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Preparing for power

Shadow health secretary Andrew Lansley’s keynote speech at the BMA on Tuesday evening was an interesting one – as much for what he didn’t say as for what he did. (You can watch the whole event on the BMA's website).

By Steve Nowottny

Shadow health secretary Andrew Lansley's keynote speech at the BMA on Tuesday evening was an interesting one – as much for what he didn't say as for what he did. (You can watch the whole event on the BMA's website).

What he did say, of course, proved to be controversial enough, with a couple of points buried in his stump speech likely to mean major changes to the way GPs work if they ever become reality. Putting GPs front and centre in the rationing debate is a talking point, to be sure, but blaming GPs if they refer patients to a hospital where they later catch C Diff? Grassroots GPs who were in the audience and whom I spoke to today – even those who were overall very impressed by Mr Lansley – didn't think that was too clever. As one put it: isn't the whole point of free choice that the patient decides which hospital to go to?

But no, the really interesting thing was what Mr Lansley left out. Speaking to the BMA membership, especially at this point in the electoral cycle, should be easier than some of the gigs he gets – certainly easier than addressing a hall full of NHS managers, as he had to at the NHS Confederation last summer.

Mr Lansley denied the ministerial charge that he always sides with the BMA. ‘Government always accuse me of being in your pocket,' he said. ‘As they say in my trade, some pocket.' But the truth is, on a number of cornerstone issues his view chimes with that of GPs. The Tories opposed the polyclinic rollout. They want to clear away a layer of NHS bureaucracy. They are against targets for extended hours.

So on Tuesday night Mr Lansley had every opporutntiy to play to the gallery, to go for votes and highlight the areas where Tory policy and GP opinion often overlaps. But for the most part, he didn't. He played it straight and wasn't afraid to go head to head with senior BMA members over areas of disagreement, such as the private sector and rationing.

Such a performance may or may not in the long run help his electoral chances – but it shows a certain confidence, as you might expect from a politican who's had five years to master his brief. Not that he'd ever admit it, but Lansley already seems to have one foot in Richmond House.

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