Dare one step further and keep Lansley in post for the full term

Far from everyone in the NHS agrees with his policy programme, which has a number of inconstencies in urgent need of attention, but almost everybody who has met him respects his knowledge and commitment to the NHS.

It would send a powerful message to the NHS that the new government was prepared to recognise the damage done by chopping and changing ministers

That, of course, is a problem for some on the right of the Conservative party. The former member of the SDP is believed to have “gone native” through his long contact with the NHS and is therefore incapable of delivering the “radical” change they believe the NHS requires.

HSJ has been briefed against the new health secretary consistently - and the first anti-Lansley text of the new era arrived within hours of his appointment. The decision not to appoint Mark Simmonds - part of the shadow health team - was the cause of the latest burst of anger and, to be fair, many in the health service were as surprised as he was that he was not offered a job. Mr Simmonds had taken the lead, for example, on the Tories’ plans to develop GP commissioning.

The allegation went that Mr Lansley was surrounding himself with a weak team who would not challenge his vision.

The other - more credible - view is that in appointing an ex-health minister in Simon Burns, the new government is attempting to avoid the mistake made by New Labour of sending a team into Richmond House with no relevant ministerial experience.

Paul Burstow - another surprise choice, this time over Liberal Democrat health spokesman Norman Lamb - and the department’s representative in the House of Lords, Earl Howe, are also brimming with useful knowledge.

But it is Mr Lansley who is key. It is he who has convinced many senior figures that the Conservatives finally “get” the NHS. Take, for example, Professor David Kerr’s appointment as a policy adviser. He has the clinical credibility and experience of major reform programmes to help the Tory plans stay on track. The fact that this former New Labour supporter should sign up to work for a Conservative government is another testament to the secretary of state’s ability to engender confidence in those who would not normally be natural supporters.

The common theory regarding Mr Lansley is that his close relationship with the NHS would be used as an electoral asset, but that he would be reshuffled within a year.

Heaven knows what pressures will bear on the new prime minister as he attempts to keep his new coalition together - but he should fiercely resist any politically motivated pressure to move Mr Lansley. In fact, he should go further, much further.

Mr Cameron should announce - in the spirit of “the new politics” - that Mr Lansley will serve all five years of this fixed term parliament as health secretary.

With a couple of sensible provisos over performance and conduct, there is no reason why he cannot do this. It would send a powerful message to the NHS that the new government was prepared to recognise the damage done by chopping and changing ministers - and the need for stability and consistency at this crucial stage in the NHS’s history.

Mr Lansley himself underlined this point when speaking to DH staff last week. He rightly identified the dangers of politicians constantly trying to reinvent strategy. He said his “ambition” was to switch to a “consistent and coherent” approach and, as a result, make reforms sustainable.

That sustainability would be significantly enhanced, if the NHS could move forward knowing another politician was not waiting in the wings waiting to impose his or her priorities on the service. David Cameron has already transformed the landscape of British politics. Confirming Mr Lansley in post for the lifetime of the Parliament would be another audacious and admirable decision.

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