Cameron's Risky Strategy!

David Cameron and the Conservative led government have had a really bad start to 2012, yet they have brought it all on themselves. Things started so well too, leading in the polls on the back of the Prime Minister's apparent veto at the European Union summit last December. Then a series of policy announcements and speeches from Labour leader Ed Miliband and his shadow Chancellor Ed Balls, seemed to upset the unions, and many supporters, which meant the Labour party seemed to be arguing within itself, rather than challenging the government.

Since those early days, which must seem a long time ago now for the Conservatives and David Cameron has found themselves under pressure on several fronts.

Economic figures have been gloomy, with increasing unemployment, and then when the fourth quarter GDP figures showed a contraction of 0.2% (something which Osborne spent the previous few days preparing us for), on top of all the forecast downgrades for growth, things started to turn against David Cameron and the government.

It began with the Welfare Reform Bill, as a series of defeats in the House of Lords on disability payments for children amongst others, put the government on the back foot. The coalition of Labour and crossbench peers, along with a number of Liberal Democrats, being enough to vote through amendments.

The government was able to reverse these defeats when the bill returned to the Commons, but they then evoked 'financial privilege to prevent it being sent back to the Lords,' the main point being:

"The Commons' claim to sole rights in respect of financial legislation applies indivisibly to public expenditure and to the raising of revenue to meet that expenditure. ... The Commons treat as a breach of privilege by the Lords not merely the imposition or increase of such a charge but also any alteration, whether by increase or reduction, of its amount or of its duration, mode of assessment, levy, collection, appropriation or management ..."

as stated in Erskine May. Therefore, the government is telling the House of Lords that they believe that only they have the right to decide on bills, or clauses, which the Lords feel are unfair, but have huge financial implications. It could be argued that the evoking of this, little used, rule, is an attempt by the government to silence debate on an extremely contentious bill.

There are two sides to this argument, of course, and as a supporter of a fully elected upper house, I do believe the Commons, as the elected body, should have the ultimate say on bills the government wishes to pass. However, the Lords does act as a revising chamber, and evoking financial privilege just looks like the government is running away from the argument.

David Cameron's second issue has been the EU (a running sore for the Conservative Party) and whether or not the Prime Minister has reined back from the boasts he was making following last year's summit, that gave him such a boost in popularity amongst his own forces.

On Wednesday January 25th Ed Miliband is generally have believed to have had the best of the exchanges at Prime Minister's Questions, and he followed it up the next Monday with what many believe was his best performance as leader, as he ripped into David Cameron over his perceived reining back at the previous weekend's summit. Even the vehemently anti-Ed Miliband blogger Paul Staines (in his alter ego Guido Fawkes) said that, 'the boy done good.'

It doesn't actually matter whether Cameron did make any new concessions at the summit, the perception is he did, and this has upset the large anti-EU bloc on the Conservative backbenches (and a couple in the cabinet), and Ed Miliband took advantage, remembered especially for the line, "The whole house now knows that a veto is not for life, it’s just for Christmas."

This was swiftly followed by another PMQs victory for Ed Miliband, and presciently the second set, on which he was adjudged to have certainly got the better of the Prime Minister was the Health and Social Care Bill.

It is this bill that is now causing David Cameron his biggest headache, as the opposition to it increases, seemingly by the day. What makes it worse for him, and the Health Secretary Andrew Lansley, is that the calls to drop the bill do not all come from the usual suspects.

The Labour Party are against it, because they see it as a big step on the road to privatisation. It is true that GPs were allowed greater say in where their patients went under the last government, but the bill would enable much greater private involvement, and doctor's surgeries would become small businesses, and doctors more concerned with profit margins than caring for their patients.. This along with 49% of hospital beds being available to private patients (if hospitals wish to) just adds to that perception.

But the real damage is that virtually everyone involved in the medical profession, outside of private health companies seems to be against it. Andrew Lansley's office, before the 2010 election, received large donations from Care UK, a private health provider, which adds to the speculation that these companies have a big influence in drawing up this legislation. To cap it all Hinchingbrooke Hospital (which had had many many problems) has now been taken over by Circle, and although this is a company with a good record, and as a result has met with less opposition than you might think, it is seen as a toe in the door.

On top of this opposition, which Lansley tend to dismiss as 'vested interests' not something likely to endear him to the medical profession, is that coming from his own side. Tim Montgomerie, of the ConservativeHome blog has said the government should drop the bill, "The unnecessary and unpopular NHS Bill could cost the Conservative Party the next election. Cameron must kill it."

This is a really big problem for David Cameron and Andrew Lansley, in that a coalition of sorts is building against the Health and Social care Bill, from opposite sides, and for different reasons; creeping privatisation or election losing, but united in that the bill should be withdrawn.

Last night (Friday 10th February) Ryan Bourne of the Centre for Policy Studies (speaking in a personal capacity), said that he found the attacks on Andrew Lansley hard to stomach. However, it wasn't the Labour Party, medical profession or even ConservativeHome (which has a reputation for independent thought anyway), but the Conservatives in the cabinet.

He believes, with some justification I think, that they are showing weakness by, 'now jumping ship,' once things got a bit rough. Indeed, Tim Montgomerie has said that three of them (anonymously) practically ordered him to write it. If they had opposed the bill from the start they should have made their views clear. I think Tim Montgomerie can't be faulted really, he's not come out against many of the changes proposed, but is honest that it should be ditched, because it could be an election loser.

David Cameron for the time being is saying he will force the bill through, but things could come to a head on February 22nd, when Andy Burnham (shadow Health Secretary) has called an opposition day debate on the risk register. This is a document widely used in government, business and other organisations to evaluate wat problems may arise from a particular policy.

Andrew Lansley has been reluctant to publish the register, despite being ordered to do so by the Information Commissioner last November. As a result, it is believed that the Health secretary has something to hide, particularly as the register is propounded to state the reforms would drive up costs in the health service. He doesn't help his case either by stating that the register isn't being published because releasing it, "would have jeopardised the success of the policy."

Now if I was a cynic, I might think that the Health Secretary, with the encouragement of the Prime Minister, was willing to block, delay and obfuscate to get his bill through parliament.

However, I really believe this is an issue about democracy, regardless of whether you support the bill or not. This government is always harping on about greater transparency, and yet they seem to be disobeying a direct order from the Information Commissioner to publish. The House of Lords are currently debating the bill, yet Lansley is refusing to make available all the information to enable them to debate with all the facts.

An Early Day Motion asking that the risk register be published, sponsored by Labour's Easington MP Grahame Morris, has cross party support, excepting as yet Conservatives, which indicates that this is not just a party political issue.

So why is David Cameron trying so hard to keep Andrew Lansley? He seems to have alienated for various reasons the vast majority of the medical profession, and large swathes of his natural supporters. If Montgomerie is correct, by hanging onto him, and trying to push the bill through, Cameron is turning the possibility of losing the next election, into a very likely event.

He daren't risk Andrew Lansley resigning over the issue, because it would be the second in a fairly short space of time (following Chris Huhne's recent one after he was charged with perverting the course of justice), and the fourth in less than two years in government. Although two were Liberal Democrats, it will just give the impression of a government rife with scandal and in disarray.

David Cameron, therefore finds himself in a very difficult position as the year progresses. He is under fire from his own side because he didn't veto an EU treaty after all, he's losing the argument in the public face of Parliament Prime Minister's Questions far too often, he's losing votes regularly in the Lords (with a large number of those who served in Margaret Thatcher's cabinets amongst rebels), and he has a bill which Fraser Nelson, editor of The Spectator, described as one of the ten worst bills of the last decade.

Hubris is a fickle friend, and throughout his Premiership David Cameron has demonstrated plenty of it. But now it could well be his downfall, if not forcing him out, but sending his government spiralling towards defeat at the next election.

Three years is a long time, and fortunes will ebb and flow over that period. But the Prime Minister has a big calculation to make over the next thirteen days. Drop the Health and Social care Bill, and take the temporary hit, even if it means losing his Health secretary in the process. Or he can plough on, and face the prospect of losing the vote called by Labour on the risk register, and the subsequent fallout from that which could make the damage irreparable.

Yet it could all have been so easily avoided. If David Cameron had stuck to his manifesto promise, "that there'd be no top down reorganisation of the NHS," or had not made such a point of refusing to sign up in December's EU summit, or was prepared to rein back on the cuts that are causing so much pain.. The problems are all of his own making, but he is a man who doesn't admit to mistakes, and will just continue on the same path whatever the outcome.