David Cameron deserved every moment of his rough ride on the NHS this morning. For he simply lied to the electorate about his plans before the last election. No ifs, no buts. He lied and Andrew Lansley lied. They said that they would not engage in any 'top-down reorganisations' of the system. And that is precisely what they are doing.
It would be one thing if Cameron were simply extending choice by engaging more private providers, which is one more sensible part of the Lansley agenda. It might be OK if they were allowing more GPs to band together to establish fundholding co-operatives to complement commissioning by primary care trusts. That isn't what they are doing. They are forcing GPs to run the £80 billion NHS budget, whether they want it or not. That is more than a brave experiment. It is a reckless gamble with the whole health service.
I support free schools and allowing schools to become academies. I support more private choice within the NHS. But I think this experiment is profoundly mistaken because it is being imposed. It is not evolutionary, it is destructive. And it comes at the same time that the coalition are tearing up the biggest success story of recent years - greatly reduced waiting times - which could see the return of the trolleys and excessive waits. I spent some time in hospital before Christmas and saw the benefits of those changes compared with my last visit ten years before.
It is one thing to press ahead with radical reform where there are clear benefits from doing so, or there are strong structural reasons for doing so. Continuing - and accelerating - the direction of travel of Labour's reforms (as Michael Gove has done to an extent in education) would have made sense. Throwing everything up in the air and seeing where it all lands is madness. It undoes ten years of solid improvement for no obvious gain. Not only will Cameron and the coalition come to regret this. So will the rest of us.
This post also appears at Public Finance. It has been highlighted at the Guardian and Stumbling and Mumbling.