The NHS was one of the most important issues to voters in the General Election – if not the most important. (See here and here). One of Labour’s strategic aims in the campaign was to turn it into a referendum on healthcare. And so wherever the service was a big local issue, Conservative incumbents and candidates came under pressure. Tory insiders believe that good candidates and MPs – such as Angie Bray, Nick de Bois and Eric Ollerenshaw – lost their seats because of Labour’s relentless and dishonest campaigning. Had the election actually turned into that plebiscite on healthcare, Ed Miliband would probably be Prime Minister today.
That it did not has most to do with the prominence during the campaign of other matters – such as voter fear of a Miliband/Sturgeon government. But it also had quite a lot to do with the changing voter scene on healthcare, hard-working Conservative MPs with a track record on health that they could prove, Labour’s dire NHS record in Wales…and Jeremy Hunt. Let’s look at those factors in reverse order.
Hunt, the first counter-attacking Tory Health Secretary. For Conservative politicians, health has traditionally been a defensive brief: even self-confident Tory Health Secretaries, such as Ken Clarke, have had limited scope to assail Labour. Jeremy Hunt arrived at the department with a bruised reputation (after the fracas over BSkyB) and succeeded a politician with a broken one – Andrew Lansley, who had worked hard on reform, but failed to explain its purpose to voters.
The new Health Secretary’s priorities were thus to avoid a “winter crisis”, close down weaknesses, press on with change, explain its purpose clearly – and attack Labour if possible. As this site has explained, Hunt swiftly borrowed from the Gove reforms at Education, using transparency and accountability to improve the service (for example, by putting failing hospitals into special measures). But where Gove had been confrontational, Hunt was collegiate – believing that in a service in which 70 per cent of staff vote Labour, he had to tread softly to catch his monkey.
The Health Secretary’s business background served him well, as did his natural talents as a salesman. His message was clear: the Government’s changes are about making the service better for patients. As the election approached, Hunt found satisfaction ratings with the NHS at their second-highest on record. This was an unfavourable background for Labour’s campaign. But the Health Secretary couldn’t simply rely on the Coalition’s record; nor could he stop Labour making the “privatisation” charge. What he could do, however, was blunt it.
Hunt was able to stop it gaining traction by making the facts known. These were taken up by the media in general and Newsnight in particular, which projected the famous graph showing that use of the private sector by the NHS grew faster under Labour than the Coalition, and subjected Andy Burnham to what turned out to be a car-crash interview. Most voters will neither have seen the footage nor clocked the Tory pledge to spend more on the NHS than Labour. However, those who take a special interest in the NHS were presented with the facts.
Mid-Staffs, Wales, “Weaponising the NHS”…and Burnham.
Hunt was also able to go on the counter-attack over the terrible failure in Mid-Staffs on Labour’s watch – urged on by backbench MPs such as Stephen Barclay and our own Charlotte Leslie – and, above all, by the party’s failure to manage healthcare as well in Wales as in England – see here, here, here and here.
Ed Miliband hasn’t denied that he or one of his closest aides said that Labour’s aim was to “weaponise the NHS”. The quote and his inability to disown it haunted him. Finally, Burnham himself was a symbol of Labour’s healthcare blunders in office.
A different health spokesman running a different campaign might have given Labour’s NHS campaign more of a cutting edge in even more marginals. But the Shadow Health Secretary was wooing the unions to prepare for a leadership contest, and thus had an interest in pitching Labour’s NHS push to the left. He seems to have had his gaze more fixed on his own future than his party’s.
The track record of Conservative MPs on health
The charge of a secret plan to privatise the NHS was always going to be harder to sustain against a Tory leader who has personal experience of the service in the most tragic of circumstances. David Cameron himself was a symbol of Tory commitment to the NHS – the one that mattered most.
And as Guy Opperman argued in his article on this site earlier this week, too many Conservative MPs had first-rate campaigning records on health in their own constituencies for Labour’s charges to gain traction. Too often, Miliband’s party looked stuck in the past.
Is Labour losing its monopoly on healthcare?
Finally, there is some evidence that, as memories of the Bevin healthcare settlement fade, Labour is losing some of the grip that it has had on the NHS issue – not so much because the Tories are doing better as because distrust in all parties’ management of the system has risen.
Indeed, one survey found last year that Cameron was more trusted on healthcare than Miliband – a position only reversed in the run-up to election day itself. Hunt was able to brief the new Cabinet earlier this week on how the health campaign had gone during the election. His colleagues have reason to be satisfied.
However, Hunt would warn Tories not to be triumphalist. “There’s still a lot of work to do in persuading voters who don’t vote Conservative to do so,” said a source close to the Health Secretary. “And there’s no room for complacency.” The main who arrived at the Health Department in a jittery condition is one of the success stories of the election – and now a heavyweight politician of the first rank.
