Editor's blog Wednesday 30 March 2011: Lansley; ex-NHS staff mutuals' "right to provide"; policy improvisation; child's play

Click here for details of Andrew Lansley's Millwall Tendency, via subscription-based Health Policy Intelligence.

Truly, I felt I probably could not be further surprised by the U-turns and confusions of Secretary Of State For Health Andrew Lansley and his Millwall Tendency.

Once again, I misunderestimated Our Saviour And Liberator - Westminster's first viral-prone Cabinet Minister.

He's done it again, with his announcement to The Guardian's Sarah Boseley and Denis Campbell that he intends to offer staff who quit the NHS to set up in mutuals a "right to provide".

Policy improvisation - it's child's play
This ever-shifting explanation is like dealing with a four-year-old child who has just been naughty: "OK, Andrew, what happened?"

"Well, I told the people that it was going to be 'any willing provider' who could do things".

"You did?"

"Yes, but then they got a bit unhappy and said I was privatising things, so then I said it wasn't any willing provider because it was about what the commissioners wanted. So actually, I didn't really say 'any willing provider', actually. Not really, they just mis-heard me: what I actually said was 'any qualified provider'. So there."

"Ah. So you said 'any qualified provider', although it doesn't mean anything because unless providers are qualified by the CQC, they can't provide anything more than pointless crap like Botox?"

"No, because, ... no, because ... actually, it's about giving them a 'right to provide', actually. So long as they're not in the NHS, or in NHS buildings."

"So you're un-inventing commissioning? Those lovely new consortia we bought you last weekend, you don't want them any more?

"And what about patient choice, and 'no decision about me without me'? That's not compatible with a 'right to provide', is it?

"And if they'd wanted to do this, didn't they get a 'right to request' a few years ago, which very few of them wanted to use?"

There is silence ... and a furious, red-cheeked look of hurt. A foot is stamped.

"Andrew, do you need to go for a wee-wee?"

Liberation explained, at last
Clearly, this is the proof that I must have been a very bad person in a previous life.

I've died, gone to hell and woken up in an episode of 'Whose Health Policy Line Is It Anyway?'