POLITICS
Some not very healthy attitudes badly in need of an urgent cure
SIMON HEFFER
he weekend after the last election, as Mr Major was putting together the Cabinet to lead Britain deeper into recession, I was trying to compose an article about newly promoted ministers. I was keen to test my prejudices about them on their colleagues. I got on the telephone. The most striking result of the exercise was the torrent of abuse against Mrs Bottomley, the Health Secretary, whom I had regarded as charm- ing and harmless.
`A complete airhead,' said one of her kinder colleagues. 'Token woman,' said another. 'Once a social worker, always a social worker,' added a third. 'Too much of this caring crap and not enough attention paid to where the money's coming from.' Discounting these observations as the obvi- ous manifestations of rivalry in high poli- tics, I stuck to my long-held view of the new Secretary of State. Events, however, sug- gest her colleagues knew more than I did.
These are difficult times for Mrs Bottom- ley. She is committed to her statutory duty to provide a health service, and various other social services, free at point of use to those who need them. That commitment is good for the Government's image, but bad when public spending is under intense scrutiny. Mrs Bottomley won a generous settlement in last autumn's spending round, which deepened her already ill-disposed colleagues' resentment of her. It was no coincidence that when Mr Portillo, the Chief Secretary, announced his review of spending, the Department of Health was one of the first under investigation. The view in Whitehall is that the National Health Service is overmanned, particularly with bureaucrats, and that the Government is a soft touch for the drugs companies (the NHS drugs bill increased by 8 per cent last year, four times the rate of inflation).
Mrs Bottomley's decision only to scale down, but not to abolish, Regional Health Authorities incensed those looking for sav- ings. These authorities have little to do now that many hospitals have become NHS trusts and run themselves. The anger of Mrs Bottomley's critics was inflamed fur- ther when it emerged that RHAs were to be kept in existence to monitor the work- ings of the internal market. More than that, they were to intervene if those workings threatened to force some hospitals to close. Many Tory MPs thought the internal mar- ket was designed specifically to put bad hospitals out of business and to encourage the growth of good ones. That is not, apparently, how Mrs Bottom ley sees it.
An even worse problem is the Communi- ty Care scheme. This came into operation on 1 April. It principally entails the Depart- ment of Health giving cash to local authori- ties to provide care for the elderly outside rather than inside institutions. Having orig- inally thought this would save money, the Treasury now realises it will incur costs on an epic scale. There is a rare consensus among Tory and Labour politicians, local government officials, councillors and the `caring professions' that the scheme is catastrophically underfunded. Senior min- isters have been saying privately that the wheels will fall off the scheme within 12-18 months, unless huge additional amounts of money are pumped into it. Labour will have a field day. One will not be able to open a newspaper without finding tales of hardship among our old folk. If Mrs Bot- tomley looks unduly serious these days, that is probably why. 'Ultimately, the Trea- sury will have no choice but to cough up,' a minister told me. 'But the grief until they do will be spectacular.'
Yet the latest horror to befall the Health Department has had little to do with the usual problem of spreading a decreasing amount of money ever more thinly. Last week Mr Tom Sackville, the jovial but somewhat other-worldly junior minister, suggested that contraceptives should be handed out to schoolchildren to stop them procreating. 'Tom's a great friend of mine,' said a colleague of his, tut he's gone off his rocker on this one.' Even Mrs Bottomley was reported as being distinctly unamused. Mr Patten, the devoutly Roman Catholic moralist and Education Secretary, in whose schools these prophylactics would be dished out, remained tactfully silent. How- ever, it was no coincidence that at Educa- tion Questions on Tuesday afternoon, and again in Wednesday night's Conservative Party political broadcast, he stressed the importance of schools teaching 'the basic values of decency, self-discipline and respect for others' to their pupils.
The Department of Health, however, seems to be a complete value-free zone. As well as its cavalier opinion of sexual promiscuity among minors, it retains a devotion to the principles of welfarism that even Nye Bevan would have found a bit
strong. To further these principles, ex- social workers like Mrs Bottomley and the younger sons of earls like Mr Sackville de- humanise their clients by assuming they cannot be allowed to think for themselves. They see nothing wrong with the state propagating a moral view lower than many children learn from their parents. However, it does not have to be like this. There are other ways of running a welfare state, as Mr Lilley, the Secretary of State for Social Security, who shares a building in White- hall with Mrs Bottomley, is proving.
Next week Mr Lilley launches the Child Support Agency. The main purpose of this body is to track down fathers who pay noth- ing towards the upkeep of their (often ille- gitimate) children, and to extract money from them. Even those on basic income support will be made to pay a token 5 per cent of their benefit to help maintain their children. It will save the taxpayer £600 mil- lion next year, but that is not the whole point. Mr Lilley, a more ascetic figure than Mrs Bottomley (though blessed with a bet- ter sense of humour), is determined to stop the free ride many able-bodied people take on the welfare state. He also believes the Government should advance a social policy rooted in family values. This involves the head of a family assuming moral and finan- cial responsibility for his kin. No doubt Mr Sackville would argue that doling out rub- ber johnnies in classrooms also furthers this aim. However, his definition of responsibil- ity is not shared by many of his colleagues, who find it a horrific prospect that the state should facilitate illegal sexual intercourse.
When the old Department of Health and Social Security was split, it would have been logical to have confined the Health Department to providing the National Health Service. However, many of the 'car- ing' functions — like looking after the elderly, disabled and mentally ill in the community, and ministerial responsibility for the activities of social workers — passed to this department. The universal welfare state, as interpreted by Mrs Bottomley, is too universal by half. Its boundlessness is not just expensive, but also morally unguid- ed, and therefore dangerous. Lady Bounti- ful ought to start to think a bit more deeply about the corrupting possibilities of wel- farism. If she needs some advice, her Cabi- net colleague down the corridor will, I am sure, be only to happy to help.
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