The listening cure
Where does it hurt? How long have you been feeling this way? Is there anything else I can do to help?
This afternoon Doctor Lansley is going to reveal his prescription for curing his ailing NHS reforms. The health secretary is, in short, going to promise to listen. That's right. Not - despite what you may have read - delay or amend or scrap or U-turn - just listen.
The question, though, is what will he and the government do if - when? - they hear that their reforms lack any friends? It's easy to find supporters for individual elements of the reform package - after all, the BMA voted to back GP commissioning, Labour encouraged and expanded the role of private health companies within the NHS, and the Lib Dem manifesto called for primary care trusts to to lose their role in commissioning care for local people. However, taken as a whole the reforms have few if any cheerleaders.
In the long term, that poses a massive political risk for David Cameron, whose modernisation of his party was rooted in his declaration of love for the NHS. In the short term, it poses a challenge when the legislation reaches the House of Lords in the summer - to be confronted by a coalition of Labour peers who want to re-contaminate the Tory brand, Lib Dems who want to an opportunity to reassert their party's independence, and anger from those like Dr David Owen, whose hearts beat for the NHS.
All the signs are that the prime minister has lost faith in his health secretary's capacity to sell this package and was becoming increasingly nervous that his coalition allies were on manoeuvres over health reform (despite having backed it all the way until a few weeks ago). That's why the coalition's Dynamic Duo Cameron and Clegg were due to launch the NHS listening exercise later this week.
Today, though, it looks as if Dr Lansley has decided that he will be the one who will declare: "The Doctor will see you now. I'm listening."
PS - I've only just caught up with Norman Tebbit's article in the Mirror joining their campaign against Andrew Lansley's NHS reforms. That's right - Tebbit in the Labour-supporting Mirror backing the NHS against the man who he helped recruit into the Conservative Party. Andrew Lansley had been a civil servant in Lord Tebbit's department. The health secretary is badly in need of some friends.