By Tim Montgomerie
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It's been exactly one week since I urged David Cameron to drop the NHS Bill in what turned out to be the most-read post in the seven year history of ConHome.
As I said in TV interviews at the time I didn't expect the PM to heed my advice and I completely understand why he didn't. At this late stage there are no easy options. Mr Cameron either mounts a humiliating retreat by dumping all of the NHS Bill's contentious components or he ploughs on in the teeth of opposition from NHS professionals and the public. I am still of the view that ploughing on is the worst course and it is the one that Labour desperately wants the Coalition to take.
If we plough on Labour will blame the Bill – unfairly – for everything that goes wrong in the NHS in the rest of the parliament. And more things than usual are set to go wrong because the squeeze on NHS budgets is going to be severe. The Bill would be forgivable if it wasn't going to deliver deliver big efficiencies. The tragedy is, however, that the Bill is unnecessary. Stephen Dorrell, Chairman of the Health Select Committee, has argued convincingly that just about all of the necessary reforms could have been pursued without an Act of Parliament. Reasonable people would have blamed the economic situation for the cuts. Many will now blame the Bill. Worse, Labour will repeat their old mantra that the Conservatives can't be trusted with the NHS. In opposition, Labour will say, Cameron vowed not to introduce a top-down reorganisation and then in government did precisely that.
The PM cannot say he wasn't warned. As LabourList blogged last Saturday: Ashcroft Warned the Tories About the Health Bill a Year Ago. Lord Ashcroft's mega poll of more than 10,000 voters from last May explained the situation very clearly:
"Many in our research believed the NHS was subject to cuts, though the government maintains its budget is being protected and increased. Most people were sceptical of the proposed reforms, and those who had noticed that some health professionals opposed them tended to take the same view. Nobody seemed to know is why the reforms were needed and how, even in theory, they were supposed to improve things for patients."
You can read a PDF of the full 'Project Blueprint' polling here.
Following the ConHome intervention Stephan Shakespeare wrote an important piece on the subject of U-turns earlier this week. Voters approve of changes in direction, the YouGov CEO argued, if they bring the polician back in touch with public opinion. And, as we know, only 18% support the NHS Bill.
The U-turn almost certainly isn't going to happen but at least the Government is now making a much better case for its reforms. Pieces in the last week by the PM, Simon Burns, Sayeeda Warsi and backbencher Nick de Bois have been a big improvement on what went before. Their substantive pieces have been a welcome contrast to the personal attacks orchestrated by one aide to the Health Secretary. Anyhow, this will be my last word on the NHS Bill for some time but if we are to win a parliamentary majority we need to get back to the position that David Cameron fought so hard to achieve at the last election – and neutralise the NHS as an election issue. I'm with Paul Goodman in believing that Jeremy Hunt is the best person to lead that effort.