The executioner has long gone and wiped the political blood off his hefty axe but the jury is still out on Andrew Lansley’s controversial time as Health Secretary. He will be an old man before they return a verdict on his reforms and maybe – a big maybe – he had something.
He’s been vilified and booted out of a job after seemingly throwing up all the letter tiles in the scrabble game of public health in the hope they would land spelling a coherent pathway rather than the unreadable mess we appear to be left with.
His, and the Department of Health’s, defence was lamentable. They simply couldn’t explain what they were doing and the sheer depth of the reforms – the original bill was more than 600 pages long – meant they struggled to find a common theme to even explain the need for change.
But, a massive but, doesn’t it take something bold, almost dangerous to achieve real game changing reform? Establishing the NHS in the first place was a cataclysmic reorganisation of health provision yet it created the brightest example of the welfare system – a progressive and humane institution the envy of the world.
There’s little reason to expect the very act of change to create something worthwhile but the NHS was facing a cliff – spiralling costs, almost limitless bureaucracy, an ageing population and, what the heck, private healthcare had already seeped into the system – so it had to find a parachute and quick.
Slashing £80 billion from budgets, allowing ‘any qualified provider’ in and fostering more postcode lotteries with re-configured services doesn’t seem the best-packed chute in history. My view is that the changes were too grand and the obvious chaotic consequences dismissed as a heresy. I can see the sense of partnering with private business but to open the doors to a profit-driven future is just asking for trouble and the doors may only be closed again once the NHS has been sacked. It is too simplistic to view the changes akin to the Visigoths overturning the Roman Empire but many feel that is all that Lansley has achieved.
His career has crash landed and the urbane, soundbite-savvy Jeremy Hunt is in post to deliver a softer, less iconoclastic sales pitch. He will isolate issues into bite-size chunks rather than keeping to his predecessor’s aloof mantra of – this is good for you, trust me, I’m a politician.
History will be a while in reaching that final verdict and there will be much anguish along the way but a future Judgement Day just might not be as unkind to the 2012 Health and Reform Act as many of us believe it to be today. One thing is for certain is that it will provide be stacks load of material for history lessons and we will be talking about it for generations to come.