Does Cameron feel beholden to Lansley?

With the news that Andrew Lansley's NHS reforms are going to "pause" for more "consultation" it is worth reflecting on how we reached this point.

David Cameron has been a lot more relaxed than his recent predecessors as PM regarding tightly controlling the activities of ministers and their departments. And good on him I say. I think ensuring ministers have proper power to implement their programmes is generally a good thing and should lead to less "government by tabloid headlines".

However I do think in the case of the NHS that Cameron perhaps should have been a bit more attuned to what was happening. The health service has an absolutely pivotal role in the lives of the people of this country and like it or not, the Tories are not well trusted in this area of policy. It was always likely that any reform of it would receive a lot of focus and scrutiny and that the government was going to need to tread carefully. Instead Andrew Lansley has been given free reign to push ahead with a very substantial programme of reform.

I do wonder if the dynamics between the Prime Minister and the Secretary of State for Health may have had some role to play in this. David Cameron's first proper political job was in the Conservative Research Department from 1988 - 1993. And the head of that organisation from 1990 onwards was none other than Andrew Lansley. It can be odd to find yourself in a position of authority over someone who was previously in a position of authority over you and this can do funny things to relationships. Is it possible that Cameron has felt less able to intervene with Lansley's activities than his instincts may have been telling him because of the fact that many moons ago he used to be his boss?

I expect some will dismiss this as nonsense but human relationships are very complex things. It would not surprise me if, even only at a subconscious level, Cameron has been less inclined to pull Lansley up because of their history.

It would seem clear that Cameron's political antennae is now amply registering the danger and he has somewhat belatedly become heavily involved to try and avoid a potential legislative car crash.

PMs have to have a ruthless streak even when it comes to former bosses. Perhaps it has taken this episode to bring that home to the latest holder of the office.