UK Politics

The 'golden rule' of NHS politics

Ambulance, Liverpool Image copyright AFP

Let me introduce you to the golden rule of the politics of the health service.

The thing politicians consult in their heads before talking about it.

To be clear, I've made it up.

It's 20 words long.

You don't have to agree with it, but keep it in your mind when you hear politicians talking about the NHS.

Here it is: "The punters love it. Trust us plead the politicians. Err, but we trust docs and nurses rather more say voters."

Elbows out

Now take a look at the following words, uttered this week.

"Magic". "Privatisation". "Birthright". "Weaponise".

Big words. All used by politicians, to talk about the National Health Service. Oh, and I forgot the inevitable "political football".

On the playing field of the general election campaign, the NHS is proving to be an elbows out, shirt-tugging tussle.

The prime minister did a question and answer session with the Chancellor George Osborne at Unilever's plant in Port Sunlight on Merseyside.

Nothing unusual about that.

The usual fodder of questions about the economy, jobs, Europe and the NHS - all in, as you might have guessed, a super-marginal constituency where Labour hold the seat, Wirral South, with a majority of just 531.

On one topic more than any other, David Cameron was particularly passionate.

'Weaponise' row

"It is a magic thing we have got in our country," Mr Cameron said, referring to the health service. "It is a birthright of being British that we have a National Health Service that is free at the point of use."

Golden rule adhered to.

Rewind 48 hours to prime minister's questions, the first of this election year, and again the NHS was a major discussion point.

"You can see this as plain as you like. The leader of the Opposition apparently said to the political editor of the BBC, 'I want to weaponise the NHS.'

"I think that is disgraceful. The NHS is not a weapon, it's a way we care for our families, it's the way we care for the elderly, it's the way we look after the frail."

Ah, here we go again. Golden rule adhered to.

A Labour source did not deny that Ed Miliband had used the word "weaponise" in connection with the NHS, in private discussions of election tactics.

Mr Miliband's assessment is simple: "The NHS is in crisis because of decisions made by David Cameron."

In a mess

Tick. Golden rule adhered to. Enter two developments this week:

Firstly, accident and emergency departments in England failing to meet their target of seeing 95% of patients within four hours last week (the figure was 87%).

Secondly, the first private healthcare operator to run an NHS hospital trust deciding to pull out of the deal.

The case of Hinchingbrooke Hospital in Cambridgeshire, while exceptional, tells you a lot about the temperature of the current debate about healthcare.

Here is what no-one disputes.

The hospital was in a mess.

Image caption Circle became the first private firm to manage an NHS hospital three years ago

And both Labour and the coalition government's fingerprints are on the attempted solution to the problem.

Labour say the handing over of the hospital to Circle Healthcare by the coalition amounted to "privatisation."

Golden rule adhered to.

That is loaded language, say senior Conservative sources, pointing out the cash value of services provided by the private sector in the NHS was 5% when Labour lost the last election and it is now 6% - the rate of expansion for the private sector in the health service has slowed down.

The shadow health secretary Andy Burnham, who used to be health secretary when Labour was in government, told the BBC: "I personally always had doubts that a private sector solution would work, more than that I didn't want one," adding "the market in my view adds cost and adds complexity in the delivery of care, these solutions in the end don't deliver."

Golden rule adhered to.

But Mr Burnham did set in train the process that led to the eventual appointment of Circle, albeit by his successors.

What will now happen is the hospital will return to being controlled by the NHS, with politicians falling over themselves to reassure patients that they won't notice any difference.

Golden rule adhered to.

'More money?'

"When people hear Tory politicians talking about the private sector in the NHS, they worry. When they hear Labour politicians say the solution has to be the public sector and that's it, they worry. They smell ideology and they don't care. They just want just care," one adviser reflects thoughtfully.

Golden rule adhered to.

Enter UKIP.

After publicly talking up alternative models of healthcare, such as insurance, note their language now.

"Trust us, we'll leave it pretty much as it is, but we'd give it more money", is the gist of their pitch.

Bingo. Even they're playing the game. Golden rule adhered to.

What will now happen in Hinchingbrooke is the hospital will return to being controlled by the NHS, with politicians falling over themselves to reassure patients that they won't notice any difference.

In other words, adherence to that golden rule all over again.

With just over 16 weeks to go until polling day, keep the golden rule in mind.

Because with government sources willing to acknowledge this is not an easy time for the NHS, and plenty of others using the word "crisis", you can be certain the politics of the health service is never going to be far away between now and May.

And neither is that golden rule.

Related Topics