Muscular Liberalism or Lack of Leadership?

I always vowed never to subscribe to The Times when it disappeared behind a pay wall. But then I began to miss some of my favourite columnists such as Giles Coren, Hugo Rifkind, Daniel Finkelstein, David , Rod Liddle and Matthew Parris.

But Saturday's column by Matthew Parris hits the nail on the head on the subject of NHS reform.

He imagines a Britain where our agricultural system is run like a Soviet collective. Everything is controlled by the state, everyone involved is employed by the state, all supplies are directed centrally. He then develops this crazy fantasy. The government decides on reform to allow farmers to choose between suppliers. He describes the response to this suggestion as follows...

"Now picture a special conference called by the farmers’ trade union to debate the proposals. Here is an extract from a union leader’s speech to the conference. He is railing against a duty, in the proposed legislation, to promote localised competition . . .

'I want proper controls nationally considered, not locals trying to sort things out . . . I want politicians of every stripe to understand that we do not need competition to run Britain’s food production. It creates duplication that is wasteful — and why give state agriculture’s money to private shareholders? What Britain’s food production needs to improve quality and efficiency is collaboration and co-operation across [all] sectors, [not] different materials being delivered by different providers in order to try to get a cheaper deal — fertilisers in one place, feedstock in another, veterinary services in another and follow-up somewhere else.

'Which brings me to one particularly unacceptable idea in the Bill: performance-related bonuses ... otherwise known as the ‘quality premium’. The idea is that farmers’ groups that ‘purchase well’ — ie, save money — will be given some money to hand out to their members . . . this idea stinks.'"

Only Parris doesn't have to imagine this response. These quotes are taken from a keynote speech by a Doctors leader at a British Medical Association conference in London last week. All Parris did was change references from healthcare to food production.



It highlights the perverse sentimentality we have in this country about maintaining a Marxist style healthcare system despite all the evidence that things could be so much better if a degree of competition, even if it is only in the supply of certain services or supplies, were introduced.

But the main point he makes is how today's Conservative party is failing to champion capitalism. Nothing illustrates this more than the backtracking on the NHS reforms we're seeing now. Many will put this down to the influence of the Lib Dems but the truth is that it is also a symptom of the Tories desire not to re-contaminate their brand. The simplistic messages put about by socialists is far easier to get across in soundbites on the telly and in newspaper headlines than some theory associated with free markets. Free markets that many people associate with selfish pursuit of profit by "fat cats".

A leader must make and keep his party electable. Cameron has gone some way to detoxifying the Tory brand (although not far enough to win a majority, it has to be said). However, sometimes public opinion needs to be led, not followed. Tragically, the case for reform has not been made effectively enough, so a dilution in the proposals was inevitable. But that doesn't mean the case for change shouldn't continue to be made and made strongly, one might say muscularly. A case that, given enough effort, would convince a sceptical public that a free at the point of use health service doesn't have to be totally provided by the state working to some monolithic central plan. That real responsiveness and quality improvements can be achieved through providers competing to be chosen by GPs and patients rather than there being only one option.

It's here David Cameron still has to prove himself. Will he lead a muscular liberal coalition that brings true liberalisation to Britain's public services and with it much improved service and efficiency? Or will he allow the left's preferred definition of the word liberal to prevail, an option that pollsters would tell him would be the best option. In which case we'll miss the greatest opportunity for decades to setup the high quality and high value health service that we need.

UPDATE
This article on the ConservativeHome website by Paul Goodman (@PaulGoodmanCH) covers the liberal/pragmatist debate really well. Definitely worth a read.

Cameron's Dead Pool

I was going to write a post on the growing need for a cabinet reshuffle where I planned to list the cabinet ministers in the frame to be dropped or moved. However, the excellent Fraser Nelson has done just that in his Coffee House blog. Have a read here: Cameron should cleanse his Cabinet of the undead

Fraser lists includes the same names I has in mind. Here's the list with my reasons for believing they may be in the frame for a move or the boot:

• Chris Huhne - for (allegedly) attempting to avoid speeding penalty points, (allegedly) fiddling his election expenses and disrespecting his cabinet colleagues and party leader
• Ken Clarke - for being more liberal than the Lib Dems on crime and his appallingly clumsy interview re rape
• Vince Cable - self obsessed egotist, too tribal for coalition (with the Tories anyway), enjoys attempting to impress young female consistency surgery visitors with injudicious boasts about his political virility, failing to impress the business community he's supposed to be supporting
• Andrew Lansley - ambitious NHS reforms not convincing key stakeholders or the general public
• Caroline Spelman - trees

I don't necessarily believe all the above deserve the order of the boot but they are probably all feeling more than a tad insecure. For example, Andrew Lansley deserves to see his NHS reforms through. Assuming the Lib Dems don't totally eviscerate the proposals. However, politically he has failed as he has not sold the proposals effectively and so he could be blamed for any resulting damage to them.

The hysteria surrounding Ken Clarke's clumsy comments on rape overshadow a generally poor performance in convincing people his plans regarding crime and punishment are little more than an attempt to reduce the prison population and save money. It's not fair but people believe he is doing little more than continuing Labour's shocking policies that led to the release of thousands of prisoners early. There is more to it than that, but he's not done enough to convince people.

Similarly, Caroline Spelman failed to sell the forestry reforms and came a cropper on the branches of public opinion, that had been much more effectively influenced by left wing groups like the online campaigning site 38 Degrees.

I considered including the sieve like Liam Fox. His courting of the Tory right (through leaking stories that will appeal to them) looks suspiciously like an attempt to build a power base to challenge Cameron. But God knows the coalition needs reminding from time to time that pandering to the left of the Liberal Democrats is not a long term option and that there is a much more significant constituency with broader popular appeal at the other end of the political spectrum.

As for Vince Cable and Chris Huhne, the charge sheet against them is much more serious (especially in Huhne's case). But sacking them is also much more tricky for Cameron who has to juggle the sensitivities of his coalition partners. But act he must. While he rightly dislikes the idea of constantly changing cabinet personnel, as the previous administration was so keen on doing, he has tolerated a little bit too much from some like Huhne and Cable. Failure to punish ineffective ministers may also lead others to relax and lose the drive that they had when they were first elevated to office.

Cameron's administration is a highly ambitious one and needs highly effective ministers to successfully carry through its reform agenda before the administration's political capital runs out.