Jonathan’s Sunday Slot
Is the Coalition doing too much to reform the NHS? Last May it embarked on reform at a frenetic pace. No area of government has been left untouched. Arguably its agenda is more ambitious than any government since 1945. But does trying to do everything at once incur serious risks? Cracks are already showing. Ministers look tired. Can Cameron hold things together and will his NHS reforms prove a bridge too far?
The coalition programme is already massive. The government is attempting to rewrite the record books with the biggest public sector cuts in history. Its welfare and local government reforms are untested and ambitious. Last week it announced the biggest post-war pension reform. And Nick Clegg has called his constitutional changes â€œthe biggest since 1832â€. That is only for starters. Even if you donâ€™t believe all the hype (for there surely is much), this is certainly not a conservative approach to government.
Compared to its post-war predecessors, this government is manic. Born out of understandable insecurity, it is trying to do everything in five years. It is too early to say if all this activity is generating more heat than light. Maybe things will end well and we must hope that they do. But attempting so many reforms in parallel is undeniably risky.
Scrutiny has suffered, as Michael Gove found out early on. The government is also discovering it has little spare capacity to correct errors and respond to events. Last week it was visibly under strain. The Prime Minister had to personally step in to manage the response to Libya. He succeeded in getting the government back on track this time, but what happens when problems emerge simultaneously as they always do? He will not able to fix them all.
So is the Prime Minister recognising his limits and setting a sustainable pace for his government? No. Instead, he is about to open yet another front and embark on controversial NHS reform; potentially a Pandoraâ€™s Box of political risks and limited rewards. NHS reform would be a gamble for any administration, but for one as overstretched as this, it is bordering on reckless. Nevertheless, Cameron seems determined to proceed with what could well prove to be a bridge too far. Unless of course that is, he listens to his battle hardened coalition partners.
Jonathan is a Labour activist from West Sussex and contributes a weekly column to PB