POLITICS
Fraud is less harmful than coercion or threats
BRUCE ANDERSON
No major reform becomes irreversible until its principles are accepted by both the main political parties. Thus it was with the Attlee government's health service reforms and with Mrs Thatcher's trade union legis- lation; thus it now is with the last govern- ment's health service reorganisation, as a result of Frank Dobson's latest proposals.
In one respect, the new White Paper is a considerable achievement on Mr Dobson's part. He has managed to persuade his offi- cials to write down to his level. Rarely, if ever, has a government document been so full of twaddle — 'the new NHS' — and gimmicks — 'The new NHS Information Superhighway'. Then again, rarely has a government document been so unneces- sary. Its sole purpose is to assist Mr Dob- son in concealing from his Parliamentary colleagues the extent to which he has now accepted the Tory changes which he and they used to denounce so wholeheartedly.
The basis of the Tory reforms was to insist that the NHS could only work effec- tively if there was a clear distinction between those who provide medical care and those who purchase it, so that market mechanisms could be used in health as they are in other areas, to ensure the efficient use of resources. Underneath all the blus- ter, Mr Dobson has accepted this.
Which is not to say that his reforms are harmless. On the contrary: they will impose unnecessary administrative burdens, and therefore costs, on the NHS. When it is not necessary to change, it is necessary not to change, and that applies a fortiori to recent reforms which are still settling down. Many doctors have only just got used to GP fund- holding. They will now have to come to terms with Mr Dobson's new variant of GP fundholding. This will require hours of paperwork: time and energy which could be better spent.
There is another dangerous aspect of Mr Dobson's reforms; a know-nothing disdain for the work of health service officials and an assumption that most of the money spent on administration, accountancy et al. is wasted. Now it may be that the Tories' reforms were too bureaucrat-friendly; that is the case with most reforms which are implemented in detail by the civil service. It may be that it would have been better to privatise much of the administration of the health service. But there must be adminis- tration; an organisation as big as the NHS cannot function without a central nervous system. That was the problem before 1979, when the health service was largely an accountant-free zone, and therefore resem- bled an especially primitive species of dinosaur; its backside could be on fire for quarter of an hour before the smoke reached its nostrils. In those days, one health authority would spend x on treating an ailment and its neighbour 4x without any discernible difference in patient welfare. Without accountancy — and internal mar- kets — those days would return.
But all in all, Mr Dobson has done as lit- tle harm as could be expected of him. His White Paper may be fraudulent, but fraud is better than coercion, which brings us to Dr Jack Cunningham. The Agriculture Minister's decision to ban beef on the bone was not the worst abuse of government power this century: that bad eminence is occupied by the Cleveland social workers of the mid-Eighties who, afflicted by collective hysteria, confiscated a large number of chil- dren from their parents. But Dr Cunning- ham's decision was as unjustified as it was cynical. The only rational explanation for the ban was a desire to re-ignite public hos- tility to the Tories over their handling of last year's BSE crisis; like most of his Cabi- net colleagues, Dr Cunningham is still determined to win the last election. But on this occasion, he may have miscalculated.
It might have been assumed that the pub- lic's response to Dr Cunningham's ukase would have been panic and that all those who had ever been in the same supermar- ket as a beef bone would have rent their clothes and demanded large sums in com- pensation. Instead, British shoppers rushed to stock their deep-freezes with oxtail and ribs of beef. In the era of Princess Evita and Nanny Woodward, that was an unex- pected outcome, and a welcome one; it seems that not all the hearts of oak have been reduced to kindling. The public reac- tion may even lead to the ban being lifted; this government can cope with anything except the threat of unpopularity.
But there ought to be another way of reversing Dr Cunningham's decision: judi- cial review. In the last Parliament, it seemed that hardly a week went by without some judge overturning a ministerial deci- sion. The average High Court judge appeared ready to behave in a way that made Lord Denning, MR — and now, a matter for exultation, OM — seem posi- tively timid. He, after all, restricted himself to making his own new laws; he never tried to strike down Parliament's ones as ultra vires. But we now live in an age of judicial activism, so why has it not been mobilised against Dr Cunningham's wretched deci- sion? Have the farmers no lawyers, have the lawyers no ingenuity, or have the judges lost their courage since I May? There are sound constitutional grounds for objecting to judge-made laws and to the excessive use of judicial review, but these are matters to be resolved in the longer term. If the judges could find a way to protect the beef indus- try and its customers, we should not enquire too closely into their methods.
As opposed to Geoffrey Robinson's finances, the Paymaster General has now brought such scrutiny upon himself. It was foolish of him to tell his lawyers to threaten the Sunday Times, a newspaper which is both powerful and thin-skinned. Under Andrew Neil's editorship, it had a tendency to resent even deserved criticism, but it is perfectly entitled to retaliate against attempts to gag it. We can be certain that at this moment at least a dozen Sunday Times reporters are trawling through every aspect of Mr Robinson's finances, with a libel lawyer or two to vet their findings. But facts are not libellous, and they may yet force Mr Robinson from office.
On Monday, emboldened by his success- ful apology over the Bernie Ecclestone donation, Mr Blair went on television to declare that Geoffrey Robinson was a very able minister. That is not in doubt. What is in dispute is whether he has obeyed the rules for ministers, whether he can answer legitimate questions and whether his behaviour is compatible with the govern- ment's general stance on taxation. In the early Seventies, Jacques Chaban-Delmas had ambitions to become President of France. It was then revealed that he had managed, entirely legally, to avoid paying tax on a large income. Chaban was a politi- cian of the Right, but even so, he was sunk by a poster which had him looking smug and affluent while saying, `Moi, je ne paie pas d'impots. Et toi?' Mr Robinson's ambitions are less grandiose; he would be happy to end up as Secretary of State for Trade and Indus- try. Until a few weeks ago, that seemed well within his grasp. He will now need all his grasp to hang on to his present job.
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