David Cameron's government: There's precious little that's Conservative about it

By Stephen Glover

Last updated at 7:29 AM on 14th June 2011

Tipping point: Has the U-turn on the NHS policy - though a bad policy - been bad for David Cameron?

There is a moment in the life of any Government that defines its character for ever afterwards.

That moment may have arrived with the imminent abandonment of much of the Coalition’s NHS reform programme.

The Health and Social Care Bill is in some respects a bad one — badly thought out by Andrew Lansley, the Health Secretary, and badly explained and communicated by him and other ministers.

But its virtual demolition at the hands of 'independent' experts yesterday means that a once-in-a-lifetime opportunity to reform the NHS has been lost.

A service that delivers some of the worst patient outcomes among advanced countries will undergo a minor tinkering when, in fact, it should be subjected to a full-scale overhaul, though not necessarily the one proposed by Mr Lansley.

The evisceration of the Bill comes after a flurry of other U-turns by the Coalition, often under pressure from the Lib Dems, who are exultantly claiming victory in thwarting NHS reform.

They were also instrumental in making Tory ministers backtrack on their pledge to cap state welfare handouts at £26,000 a year, though Iain

Duncan Smith, the minister responsible, denied yesterday that the policy has changed. Maybe we have a U-turn of a U-turn.

The Lib Dems claimed another scalp when ministers were forced to accept lax repayment terms over spiralling student loans, which will mean that a large proportion of them may never be paid back, creating a hole in the public finances.

Meanwhile, the Government has broken the Tory election promise to reinstate weekly bin collections, though in this instance recalcitrant Tory local councils rather than the Lib Dems are apparently mostly to blame.

Eric Pickles, the Communities Secretary, has said that weekly collections are 'a basic right'. This is one basic right which the Coalition is unable or unwilling to deliver.

The list of other broken Tory pledges is so long that it would take up the rest of this article to recite them all.

They range from the softer-than-promised line on crime and sentencing taken by the Justice Secretary, Ken Clarke, to a series of betrayals over Europe, to unforeseen smash-and-grab raids on the hard-pressed middle classes, of which the withdrawal of child benefit for those earning more than £44,000 a year is the most notorious example.

Many Tory MPs rightly blame the Lib Dems for extracting more concessions than their slight weight in the Coalition justifies.

What is particularly difficult to understand is that the concessions continue — indeed, they seem to multiply — even though the Lib Dems as a party have practically sunk below the waterline, and their shell-shocked leader, Nick Clegg, is pretty well the most unpopular man in Britain.

Their conduct over the Health and Social Care Bill has been despicable.
Realising rather late in the day that Lib Dem activists hated the idea of NHS reform, and anxious to make amends after breaking its promise to abolish tuition fees, the Lib Dem leadership cynically disowned vast chunks of a Bill which it had previously enthusiastically supported.

Now Mr Clegg has the nerve to claim victory for making David Cameron change his mind over NHS reform when he himself should be exposed as an unprincipled and inconsistent charlatan.

All that has happened can be reasonably adduced as proof that coalition politics are intrinsically flawed, inevitably leading to broken promises and innumerable compromises, with the end result that no one is very happy.

Andrew Lansley: His health bill was bad from the start, but now instead of real reform we get only tinkering

But I suggest that it would be a mistake to blame the Lib Dems for every jot and tittle of each U-turn.

The truth is that at least some of the U-turns have suited Mr Cameron rather well.

The Lib Dems serve as a convenient cover for policy retreats which the Prime Minister might anyway want to take.

The Health and Social Care Bill is a case in point. Mr Lansley was allowed to make the running for several months without Mr Cameron showing much interest, though it was clear to many observers that some of the measures, not least putting GPs in sole charge of health commissioning, were impractical, if not actually barmy.

The irony is that Mr Cameron, who has been obsessed in his PR way with 'detoxifying' the Tory Party, allowed Mr Lansley to blunder around so that people began to think that the NHS was not safe with the Tories after all.

Panic set in when No 10's focus groups showed a collapse of faith in Mr Cameron’s custodianship of the NHS.

So, irrespective of what the Lib Dems may want, the Prime Minister — by no means so savvy a PR operator in this case as he is usually cracked up to be — is most relieved to drop a measure that has got too hot to handle.
Is this any way to run a Government?

The tragedy is that, however ill-conceived parts of Mr Lansley's Bill may have been, it represented an honest and much-needed attempt to shake up an inefficient State behemoth.

Despite vowing to proceed with his 'modernisation' programme, Mr Cameron will now be wary of undertaking any other sort of NHS reform for fear of upsetting those dreaded focus groups.

In other words, for all his swashbuckling élan when it comes to bombing Col Gaddafi, or his announcement yesterday of a vaccine programme for the Third World, Mr Cameron becomes strangely timid when important domestic reforms meet entrenched opposition.

That is why the climbdown over the NHS may mark a defining moment for this Government by illuminating its true nature.

What is there left of Tory policy? There are Michael Gove's free schools, though I suppose they are themselves a kind of second-best since Mr Cameron believed that the re-introduction of grammar schools would damage the Tories' image and 'contaminate' the party.

There is Iain Duncan Smith’s thorough-going welfare reform. After remarks on Sunday by Lord Freud, the Tory Welfare reform minister, suggesting that the £26,000 upper limit for state handouts for a single family might be raised, there may have been a change of heart.

Swashbuckling? On the world stage he at least attempts to look that way, but at home he is looking decidedly less than that

Subject to change: Iain Duncan Smith's thorough Welfare reform programme has already altered, but may change again

But I wouldn’t be surprised if further aspects of Mr Duncan Smith's reforms were watered down over the coming months.

And there is George Osborne's deficit reduction programme, allegedly draconian, though at the end of it all in 2015 public spending is projected to be the same as it was in real terms in 2008, after more than a decade of growth.

There are, as yet, no signs of any weakening on this front, but it would be foolish to rule out some backsliding if the Lib Dems lost their nerve.

Which Cabinet Minister will now bring forward radical proposals if he or she fears that the Prime Minister will one day pull the rug?

I’m afraid that what has happened over the NHS will act as an antidote to bold and imaginative government.

David Cameron is, of course, doubly blessed because he has no formidable rivals on his own benches, and Labour has an almost comically ineffectual leader.

If this were not so, a succession of U-turns which reveal an alarming absence of consistent principle, most damagingly in the case of the NHS, would be represented as a major crisis.

As it is, the show goes on.

David Cameron looks on top of the world while Labour's leading lights are at one another’s throats.

The fact remains that there is precious little about this Government that is visibly Tory.