The relegation of Andrew Lansley

By David Beeson

What a fascinating spectacle Andrew Lansley provides as a minister. And if you want to enjoy it, take advantage of the opportunity now: all the signs are that his tenure as Health Secretary is not going to last much longer and that he may even be the first sacrificial victim of a government trying to shake off a reputation for incompetence which it richly deserves.

Whenever I see Lansley in action, I think back nearly quarter of a century to another Tory minister in that post. At the tail end of the 80s, the position was held by Ken Clarke. It was a time of more health service reform – it always is, isn’t it? – and Clarke was making himself highly unpopular with changes that threatened people’s jobs though no hard evidence existed that they were likely to deliver benefits.

Sound familiar? Yep, it was the Conservatives banging on then as they are now about the need to give GPs more of a say over managing the health service, It’s an idea that certainly has much to commend it in principle, but which they tend to make a complete pig’s ear of in practice.

There, however, the resemblance ends. One of the bodies that was most outspoken in its opposition to the moves was the then Institute of Health Services Management. I attended its conference, in Torquay, if my memory serves me. And the health secretary announced he would be there.

He came, and he was Ken through and through. Ill-fitting suit, shirt stretched by an over-indulgence in the after-work pint and a general air of congenial blokishness. He made a short but straightforward speech explaining his point of view. And then, to my utter amazement, he invited questions from the floor. In front of him were several hundred NHS managers, the vast majority of whom opposed every last jot of the changes he was proposing. And he agreed to take their questions.

Not questions submitted in advance and subject to censoring. Not filtered questions, written down and passed to a couple of apparatchiks who would weed out the tough ones. Oh no. Delegates held up their hands and a microphone was passed to them and they asked tbeir question.

Even more amazing was the way he answered them. Several times I heard him say ‘I’m not sure of the answer to that, but it’s a good question, and I think that we’ll probably do the following.’ Was he being evasive? If he was, he was showing extraordinary skill: I certainly couldn’t see him dodging anything. It looked to me as though he was taking each question head on, dealing with it when he could, and admitting it when he couldn’t.

And the most amazing thing of all: as time went on, you could feel the hostility of the hall evaporating. Opponents who rose to attack him sat down having asked a sensible question to which they’d received a reasonable answer. He disarmed his critics.

Now roll forward nearly a quarter of a century to the Royal College of Nursing Conference of 2011 in Liverpool. Again, the conference is massively hostile to the Health Secretary, passing a vote of no confidence in him by a 98% majority. Lansley travels to Liverpool, as Clarke travelled to Torquay. But did he walk into the lions’ den? Did he heck. Sixty delegates were hand picked to see him in a separate room, from which even the press was going at first to be excluded. Lansley simply didn’t have the confidence in his own beliefs, or in his ability to defend them effectively, to take on his critics as Clarke had.

Now there’s plenty to say against Ken Clarke, not least of which is ‘what on Earth are you doing in that appalling party?’ But you can’t fault him on his courage, on his skills as a communicator, or even showing a great deal more honesty than most politicians.

Lansley, alas, just isn’t in the same league. And what happens if you’re in the wrong league? Why, you get relegated.

Don’t worry, Andrew. The guys who’ll be sacking you in a few months time won’t be that far behind you. They belong in your league too, you know.