Health Matters | Paul Corrigan's blog

Yesterday I explained how sources are blaming the civil service for not preventing the government from carrying out some of its own policies. In particular government sources were seeking to excuse the Prime Minister from the bad political outcomes stemming from the Leveson Inquiry because, they claim, it was really the fault of the Cabinet Secretary for not preventing the Prime Minister from acting on his decision to have an Inquiry.

This line of thinking seems to seek to absolve an elected government from responsibility for its policies because an unelected civil service did what it was told to do.

Before the summer’s out some will seek to blame some of the worst excesses of the  government’s NHS reforms upon the civil service. We will be told that the civil service should have toned down and delayed Andrew Lansley from publishing the government White Paper and from passing the NHS reforms into legislation. We will no doubt hear that a naive new government should have been told by the civil service to spend some time thinking about the reforms before rushing, within 6 weeks, to publish a White Paper and then, within a further 5 months, to passing legislation.

This line of thinking claims that it is the task of the civil service to water down half baked radical reform ideas and stop ministers from being too naive.

Let’s think for a moment about what that would have meant.

In May 2010 the electorate, Parliament, and our own very odd constitution created – for the first time since the Second World War – a new form of government – a coalition. Whatever else the electorate may have decided, it was obvious that Gordon Brown’s government had been defeated.  The electorate even said, in an odd sort of way, that they wanted a change of government.

After a few days of negotiation, a government emerged and after a few more days, on May 22^nd, the leadership of the two political parties that make up the government published a Coalition Agreement. (I had reason to review its health policy aspects the other day and will return to it later in the week).

However odd this policy may have been it was the policy of the government. And that government was still less than 2 weeks old after its election by the people.

The Secretary of State for Health walks into the Department of Health and says that he wants a White Paper published within a couple of months. I suspect that civil servants would say “That seems a bit too quick Secretary of State, let’s make it the autumn.”  To which I suspect the reply would have been “That’s OK I know in detail what I want it to say. I will write it myself”.

The civil service are not in a position to say “no”. In my opinion, as someone who worked for politicians who wanted to carry out reforms, I don’t think civil servants are even in a constitutional position to prevaricate.

They are not in a position to, for example, remind a Conservative Secretary of State that the Conservative Party had said that there should be no more top down reorganisations. All of this is politics.

A determined Secretary of State has to have his own way. Anything else would be unconstitutional.

Now of course there are checks and balances within the system to stop a rogue minister from simply telling his civil servants to write a White Paper that is intemperate. The Secretary of State is a part of the Cabinet and it is the Cabinet’s responsibility to agree the White Paper.

Especially important is the Prime Minister’s position as leader of the Cabinet. He is in a position to go through early drafts of the White Paper and make comments. He can ask other members of the Cabinet to form a small subcommittee to look at the detail of the White Paper.

So when in July 2010 the NHS reform White Paper ‘Liberating the NHS’ is published, it is published with the full and detailed agreement of the Prime Minister. This is especially the case with David Cameron because he has said so loudly and so powerfully that he believes in the NHS. It is therefore inconceivable that he would not have been through the NHS reform policy in detail.

So we can assume these checks and balances happened with the White Paper in July 2010.

The same must be true with the draft Bill written between July and December 2010.

Legislation is the business of government and the civil service. Writing words that may become law is very different from writing any other words. It can and does take ages to turn White Papers into legislation.

Couldn’t the civil service have simply slowed the process down with a flurry of Sir Humphrey’s finest obfuscations?

“Very sorry minister but we have mislaid the Parliamentary Counsel who was meant to write the Bill”. That sort of thing.

But that’s the difference between television and the powers of different parts of the government. In 2010 the Secretary of State wanted his Bill. He was backed by his boss the Prime Minister and the job of the civil service was to deliver what the Prime Minister wants.

Again in December 2010 when a number of people in government were worried about the radicalism of this draft legislation, it was the Prime Minister that said it should go ahead.

How, in the summer of 2012, might all this pan out?

At some point later this year the government is going to need an explanation for some of the oddities of its NHS reform. At the moment the current Secretary of State sees no need for any explanation – because he sees no oddities. Since his Bill became an Act in late March he is ‘back on form’ ‘Determined to prove all the opposition to his Bill as wrong’, or so we learn from the press. He thinks everything is going really well.

But if in the late summer he were to be replaced, the government will need an explanation as to why all of these very odd things became its policy.  One of the explanations that will come to hand – as it has proved with the Leveson Inquiry – will be to blame the civil service from not stopping an inexperienced Secretary of State from being too radical and too precipitate.

Such an explanation would have been expecting the civil service to work outside of the constitution.

But one of the reasons for choosing this explanation will be that the part of the constitution that could have slowed down Andrew Lansley and his reforms in July and December 2010 wasn’t the civil service – but the Prime Minister.

Twice in July and December 2010 he actively chose not to do so.

That’s why, later in the year, “sources” will be looking around for someone else to blame.