There was a time not so long ago when Labour ministers could console themselves with the thought that, however bad things got for the government, it would at least have its record on the NHS to fall back on. No one surely, they argued, could seriously believe that the NHS could ever be better off under the Tories after what Labour has done for health since 1997? Sadly, even that last crumb of comfort looks as though it’s on the brink of being swept away. As the Guardian gleefully reported over the summer, more voters now think the Tories would improve the NHS than make it worse. Even one in four Labour voters are purported to think that a spell of Tory government wouldn’t be such a bad thing for the NHS.
How have things come this? After a nightmare August for the Tories, in which Daniel Hannan signed up as a willing cheerleader for the US Republicans’ NHS bashing campaign, how on earth has David Cameron managed to emerge not only unscathed, but ahead on points?
The party’s gut instinct, of course, is to say that it’s not about the Tories, it’s all about us. Voters aren’t in the mood to listen to us, or trust us, on any issue at the moment, and the NHS is no exception. All we can do is to hope that when it comes down to making a hard choice at the ballot box, people won’t feel quite so sanguine about the Tories.
There may be some truth in this, but it’s also possible that despite all the opprobrium that’s been heaped on Daniel Hannan, it’s Cameron’s enthusiastic and apparently heartfelt support for the NHS that’s resonated most with voters. Rather than attacking Labour’s record on the NHS, Cameron has in fact endorsed many of its reforms and investment choices, and this has no doubt helped to assuage a lot of voters’ lingering concerns. We’re not interested in any change in ideological direction, he soothes, we just want to make sure that the NHS is efficiently and competently managed, and we think we can do this better than Labour.
You have to admire his chutzpah. Getting up and trying to exude calm while laying out the Tories’ credentials as dry technocrats cannot be easy when some of the leading lights in your party are salivating, very publicly, at the thought of public spending cuts to come and thirsting for the introduction of self-funded personal health accounts. At times Cameron must wonder how he continues to get away with it. Exposing this glaring chasm between what Cameron says and what his party thinks is crucial, therefore, if we are to dent the Tories’ lead on health before the next election.
It isn’t just the Tories who have to tread carefully though. There is no doubt that the NHS is better equipped, better staffed and more responsive to the needs of patients than it’s ever been. Performance in places is still very patchy, though, and we need to be honest about this. For every three or four GP practices in swish facilities, for instance, that can guarantee you an appointment with a GP within two working days, there’s another practice in a building that has seen better days with a creaking phone system that never seems to have a spare appointment when you need it. It’s these shop-front experiences that people remember at election time – not the billions that have gone in transforming the acute sector and ensuring that staff are decently paid.
If we want to convince people that the NHS is better off under Labour then a renewed effort to deal with these primary care access issues wouldn’t be a bad place to start. Get this right, and some of the gloss of Cameron’s message might well begin to rub off.