Lobbying On Health

Like many of us I have been adding my voice to the often aptly named cacophony of views on how our health services can be delivered in the future.

The Lib Dems have clearly scored a victory in this debate but I am not necessarily celebrating. While there were big problems and risks in the Lansley reforms-as-were, there was much good too which is now at risk. One of these is the role of non NHS providers, including, if we're not careful, social enterprises. These could be the baby thrown out with the privatisation bathwater.

To this end, I have been lobbying, among others, Norman Lamb, who really understands health and the party to speak with colleagues, particularly their Lordships, who might not be aware of the small miracles being achieved by the Central Surrey Health's and City Partnership Hull's of this world. Achievements any self-respecting Lib Dem should be proud of.

The plain truth of the matter in health and social care is that different parts of the system require different combinations of competition and collaboration. The argument to keep competition out of say, a big city hospital's coronory services in order to be able to deliver a specialism it otherwise couldn't can be matched, just as powerfully, by the case to introduce competition into areas like speech therapy or physio, where only one, often very sloppy, NHS provider, can legally claim public money for its work.

My point here is that different permutations of competition and collaboration, integration and break-up, are required across the system. This point is somewhat lost in the binary discussion in even the intelligent newspapers - and in politics. Their Lordships - who are often above this sort of thing - have been joining in with our own Lord John Pugh sounding off about Stephen Bubb's involvement with third sector capital provider Social Investment Business. This is exactly the kind of nonsense I fear could lead Lib Dem peers to try to kybosh social enterprise health providers too on the grounds that they are are kind of privatised service.

It has been interesting watching this unfold. Cameron is clearly highly sensitive to public opinion and a pragmatist, possibly too much of one. Too many U turns and he'll start to look very weak. Politically the Lib Dems needed to play this one as a win and, for once, seem to have got the politics right after a shocking year.

Lansley, on the other hand, is heading for Northern Ireland, as they used to say.