Over the last three weeks, Labour, the Conservatives and the Liberal Democrats have tried to rally their troops ready for next May's election, whilst setting out clear public narratives for the public to (hopefully) soak up. Nothing has been more central to this than the NHS. With Labour taking the lead with a modest yet politically significant funding pledge, there is still plenty of time for the other parties to gain ground in the perennial political football that is the NHS.
Labour, the Conservatives and the Liberal Democrats are scrabbling over the title as the most trusted party on the NHS, and for good reason. Polling has shown that the NHS, always high on the list of issues most important to the electorate, is likely to be priority number one come election day. Don't expect the noise around the NHS to abate anytime soon.
The conference season started on a pessimistic note - Labour's key message was that the NHS is a "shattered service" that needs to be saved. Labour's constant narrative over recent years has been that merging health and social care will save the NHS. Whilst agreeing that this is the way forward, many health organisations, such as the Nuffield Trust, have argued that this will not deliver financial savings in the short-term. Heeding this, Labour's conference was about what to do in the here and now - fitting nicely into a saving-the-NHS-theme. Ed Miliband used his conference speech to announce an extra £2.5bn for the NHS. The figure was almost irrelevant; the political message was key - Labour will increase NHS spending.
The Conservative Party conference theme of economic competence fed into every conference speech, with Jeremy Hunt's no exception. The NHS cannot be funded if the economy is bankrupted, was his key refrain. Whilst Conservatives confirmed they would ring-fence the NHS for the whole of the next Parliament, there was no eye-catching give away. The focus was on primary care - pledges to make it easier to get GP appointments, a named GP for all and patient access to health records.
Conveying a party holding the centre ground, the Liberal Democrats went for a £1 billion real term investment in the NHS in 2016/17 and 2017/18. Norman Lamb's speech focused on mental health, seeking to place the party at the centre circle between the opposing teams - Labour do not get that the biggest threat to the NHS is the state of the public finances; the Conservatives would cut the NHS because of pressure applied by its right-wing to further trim public spending.
So, whose vision is most credible? The Labour and Liberal Democrat positions start from a premise that the NHS, as it currently stand, needs more. The Conservatives dispel this - "doesn't the Commonwealth Fund rate the NHS as the best health service in the world?", they retort. However, the public perception is with Labour and the Lib Dems - with constant debates about timebombs, funding crises and substandard care, this is not surprising.
In a health system, rising demand, an ageing population and an ever increasing array of medicines means that extra funding will always be called for. The credibility factor raises its head with all parties' plans - can parties expect further NHS pay restraint, a large factor in delivering the Nicholson savings, to be repeated ad infinitum? Isn't a seven day a week GP service and a named GP for each patient a contradiction, unless every GP works seven days a week? If budgets are not pooled locally, will this be mandated from above?
However, this conference season was not about the detail - each and every missive is another piece in an electoral narrative. Lacking in specifics for policy wonks maybe, but lacking in clarity for a wider public narrative? Certainly not. Labour is the party of extra funding, Conservatives rely on an emotional appeal as the guarantor of NHS patients, and the Liberal Democrats are the party for the forgotten.
The politics of the NHS will determine May 2015. Labour is ahead, but expect the Conservatives to play the patient empowerment supersub. Numbers and structures matter, but the Conservative emotional appeal on the NHS might just work.Suggest a correction