Health Lexcomm: Post Conference 2011

07/10/2011

Health Lexcomm : Post Conference 2011 (PDF)

Despite the build-up, health failed as a policy area to ignite a generally low key and unexciting conference season. In what turned out to be his swan song in Liverpool, former Shadow Health Secretary John Healey repeated Labour’s traditional charge that ‘you can’t trust the Tories with the NHS’, a theme picked up by Ed Miliband in his call to the faithful, but the message was lost in the debate over the Labour leader’s analysis of ‘producer versus predator’ capitalism. Similarly, although much was expected of the rebellious Lib Dems, the conference failed to further punish the Coalition’s reforms and instead concentrated on some back slapping selfcongratulation over the ‘victory’ of the changes made to the Health and Social Care Bill.
For the Conservatives, the beleaguered Health Secretary Andrew Lansley appeared tired of the long running saga concerning the reform agenda and made a somewhat unconvincing address to his party’s conference that made much of the Coalition’s commitment to spend more on NHS services. In keeping with David Cameron’s ‘One Nation’ position, Lansley made great play of the Conservatives’ commitment not to privatise services which did get the faithful cheering. However, the poor attendance at his speech in
Manchester and lacklustre accompanying presentations indicated that again, attention was focused elsewhere. The one speaker who did up the ante was Health Minister Simon
Burns whose populist address somewhat over shadowed his boss.

Away from the conference hall and the main stage, some slightly more exciting and controversial discussions could be found on the fringes of conference including the Institute of
Economic Affairs causing quite a stir at the Conservative conference by criticising the commissioning abilities of GPs and advocating for far greater competition in the NHS, much
to the upset of Dr Clare Gerada from the Royal College of General Practitioners. The Health Hotel’s flagship Health debate also provided some entertainment at each of the
conferences showcasing a scene of one-upmanship between John Healey and Stephen Dorrell at the Labour conference and a grumpy and belligerent Health Secretary at the Conservative conference.

However, as the dust settles on the conference season for another year much remains at stake on health as MPs and Peers get over their hangovers and return to Westminster.
Attention is very much focused on the House of Lords as the Health and Social Care Bill enters its next tortuous stage of becoming law. Lansley’s mood ahead of this will not have been helped by the letter published this week by 400 leading health experts calling for the Bill to be scrapped and, however unlikely this may be, further concessions could be required to appease this lobby via the mutinous Peers led by Baroness Williams. The Health Secretary is unlikely to give up without a fight given the large number of concessions that have already been made although the Department of Health will have one eye on the Parliamentary timetable and the need to press on.  In order to get the Bill finally passed there may need to be a willingness to concede on key points should the final cut-off date of next spring appear in doubt at any stage.

The debate over the reform agenda continues to rage against a backdrop of ever present pressures on the NHS to deliver on its efficiency targets. There is still a perception that pressures on budgets and the implementation of the Nicholson Challenge will lead to increased rationing and restrictions on access to the latest therapies and technologies. It is timely, therefore, that the Government now has at its disposal the responses from industry and others to its innovation review consultation. Officials are currently trawling through a mass of material to come up with some practical ways in which top class healthcare can be delivered for less. Rising inflationary pressures will not help the situation though – it should be remembered that the Conservative promise to raise the NHS budget in real terms was made using a very cautious assessment of what this actually entails in cash terms.

The Health Secretary will also be acutely aware of the simmering tensions building over potential hospital reconfigurations, with many of the stated closures set to take place in marginal seats. It will be a true test of his mettle whether or not he chooses to fight on yet another front or resorts to the default position of kicking decisions into the (very) long grass. The situation may not be as adversarial this time round as a number of high profile organisations have come out in support of some shifting of capacity to help cope with the financial challenges facing the NHS. With even Unison promising not to oppose every proposal, Lansley may find himself in agreement with some unlikely allies.

Back at Westminster, the political dynamic on health will, clearly, undergo a significant shift with the return of star performer Andy Burnham to the shadow Health Secretary role. With a good understanding of the detail of policy and a significant level of support within the associated vested interests who have been so vigorous in opposing the reforms (he was after all the proponent of the ‘preferred provider’ policy which minimised private sector expansion), Burnham will be seeking some quick wins to make his mark and keep Andrew Lansley on the ropes. It is certainly unlikely that the Health Secretary will relish the prospect of a tougher opponent on the Labour benches just when he might have felt the Coalition had turned a corner, finally increasing the pace of
reform after a long drawn out compromise process. In any event, all the pieces seem now to be in place to ensure another lively term on health matters in Westminster this Autumn.


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