According to this morning's Times, one of the prices to be paid for securing the Coalition is the head of Andrew Lansley.
To be honest, that's a bit too easy for my taste. Don't get me wrong, I hold no candle for the MP for South Cambridgeshire, but he isn't the problem. The problem is the policy, in that it isn't wildly popular. That doesn't make it bad policy, ironically, because popular isn't always good - dangerous dogs, anyone? - but it does mean that revisiting the drawing board might be a very good idea indeed.
Firstly, strip out the entirely artificial deadlines. All they do is create an undue sense of urgency and make transition management a nightmare, a car crash waiting to happen. That's not only bad politics, but bad administration. Good policy is straightforward to administrate, so that you can make it happen.
Second, decide upon your criteria for a well-run NHS. Cost-efficiency, improved care standards and democratic accountability are not mutually exclusive, and a proper debate on the future of health provision might just make for better decision making. And that means not simply demanding the full ice cream sundae with whipped cream, a flake and a cherry on the top, it means a realistic assessment of what we need in the future and what we can afford.
Thirdly, the notion of private sector cherry-picking is something that some Conservatives do not, or do not want to, get. And yes, there do appear to be some in the Labour and Liberal Democrats who suffer from the same myopia. That isn't to say that there isn't a place in health provision for the private sector, but it makes people nervous. So, for example, why not allow private companies to run an NHS Region leasing all of the buildings and equipment from the State? Any savings could be split on a shared basis between provider and government, and the assets revert to us when the contract ends. Indeed, you could even allow said provider to subcontract bits of work, so as to open up opportunities to small and medium sized enterprises.
Ultimately though, the problem is less about policy than about fear and trust. On the NHS, people don't trust the Conservatives, and the fact that the changes appear to be all about one of the three key criteria - cost - excites suspicion. And it isn't the job of the Liberal Democrats to reassure people that Andrew Lansley has the best interest of the NHS and patients at heart, it's our job to test, prod and probe the policy, and to do it publicly. If it survives proper scrutiny, then fine.
And if Andrew Lansley doesn't like it, he can quit, rather than be sacked. That way he gets to retain his honour and his integrity, and we take a small step towards the new politics that people keep talking about.
