns, after various previous policies - such as the forestry sell-off - were scrapped in the face of public opposition.

But senior Tories consider the bill a political disaster which could lose them the next election. Analyst believe any faults in the NHS after the bill is passed will be blamed squarely on the coalition.

Labour will also be able to maximise the political damage by pointing to David Cameron's promise before the election that there would be no "top-down reorganisation" of the NHS.

In a carefully executed manoeuvre, Labour is focusing on the publication of a risk-assessment paper on the reforms.

The information commissioner ruled it should be published but the government appealed the decision, prompting a tribunal which will adjudicate before the bill completes its passage through parliament.

Labour has tabled an amendment demanding the publication of the document, which maps out the worst-case scenario of the reforms, for immediately after the half-term break.

The move also risks splitting the coalition down the middle. The Liberal Democrat's strong track record on freedom of information means they will struggle to vote against its publication.

Mr Cameron has enough problems from his own ranks to worry about the Labour motion, however.

Writing in the Mail on Sunday, backbench MP Nadine Dorries – a supporter of the bill - accused the government of authorising the briefings against Mr Lansley.

She wrote: "In my view, those orders are most likely to have been issued by George Osborne, who knocks the Machiavellian tendencies of Gordon Brown into the shadows.

"Such a briefing sends a clear message to ministers: it was code for the prime minister’s general direction of travel. It said: ‘feel free to start smearing Lansley.’

"Lansley is toast. It is clear that Cameron wants to kill his own NHS bill – and Andrew Lansley’s career with it."

The Mail also revealed damaging reports that international management consultants McKinsey and Company had been allowed to draw up several of the health and social care bill's proposals wholesale.

It was also accused of sharing information with its corporate clients, including firms which will bid for health service work.

The report will fuel suspicions that the coalition is overseeing the back-door privatisation of the health service through the bill.

A YouGov poll for The Sunday Times found just 18% of rhe public support the reforms. Just 19% of people believe increasing competition will improve NHS services.

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