In 1997, Tony Blair was swept to power on a wave of the need for change and his own personal charisma. It didn't hurt that he adopted many of the clothes traditionally woven in Conservative blue. David Cameron is utilising this Blairite tactic – for him, this season’s colour is most definitely red. Not content with claiming the Tories are the party of the NHS (which, of course, will be forever associated with Labour in most minds), he has now adopted co-operatives (the Labour Party sprung from the co-operative movement in the North West of England).
So, if New Labour was the Tories and New Tories are New Labour no wonder voters are confused. Not that it matters of course as the Lib Dems are about to ‘sweep to victory’ – in reality hold the balance of power in a hung Parliament – according to the latest polls, which seem to be based on the fact that Nick Clegg managed to look less shifty than Mr Brown and Mr Cameron in the opening leaders’ debate.
Depending on the number of seats they win, the Cleggies could demand a few cabinet seats – Vince Cable as chancellor would be an obvious (and popular) move, but what about Norman Lamb as health secretary? Would David or Gordon let him carry out the Lib Dems’ manifesto commitment to turn commissioners into locally-elected health boards? Or would they be more likely to acquiesce when he proposed abolishing strategic health authorities, cutting 50% of the Department of Health’s costs and limiting senior managers’ pay?
What happens if current polls are reflected in votes on 6 May is for later. On the campaign trail, if truth be told, we are still waiting for health to become the focus of a landmark battle between the parties (come to think of it, has there been any issue of policy that has defined the differences between the parties and sparked the campaign to life? National insurance did briefly, but in the age of ‘X Factor’ and ‘Britain’s got dancing dogs’ are we focusing too much on personalities and the weekly dose of contrived sound bites in the leaders’ debates?).
In the absence of this year’s Jennifer’s ear, we must make do with what the parties serve up.
On 17 April David Cameron launches the Conservatives’ pubic sector manifesto [download here], setting out how every public sector body can become an employee-owned co-op and promising to deliver fairer pay (presumably the money for fairer pay will be generated by selling cigs and newspapers down at the co-op).
More manifestos are published this week, including the Democratic Unionist Party [download here] in Northern Ireland, which promises increased spending on prevention and early intervention and greater identification of non-cost effective practice. On Wednesday (21), another Northern Irish party, the SDLP, launches its manifesto [here]. It pledges to oppose frontline cuts in health services, invest in hospital construction and start a preventative health fund.
However, the promises from the Northern Irish parties are quickly brought into sharp focus as the local Assembly debates a revised Budget for 2010/11 [see alert]. Though revenue funding is to increase, £16m has been cut from the capital budget and additional savings totalling more than £110m will have to be found.
Some much-needed levity is provided by the Zombie party - no, not a grouping of your favourite ageing politicians, but the Citizens for Undead Rights and Equality. The party’s top health policy – investment in research to find a cure for Zombie bites, naturally. Key slogan – ‘I’m not a Zombie, but one day I might be – let’s find a cure.’ You can find the party’s disappointingly normal looking website via Google.
Once again the focus of the week is the leaders’ debate on Thursday (22 April), which gets feisty at times (nine people are arrested outside, mainly for public order offences, in scenes not seen in Bristol since last Saturday night). Inside, the prime minister chides David Cameron, alleging his opponent would not maintain free prescriptions or eye test for the elderly. Mr Cameron dismisses this as scaremongering.
With the focus of the debate on foreign affairs, it’s not surprising there is little about the NHS. However, earlier in the day the three main parties health spokesmen line up to debate at an event organised by the King’s Fund, BMA, NHS Confederation and RCN.
You can watch a video of the 90-minute debate here. Some of the detail that has been frustratingly absent from the campaign is there, with the spokesmen knowing they cannot get by with vague answers in a room full of clinicians, managers and commentators. But what shows up most is the little difference between the parties – in this economic climate there is little room for grand plans.
Health secretary Andy Burnham criticises his opponents for failing to acknowledge that the tough decisions will mean hospital reorganisation and services moving to other units, but otherwise they are broadly in agreement. Funding will be roughly the same and efficiency and quality are the watchwords of the next few years. And even when shadow health secretary Andrew Lansley raises payment by results (no, this is not going to be a Zombie joke), it is to say that payments should be more closely aligned to quality. But isn't this the road we’re already travelling?