Nhs

Andrew Lansley's career prospects were boosted yesterday — when Simon Hughes said that he should ‘move on’ after the NHS reforms have been implemented. Since then, Downing Street has redoubled its defence of the Health Secretary; with a spokesman explaining tersely this morning that, ‘Simon Hughes speaks for himself ’. And Nick Clegg himself has added that, ‘Andrew Lansley is the architect of the NHS bill. He cares passionately about the NHS. He's the right man for the job and he must see it through.’ Clegg's general support for the Bill — and Danny Alexander's — is worth noting because it's one of the factors helping David Cameron hang on to both it and his Health Secretary.

After originally deploying Sayeeda Warsi against ConservativeHome's anti-Health Bill sentiment, David Cameron is now doing his fighting for himself. He has an article in today's Sunday Times (£) that says, with no equivocation, ‘I am at one with Andrew Lansley, the reform programme and the legislation going through parliament’. And, aside from that, it's also an unusually spirited explanation of just what the government plans to achieve by these reforms. Much better than Cameron's wavering performance in PMQs on Wednesday. For all its spirit, though, this article doesn't come across as angry.

A small war has broken out over Lansley's NHS Bill — ConservativeHome has three Cabinet members attacking it. I find that shocking. At least a dozen want the Bill killed, and why ConHome found just three is beyond me. Politically, it's probably impossible for Cameron to drop it. But if it was torn up, I for one would shed no tears. For what it's worth, here's my take. It’s depressing to think that Alan Milburn’s NHS Plan of 2000 was both more radical and more sensible than what Andrew Lansley is serving up now. The whole debacle has shown politics at its most petty, partisan and pointless — a complete contrast to the coalition’s approach to school reform, which has been to fit rocket boosters to a very good Labour reform.

How much does it cost to change a light bulb? Three hundred quid, said David Cameron at PMQs today. Ed Miliband came to the House eager to pile more pressure on the PM and his unloved NHS restructuring plan. Cameron fought back by citing the health bungles Labour presided over while in office. Billions wasted on kaput computers. Hundreds of millions blown on phantom operations. And dead light bulbs that cost more to replace than a week’s holiday in Spain. Cameron’s tactics were better than in previous weeks. Rather than citing some lone wolf medic who supports his reforms he gave us a surprise announcement, albeit unsourced.

Andrew Lansley should be grateful for small mercies. Rachel Sylvester's column (£) today may quote a Downing Street source to the effect that ‘Lansley should be taken out and shot’, but there is yet no sign that a hundred Conservative MPs will write to the Prime Minister to say that the Health Secretary's reforms have to stop. We've had such a letter for wind farms and for Europe, but on the NHS it's not very likely. Most Tory MPs find the NHS a difficult rallying point at the best of times. And these are the worst: they are acutely embarrassed by the car-crash that has been the Health and Social Care Bill, and dearly want the whole thing just to go away. Besides, you try finding a hundred of them who actually know what these health reforms are about.

You're more likely to die if admitted to hospital during the weekend. It's a shocking truth, and one that's explored further in the Journal of the Royal Society of Medicine today. Last year, as Pete blogged at the time, the 2011 Dr Foster Hospital Guide discovered that emergency patients are 10 per cent more likely to die if admitted at the weekend. Today's report goes further than that, and finds that patients are 16 per cent more likely to die if admitted on a Sunday as opposed to a weekday — for all admissions, not just emergency. It's a finding that undermines the idea that the increased mortality rate can be put down to more drunks staggering into A&E at the weekend.

Now that the three party leaders have each pronounced on capitalism, domestic politics is returning to its familiar battlegrounds. And there are few more familiar battlegrounds, for this government, than the NHS. Earlier this week a couple of unions came out completely against Andrew Lansley's health reforms, despite his previous efforts to accommodate their concerns. And now we learn that the Commons health select committee, chaired by the former Tory Health Secretary Stephen Dorrell, is set to criticise those reforms as well. According to the Observer, a report that they're publishing this week will raise a common complaint: that it's tricky for the NHS to both reorganise and find efficiencies at the same time.

Another day, another exercise in obstructionism from the unions. Only this time it's not Ed Miliband that they're complaining about. It's Andrew Lansley and the government's health reforms. The Royal College of Nursing and the Royal College of Midwives have said that the entire Health Bill should be dropped. They have shifted, as they put it rather dramatically, to ‘outright opposition’. Which must be annoying for Lansley, given how he took time to ‘pause, listen and engage’ last summer, and adjusted his Bill accordingly. That whole process was meant to anaethetise this sort of disagreement, but the tensions clearly persist and could indeed get worse from here.

Look slightly to the left, CoffeeHousers, and what you'll see is the cover image to this week's Christmas double issue of The Spectator — a brilliant send-up of Bruegel's ‘The Hunters in the Snow’ by Peter Brookes. You're now able to buy your own copy, but we thought we'd pull out an intriguing little snippet from James Forsyth's interview with Andrew Lansley, by way of a taster. The Health Secretary, it seems, isn't just determined to see health spending rise in real terms in this parliament, but beyond that too: ‘I ask him whether, despite the ramifications of the autumn statement, the NHS budget will still be immune from cuts.

If you like your literature gloomy, then, at first, there may not be much to interest you in the latest Dr Foster Hospital Guide. A double-page diagram, across pages 10 and 11, is mostly about the positive trends of the past ten years: declining mortality rates and waiting times, that sort of thing. The only particularly sour note sounds out from the timeline at the bottom of the spread, which notes the creation of that big, galumphing NHS computer system in 2002, and then its abolition this year for not ‘achieving objectives’.   But keep pressing on, because there is much to be concerned about in the pages that follow — particularly in the second chapter, entitled ‘Reducing mortality at nights and weekends’.