Andrew Lansley says sorry as nurses vote against him
Health minister admits he has to 'live and learn' about troubled NHS reforms as he slips into private meeting
A day from hell: Andrew Lansley faced the humiliation of a 99% no confidence vote by nurses. Photograph: Dan Kitwood/Getty Images
A grey-haired man with a puzzled frown slipped into Liverpool on a secret mission to the nurses' conference. He had to "listen and learn" about his troubled NHS reforms without being tossed trouserless into the nearby Mersey – live on the six o'clock news.
But how to pull off a stunt that would have daunted escapologists of the calibre of Harry Houdini or David Blaine? That was the challenge facingAndrew Lansley, a minister more famous for locking himself in an underwater legislative trunk and swallowing the key.
Lansley's plan was audacious in its simplicity. He would accomplish his mission by avoiding most of the 500 delegates gathered for the Royal College of Nursing congress in the cavernous basement of the BT convention centre. No Andrew in the lions' den for him, more Andrew prodding safely with a stick outside the cage.
So he agreed to meet 60 nurses privately two floors up, thereby further annoying most of the 478 who, just hours earlier, had supported a vote of no confidence in his policies. Six delegates voted against the motion, 13 abstained. It was 99% to 1%. Only an optimist of Lansley's class would think "1% eh? We can build on that."
It must have been a day from hell. The health secretary had spent part of the morning putting on a hangdog show of unity at a made-for-TV coalition health summit, with David Cameron and Nick Clegg doing most of the talking. With Ed Miliband's jibes ringing in his ears, Lansley then had to take the train to Liverpool, a city synonymous with militancy.
Not since the German emperor crawled through the snow to apologise to a medieval pope at Canossa had such an abject journey been made. The difference was that the German emperor hadn't meant a word of his apology: it was a made-for-parchment media stunt.
It was clear that Lansley does mean it, up to a point. No fewer than four times he said " I'm sorry" or "I apologise" for his failure to communicate his vision for an NHS, free, fair and efficient. He is not a cynic. It was painful to watch.
RCN anger over the sweeping reforms promised by the coalition's health and social care bill – now officially "paused" for a two-month rethink – is much like that of other NHS trade unions, including the doctors' own BMA, but more solicitous. However often its members drop elderly patients or leave them to stew in their own pee, the RCN gracefully embraces the public's image of them as the National Union of Angels.
If a no confidence vote from the kindly Angels was not bad enough, the conference's morning session was enlivened by a masterclass in political communication from Tony Blair's svengali, Alastair Campbell As You've Never Seen Him. With Campbell's ability to sell a message Lansley might have been home early for supper last night instead of halfway to Euston, still imprisoned in bureaucratic jargon.
Campbell was political. When is he not? But he was better than that. There to beat the drum for mental health – which he now champions in many ways – he started with a winning show of vulnerability, speaking about his boozing, his psychotic episodes, the breakdown and paranoid voices, his arrest in 1986. There was a serious point to this: mental illness still carries a stigma that cancer or a broken leg does not. When Blair offered him that job he had confessed all. "I'm not bothered if you're not bothered," said Blair. "What if I'm bothered?" "I'm still not bothered."
It was gripping and gave Campbell the leeway to urge the Angels – voters trust you more than the media or MPs, he said – to fight for Cinderella mental health services against cuts that would end up costing society more in the long run. Don't trust the coalition's "pause" – the strategy remains the same, Campbell said. And don't scapegoat Lansley: they're all in this. What's more, they're not like Margaret Thatcher – "not for turning. They respond to heat, so let them feel the heat."
It was a bravura performance in which he gave a nod to the "famous 50" (later 60) chosen to meet the health secretary. Remind him that the NHS enjoys record satisfaction levels, he added.
Of course, Campbell would never have allowed his boss to duck the main conference hall. Blair's "masochism strategy" required him to take his punishment on TV – the kind meted out to Lansley's Labour predecessor, Patricia ("Hewitt Blew It") Hewitt by the RCN conference during her cuts in 2006.
But this was an improvised visit. Until the "pause" a junior minister, Anne Milton, an ex-nurse, had been deemed enough for Liverpool where she was politely received on Tuesday. Lansley's session with the 60 was a compromise at which one TV crew and no reporters were to be admitted.
That provoked uproar in the press room and was eventually rescinded. Without full media access the 60 might have been dismissed as stooges, all of them promised an MBE. Or all deaf. Or all Freemasons. Or all fed with tranquillisers in their lunch. Actually they were all picked by their region.
In the event the compromise went as well as could be expected. Lansley arrived, grim-faced and little-noticed, at 3.25pm. "Are you here to listen to us?" cried a delegate at the door. "I am always here to listen to nurses. I have been to Congress before," he said tetchily.
Ten minutes later he met the 60, all seated at round tables, New Labour-style and just like a primary school. Tell him the depth of your feeling, said the RCN's general secretary, Dr Peter Carter, albeit politely. Lansley then assured them: "If there is an ideology here it is that I believe in the NHS" – stronger and better. "I am sorry if what I set out to do has not communicated itself."
It was the first of the four apologies, all about communication, not substance. He then spent 90 minutes touring the tables. Don't talk so much, said Carter. You're here to listen. Nurses complained about the £20bn worth of efficiency cuts (first sought by Labour) eating into frontline NHS services; about rising pension contributions and Lansley's failure to give the nursing profession a bigger share of his vision of GP-led health commissioning.
Far from retreating on substance he argued back that without reform in four years the NHS would be so hard-pressed that "people would say: 'why didn't you do something?' Well, I am doing something." If he thought the RCN's dire predictions were true, "I'd be joining you and voting against me," he told them at the end.
It was a rare example of a striking Lansley soundbite.
A pity the whole conference did not hear it, some unconvinced delegates remarked later. As a parting shot Carter warned him that if there were no policy change in two months the RCN's cynicism would be vindicated. Lansley acknowledged himself "rebuked" by Angels. It does not happen every day.
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