A bad day for Lansley
It was never going to be an easy week for Andrew Lansley, but I'm sure even the Health Secretary wasn't quite expecting to see Downing Street sources saying he should be "taken out and shot" over his controversial NHS reforms when he opened his newspapers this morning.
There is certainly a lot of anger among Tory MPs about the reforms, which face a mauling in the Lords tomorrow. One told me Lansley had "failed to do the pitch rolling" and complained they didn't know what the shake-up was really meant to do. Another complained: "We spent years convincing people that the NHS would be safe in our hands - this bill is destroying that reputation".
Lansley was also faced with a little, erm, local difficulty. First it emerged NHS South West was facing a £370 million black hole which campaigners warned could put vital services at risk. Then it emerged St Helier hospital in Carshalton could be the first victim of plans to hand doctors billions of pounds of the NHS budget.
This is particularly sensitive because the hospital is in Health Minister Paul Burstow's constituency. Neighbouring Labour MP Siobhain McDonagh claims a merger between St Helier and St George's fell through last week in part because GPs in the new clinical commissioning group are planning to reduce dramatically the use of the hospital. Fears have been raised it could close as a result.
Mr Burstow told ESP this was "shameful political scaremongering" and warned people not to be "duped" by it. Certainly there were other considerations for the merger's collapse as well, but Dr Martyn Wake, who is joint chair of Merton CCG, does say that "as GPs we are keen to keep our patients well and out of hospital".
"Whilst Ms McDonagh may not agree with the government's policy to put GPs in charge of commissioning health services we all feel it is most unjust to blame local GPs for the historic financial challenges facing our local hospitals," he said.
"The shift to care out of hospitals and into the community is no different in scale in Sutton and Merton than it is in other parts of south west London and the rest of the country."
But Labour and other campaigners are adamant. Shadow health secretary Andy Burnham told ESP: “The fact a Health Minister’s own local hospital may be the first major casualty of the Government’s reorganisation might bring home to him how wrong these reforms are.
“This is a glimpse of what is to come if this Bill goes through. Fragmenting decision-making in this way threatens the ongoing viability of hospitals. Paul Burstow has now got the biggest of all reasons to drop the Bill.”
There appears to be little appetite among Tories for the Bill to be dropped entirely, though (as my colleague Nicholas Cecil has reported) some Lib Dems would be delighted if that happens.
While today was a bad day for Lansley, expect a few more ahead.
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