Health Matters | Paul Corrigan's blog

A key point to remember is that this Bill, despite all the carnage that it has been through, is still only at the halfway stage of its journey through the Houses of Parliament – and the second half is likely to be harder than the first.

The content of the Bill has ceased to matter to anybody in Government apart from the Secretary of State and a few of the civil servants who drafted the thing. The simple motivation for the rest of the Government is to get rid of the thing by getting it through.

Then for the Government (or so they hope) the nightmare is over. The problem for the Government’s business managers is simply a matter of the tactics required to process something vaguely recognisable through the rest of its stages.

However in the real world the problem is that ‘getting the Bill through’ isn’t really the problem. The bigger issue is the impact that the Bill already has, and will have on the actual delivery of NHS services.

But this Bill has caused the Government so much pain – and they have used up so much political capital in getting to where they are now – that stopping the pain of the politics of the Bill has become synonymous with stopping the pain caused by the politics of the NHS.

For this Government there is a worrying historical lesson that looms at them from the past. In the late 1980s Margaret Thatcher became very interested in changing the way in which local Government was funded. A Bill was introduced to Parliament called ‘the poll tax’. As it passed through both houses, the Government had to change this Bill several times. In the end all that the Government wanted to do was to just get rid of the thing. Pass it and forget it.

Unfortunately when it was passed the state started to implement it. Then the problem for the Government wasn’t the passing of the Bill, it was that it was being implemented.

The same will be true of the Health and Social Care Bill. At the present moment – in the autumn of 2011 – the political problem for the Government is getting the thing through the House, but if they do the problem from April 2012 will become its implementation.

Since the Bill impacts on every single aspect of the NHS, it means that from April next year every single aspect of the NHS – and all of the the problems in it – will be caused by the Government’s new Act. That in turn means that for the three years leading up to the next election – the three years when the NHS has to undergo the most difficult financial regime it has ever experienced  - everything will be the ‘fault’ of this new Act.

The Government may not think it at the moment, but if they were to raise their sights just a little from the day to day difficulty of votes, they may see that it is in their interests that in the next few weeks this Bill is defeated and withdrawn.

That’s the only way they can escape the certainty that for the rest of this Parliament, every problem in the NHS will be their fault.

It is perhaps the greatest political irony that a Bill originally intended to stop the Secretary of State being responsible for every aspect of the NHS is likely to end up ensuring that this is precisely what he is seen to be – for the rest of this Parliament.