nhs reform

Nicholas Timmins

As David Cameron, Nick Clegg and Andrew Lansley strutted their stuff at Guy’s Hospital today, arguing that lots of detail had altered over their NHS plans but that the fundamentals remained the same, who quietly re-emerged as the most powerful man in the NHS?

Answer: Someone who wasn’t there – Sir David Nicholson, the NHS chief executive. Up until the “pause”, Sir David had been the most powerful since his appointment as chief executive designate of the commissioning board was forced on Andrew Lansley back in December in the first sign that the government was panicking about the health secretary’s NHS reforms. 

Nicholas Timmins

Politics is full of the bitterest of ironies. Deep inside Andrew Lansley’s reform of the NHS was a desire to take politics (or at least as much of the politics as may be possible) out of the NHS.

Today, as a result of producing the biggest bill in the history of the NHS – far longer than the founding act of 1946 - he has subjected the NHS to the biggest bout of political in-fighting since its foundation.