Craig Barrett 1.46pm
One of the more delicious aspects of the last Labour governments was their dawning realisation that, contrary to everything Gordon Brown wished to believe, the Tories had not spent the 1990s trying to destroy the NHS.
Having abolished trust hospitals, the Labour government was forced into a humiliating retreat when it introduced the suspiciously similar “foundation hospitals”. And ministers went on to double spending on the NHS without a commensurate improvement in service or efficiency.
The NHS is one of the great glories of post-war Britain. A Liberal concept, enacted by a Labour government in the teeth of opposition from the British Medical Association (see Nik’s past posting here).
However, only the most blinkered dinosaur or Pilgrim would deny that the same idea today would be viewed as an unworkable and bureaucratic behemoth.
We ought not consider the NHS purely in financial terms because the benefits to the nation’s health and well-being must outweigh the mere cost. Yet that is not an argument for it to remain unchallenged or unreformed. The NHS must be continually analysed and rationalised to ensure that it is fit for purpose in the modern world.
Consequently it has become something of a political football. Who remembers "The War Of Jennifer’s Ear" or "24 hours to save the NHS"? Andrew Burnham’s hyperbole over the weekend about how these reforms will kill the NHS do him little credit as an supposedly serious politician.
However, his comments are illustrative of a truly massive problem sitting at the heart of Government - no one actually has any idea what Andrew Lansley is trying to achieve.
His reforms carry no support among the Liberal Democrat side of the coalition and there are very few Tories who appear to be ready to put their heads above the parapet and defend him or his ideas. Is this because of a lack of support, a fear of electoral disaster or a genuine incomprehension of what Mr Lansley might be trying to achieve?
Irrespectively, the public mood is such that people are happy to feast on the media painting his plans as change that nobody wants, least of all the doctors, the nurses and other healthcare workers.
The Government was wrong to push these changes as a flagship bill. The fact that many of the reforms do not even require primary legislation makes the resulting headache look embarrassingly self-inflicted. Without a proper mandate, it looks undemocratic.
Mr Lansley seems like a man clinging to a time-bomb that only he cannot hear ticking. The Government urgently needs to look at what he is trying to do and accept that it needs drastic, perhaps total, reconsideration.
Is politics truly the art of the possible? What is certainly impossible is ploughing on without confidence. This is the situation in which Andrew Lansley now finds himself, where self-confidence is no match for the lack of confidence held other people.
That we need urgently to consider what this Health Bill is doing is obvious. In all likelihood that means starting all over again. Moreover, it is clear to me that the current Health Secretary is not the man to preside over this process.
For the good of the NHS, Andrew Lansley must admit defeat and head to the backbenches.
Follow Craig on Twitter @mrsteeduk