Harsh sunlight shines on a failing NHS, as fire consumes the Blairite vanities
There was a definite gaiety among MPs as they came back from Easter recess this week. The winter has been longer and colder than any in recent memory. Westminster, cheerless and crepuscular at the best of times, has a way of magnifying the gloom. Now spring has finally arrived with a series of fine sunny days. Best of all, we have the local elections. Ministers are out in force on the doorstep, and as a result carry an enviably tanned and weather-beaten appearance.
This loosening of mood is palpable at the top of government. There are, for example, undeniable signs that Gordon Brown and Tony Blair have been working together more harmoniously. Two weeks ago the Chancellor surprisingly caved in to Downing Street pressure over pensions reform. Last week Tony Blair returned the compliment. He has allowed the Chancellor to claim victory in the long, agonised internal debate over how New Labour should deal with David Cameron.
Gordon Brown has been given licence to target Cameron personally, and after long thought has chosen to depict the Conservative party leader as a chameleon, shamelessly telling voters what they want to hear in a ruthless quest for electoral success. If Labour’s light-hearted and enjoyable party political broadcast is the best the Chancellor and his strategists can manage, Cameron probably hasn’t got that much to worry about.
Meanwhile the atmosphere in Downing Street has changed. At times, during this difficult winter, there’s been an air of beleaguered defiance bordering on self-righteous despair. But now there’s confidence and selfbelief. Downing Street insiders feel that the Education Bill, for all the concessions, is a triumph, and the prospect of a settlement over pensions means that the Prime Minister has gone some way to securing his legacy.
A self-confident Prime Minister has turned his attention to the NHS. He has lost confidence in his Health Secretary, Patricia Hewitt, even though she was appointed to her post only 11 months ago. I am told the problem started late last year, when Downing Street became disturbed by the sharp contrast between the relatively complacent accounts of NHS problems it received from the Department of Health and the more realistic descriptions from elsewhere. The loss of confidence has started to become embarrassingly obvious in public situations. Tony Blair all but ignored Patricia Hewitt when they jointly met NHS bosses last week, and he was at it again in his speech to the New Health Network on Tuesday morning. With Hewitt sitting in the audience, the Prime Minister failed to refer to her in the speech. It will not come as a surprise if Hewitt — who was until recently being talked up by influential Downing Street aides as an alternative to Gordon Brown as Labour leader — is moved in the looming summer Cabinet reshuffle.
The central thrust of the Prime Minister’s speech was positive. He asserted that everything was fundamentally on course and there was nothing much to worry about. This claim was accepted by the more credulous Blairite commentators, among them Peter Riddell of the Times, who informed his readers that the Prime Minister ‘is correct that the overall deficit is small and there is no overall NHS “crisis”’. The judgment does not square either with the facts or with what I guess the Prime Minister is being told privately.
One has only to study the recent turnover of the most senior staff at the NHS to grasp that something horrifying is going on. The sudden departure of Sir Nigel Crisp from his onerous double role as chief executive of the NHS and permanent secretary at the Department remains a curiously unexamined event. Few Whitehall permanent secretaries have left their jobs accompanied by such glowing words of unequivocal praise from ministers, or with such a generous financial package. More exceptional still is the place in the House of Lords which awaits Sir Nigel.
There are four former Cabinet secretaries sitting in the Lords at present, two former permanent secretaries from the Treasury, two from the Foreign Office and one (Lord Allen of Abbeydale, dating back to the 1972 vintage) from the Home Office. No permanent secretary of any Whitehall department outside the Treasury, Foreign Office or Home Office sits in the Lords. Taken at face value, this can only mean that Sir Nigel was utterly outstanding, uniquely successful among every other permanent secretary over the last two or three decades. Yet if that were the case, surely the Prime Minister would have fought desperately to retain the services of Sir Nigel at this critical juncture in the NHS’s fortunes rather than — as strong Whitehall reports insist — demanding that he should be removed from post, against the will of Patricia Hewitt.
But Crisp is not the only curiosity. John Bacon, in charge of IT for the NHS as well as being ‘director of delivery’, has also quit suddenly. According to my Whitehall sources, strenuous efforts were made to secure Bacon a job in the Far East, but these fell through. He is now looking after ‘transitional strategy’ in London. A third very prominent departure was also announced internally last week. Andrew Foster, the director general of Workforce at the NHS, is leaving. Unlike Sir Nigel Crisp, no lordly apotheosis awaits Foster. He retreats to Blackpool, where he will take responsibility for human development at the local NHS Trust.
Imagine if a major private-sector company had suffered the so far largely unexplained departures of the chief executive, the head of IT and the human resources chief while haemorrhaging an estimated £750 million a year. It would be a massive story, and inconceivable that the business could survive without a major restructuring and probably a takeover. No wonder Tony Blair has put the NHS at the top of his list of priorities.
Meanwhile there have been fresh developments in the cash-for-peerages scandal, which is rapidly becoming the deepest and most serious public corruption scandal since before the second world war. The first concerns Gavin Barwell, the registered treasurer of the Conservative party. Though surely blameless, Barwell’s position means that he is the figure most likely to be arrested by police when they turn their attention to the Tory party’s funding. Barwell, who is rumoured to have fallen out with Tory chairman Francis Maude, is off to work in a private capacity for Michael Ashcroft, deputy chairman of the Conservative party.
Secondly, it emerges that the Marylebone offices of the New Labour treasurer, Lord Levy, have been devastated by a mysterious fire. This took place last November, well before the police investigation began and around the time the House of Lords Appointments Commission raised the first queries concerning Tony Blair’s list. When I rang Downing Street for a reassurance that no papers relevant to the police investigation had been destroyed, I was informed that ‘that is a matter for Lord Levy’.
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