Man overboard: the collapse of the NHS reforms

One of the advantages of being an ex-Civil Servant is that you can easily spot the symptoms of a good old-fashioned Whitehall panic. And the current shenanigans over the NHS reforms are clearly a prime specimen – a sweaty-palmed, swivel-eyed, world-falling-around-your-ears late-night-emergency-meetings outbreak of pure bureaucratic meltdown. Sir Humphrey’s phrase – “man overboard” – doesn’t begin to describe this one.  Indeed, I’d guess right now the mood in the Department of Health is less Sir Humphrey, more Corporal Jones.

The Government has apparently decided to use a “pause” in the legislative process to allow further consultation on the content of the Bill.  As someone who has been part of a team of civil servants taking a major piece of legislation through Parliament, I find this desperately unconvincing.  Behind the scenes there is no pause, as the legislation is refined further and the process grinds on; all legislation gets amended during passage (I recall an awkward conversation with one of the less intellectually confident  junior ministers in the Major government, telling him that, no, Government amendments didn’t necessarily mean the Civil Service got it wrong in the first place), especially when that legislation has been introduced in the first Parliament of a new Government.

And we know that this bill needs more work than many.  The Health and Social Care bill is a huge piece of legislation. Time and time again in its earlier Parliamentary stages it has become obvious that the Bill is unclear, and needs substantial clarifications just to make its existing provisions workable; it suggests hurried, messy drafting resulting from unclear instructions to the Parliamentary Counsel who prepare the legislation.  And that’s before even considering rethinking the policy.

The pause, then, is unlikely to produce any substantial change. The most likely outcome of this panic is more, late Government amendments leading to botched, inconsistent legislation which will receive no real Parliamentary scrutiny, and an increased risk that future health policy will be set not by Parliament but in the courts.  If this pause is anything other than a pre-local election ploy, the honest and democratic approach would be to pull the Bill now and go back to he drawing board.  It won’t happen, though, as the loss of face would be too much for the Government to bear.

As with the economy, it’s just another example of a Government of ideologues sleepwalking into disaster, unable and unwilling to engage with the realities of the world around them.


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