To give Nick Clegg credit, his implementation of the support for the NHS Bill in his own party succeeded. Aside from the numerous articles written elsewhere about the substantive issues of the Bill now as amended, I should like to explain why selling the Bill to his own party worked. I will also briefly discuss the consequences.

Nick Clegg is an odd type of leader – fundamentally he is charismatic (his popularity figures always remain surprisingly high), and he is indeed transformative (in that he has achieved some noteworthy successes such as ‘the Pupil Premium’). He has been able to ‘sell’ some very difficult policies to the Liberal Democrat Party, but an unfortunate characteristic is that people tend to give him no credit and all the blame (the opposite pattern to Steve Jobs, whose failure over Apple TV is rarely remembered.)

‘Strategic change’ is a key issue studied in great detail in many MBAs, the one at BPP Business School included. Books have been written about complex strategic change, and there is no doubt that the implementation of the actual NHS reforms (already started) will result in failure. This is primarily because it has failed to take into account the current structures and culture of the NHS, including the views of the key personnel within it (including the majority of doctors and nurses).

However, Nick Clegg got the support of a key follower, in this case, Baroness Shirley Williams. She is a good choice as she is a former member of Labour, and the assumption is that she would be fiercely defensive of the NHS as an organ of the welfare state. Nick Clegg was therefore very shrewd to get her support, and, with the help of trying to communicate effectively why he felt the amendments were sufficient, was able to get support from his party members. The support of the ‘lead follower’ is an important factor in follower support, and, is for example very important if you are seeking adoption of an innovative problem or service.

Unfortunately, the issue now is what Nick Clegg will have achieved by all this. Left-wing voters are likely to desert the Liberal Democrat Party in droves, meaning that Lab-Lib marginals will almost certainly go Labour. The thorny issue is what happens in Tory-Lib margins; it is very likely that the Tories will win these seats, particularly if Liberal Democrats lose some of their core support. In Tory-Lab marginals, the issue is equally complex, but this could be impacted by a number of factors, including the perceived performance of the economy in 2015; currently it is felt that the deficit will not be paid off until 2017/8 at the earliest because of the very poor level of growth in the UK economy. Conversely, the US economy is now doing very well, as a result of the fact it embraced the importance of fiscal stimulus, and did not reject textbook Keynesian economic theory. Whichever way you look it, it is still possible that the Tories might win with an enhanced majority. However, also, whichever way you look at, while Nick Clegg will have finished a term as Deputy PM by 7 May 2015, the Liberal Democrats are likely to be obliterated electorally in 2015. This presumably does not matter much to Nick Clegg, as his proposals for a reformed House of Lords are likely to fail too.

@legalaware