Intended for healthcare professionals

Observations Body Politic

Lansley has pulled off one of the profoundest reforms ever

BMJ 2012; 344 doi: (Published 04 April 2012) Cite this as: BMJ 2012;344:e2429
  1. Nigel Hawkes, freelance journalist, London
  1. nigel.hawkes1{at}

To sack the health secretary now would be an admission that all the blood and sweat was spilt in vain

Phew! It’s over. England’s Health and Social Care Bill has received royal assent, words I thought I might never write.

Opposition continued to the last breath, with the shadow health secretary, Andy Burnham, contriving a debate in the Commons after the passage of the bill, and the Unite union suggesting—in surely the least plausible of many implausible claims about this bill—that Her Majesty might decline to give her assent. As an index of how strongly some people feel, that wins my gold medal. But I say “some people” deliberately.

This bill, hated as it is by many inside the NHS, has not actually animated the public to anything like the same degree. There have been demonstrations, but notably feeble ones, nothing like the countryside march or the students’ protests against rises in tuition fees. The objectors have failed to persuade the public that the threat is as great as they deem it to be. Health secretary Andrew Lansley may have failed the political test, but so have his opponents. Far more people were mobilised to oppose the …

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