Mandarins line up to attack health reforms

Scotland’s most senior civil servant has sparked controversy by declaring Andrew Lansley’s health service reforms to be “enormously risky”.

According to Scottish political editor at the Sunday Herald, Tom Gordon, Sir Peter Houdson, who is permanent secretary to the Scottish government and had previously been permanent secretary at the Department for Communities and Local Government in Whitehall, criticised the reforms as he delivered a speech to a seminar organised by the Scottish NHS.

The paper explains:

“In it, Housden said the Scottish government had developed a seven-point test for new policies called “Changing the World”, which asked if they had vision, a recognisable story, clear actions and other necessary qualities.

“Applying the test to the Coalition’s NHS reforms, he said Lansley “got a tick” for a vision of a world-class health service free at delivery.”

However, it continues by quoting Houdson directly as having said:

“Thereafter Mr Lansley got into a bit of trouble. Had he got, secondly, a story to enable people to recognise where the NHS south of the border had been and where it was going?

“And thirdly, could they recognise a set of actions that would help move them forward? Now here we come to GP commissioning – a solution to no known problem.

“Mr Lansley could not persuade anyone, actually, [that] the things that they perceived needed to happen in the NHS would be resolved by GP commissioning. People could see some of that argument, but to base a system on all of that seemed to be enormously risky.”

Whilst the remarks sparked fury within the Scottish Conservative Party, Scottish Labour’s Leader, Johann Lamont, praised Houdson for having aligned himself with the mood of the country, arguing:

“I think on this issue Peter Housden has caught the mood of people not just in Scotland, but across the whole of the UK. The Tory reforms would be a disaster for the NHS.”

The revelations north of the border come as a former senior Whitehall mandarin dubbed the health reforms a simple “mess.”

Speaking to Radio 4’s “The World This Weekend” on Sunday, Lord Crisp, who between 2000 and 2006 served in the joint post of permanent secretary to the Department of Health and Chief Executive of the NHS, derided the plans, declaring:

“I think it’s a mess is my straightforward view of it. I think it’s unnecessary in many ways, and I think it misses the point.

“The point is that it should be setting out the direction of travel of the NHS – which is more community, more prevention-based and it should identify the mechanisms for using that which would obviously include some competition, some use of the private sector, but much greater emphasis on integration, on planning and on getting the balance right.

“I think it’s confused and confusing, and I think it’s unfortunately setting the NHS back.“

He continued:

“I think the great mistake that the current government has made – and I can say this as an independent and not a politician – that this is a terrible confused and confusing bill.

“It has tried to elevate the ideas of competition and the use of the private sector, which are just mechanics, just mechanisms, as if they were the purpose.“

Peers will this week resume consideration of the controversial reforms as they continue line by line scrutiny of the legislation.

See also:

• Tory voters trust BMA and co. over Cameron and Lansley on the NHS – Neil Foster, February 20th 2012

• Jones pledges to listen to NHS staff as Cameron leaves them out in the cold – Ed Jacobs, February 20th 2012

• How the coalition is breaking the NHS – Alex Hern, February 15th 2012

• The government continues to bury the risk of the NHS reforms – Alex Hern, February 14th 2012

• The five reasons why the NHS bill is still being opposed – Alex Hern, January 19th 2012