Health Policy Intelligence 50: Lansleyshambles - game over, as Jeremy ‘Bellflinger’ Hunt does the reconfiguration hokey-cokey

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Looking back at it with a little perspective, the end of Our Saviour And Liberator Andrew Lansley’s front-line political career was appropriately bizarre. Here was probably the worst communicator ever to be Health Secretary, whose radical reforms were effectively kept a secret before the election, and whose plans generated such opprobrium that the legislation had to be stopped in its tracks through Parliament by a coalition government with a large majority.

And then Prime Minister David Cameron decided that the right time to discard Mr Lansley was six months after the passage of the 2012 Health and Social Care Act, and before all the crucial regulations are issued.

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It remains a baffling decision, timing-wise. Despite leaks to the national press, with the Act passed it did not seem to me politically shrewd to sack Our Saviour And Liberator – but that is what the Prime Minister did.

At least there is a certain symmetry: I thought and wrote many times that surely yet another Lansleyshambles Moment meant that at last, Mr Lansley’s career as a political zombie had to be gently defenestrated. I was wrong on all of those occasions, and I was wrong again right at the end. There we go.

It is difficult to guess whether history will be kind to Mr Lansley. His reforms will never be implemented as he wanted; as such, they may prove impossible to judge. Mr Lansley leaves the NHS in the middle of a revolution half-completed, which is a particularly dangerous state of affairs.

It is clear from Mr Lansley’s sacking that the Government, and in particular the Prime Minister, no longer supports its own health policy and defining NHS legislation. Andrew Lansley didn’t seem to be a bad man; just a desperately poor politician and salesman, who saw the NHS as a puzzle which only his reforms could solve.

So Number 10 Downing Street is resuming control of health policy, and it is reasonable to suppose that changes of emphasis will follow. Value-based pricing of new medicines might prove a bellweather policy: one that almost nobody apart from Mr Lansley believed would work.

Mr Lansley was consoled with the non-job of Leader of the House of Commons, and has not since bothered trying to look anything other than deeply annoyed in his appearances in the Commons.

Why a new Cabinet job? Because exiling him to the backbenches could have been risky for Mr Cameron and his strategist, Chancellor George Osborne. For all Mr Lansley’s limitations, he ran a campaign that won a general election, which he lists as one of his proudest political achievements. (Bathetically, the other is “transforming the public's view of the Conservative Party's support for the NHS”).

Mr Lansley can now unleash his claws. At a You Gov conference in Cambridge, Spectator editor Fraser Nelson reports Mr Lansley said “In normal circumstances, with that election result, there would not have been a coalition. We’d have formed a minority government, put forward a programme, challenged the House to support it or not and after a decent interview – probably a few months – we would have had a general election and would have almost certainly won a majority … the Conservative Party surrendered what would have been its narrow political interest for the national interest”.

This line could get interesting traction among discontented backbench and right-wing Tory MPs.

Mr Lansley’s replacement is Jeremy ‘Bellflinger-Murdoch-Spoonerism’ Hunt. There is a lovely anecdote of the PM’s conversation with Mr Hunt about the job: it reportedly went, “Jeremy, I’ve got two alternatives what to do with you. I can sack you, or you can be Secretary Of State For Health”. Hunt is said to have replied, ...

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