This article is from the February issue of Total Politics
David Cameron is masterminding a mission to ensure health remains a neutral issue between now and 2015. The PM knows the Conservatives must do all they can to stop Britain’s NHS become a concern on voters’ minds. Neutralising the public’s fears about the issue is part of the No 10 re-election strategy. Cameron can’t do this on his own.
He has placed huge trust and faith in health secretary Andrew Lansley to help him deliver on this objective. Those who have lined Lansley up for the axe in a 2012 reshuffle will be proven wrong, I understand. He stays put to deliver on a new plan to put patients first.
The personal chemistry is very good at close quarters, well-placed observers report. And crucially, the PM believes Lansley was not wholly to blame for the crisis that hit the delivery of his Health and Social Care Bill. It’s worth pointing out that Lansley was once the PM’s boss and their ties were forged in the heat of battle. A young Cameron was promoted to head the political section of Lansley’s Conservative Research Department in 1991. It was here they collaborated to draw up the successful 1992 general election manifesto – confounding all commentators and most Conservatives at the time.
So what does this plan look like?
Cameron has decided to focus on the real practicalities that patients and their families experience. He wants to concentrate on three deliverables between now and the May 2015 general election. There will be a commitment to do the basics better than before – ridding hospitals of infection and a relentless pursuit of cleanliness. Nurses will go on hourly rounds, matrons or ward sisters handed more authority so they once again rule the roost in a way crudely described as ‘Carry On Nursing’ by The Sun.
He even wants to improve the way patients are fed and watered while in hospital.
His team is now working with the Royal College of Nursing’s chief executive Peter Carter to deliver a better patient care experience. Officials will be ordered to drive up NHS results in treating the major illnesses like heart disease and cancer so they compare favourably with those in other countries.
The PM has often been heard telling colleagues that if it can be done overseas, it can and must be done here. And he wants a ‘big bang’ approach to public health aimed at easing the pressure on the NHS by getting us all to live better so we need it less. Minimum pricing for booze is on the agenda. Further pledges from the food and drink industries on calories are expected.
That’s not all, though.
The PM and Lansley are under pressure to deliver the ‘Nicholson challenge’ – the need to find efficiency savings across the entire health service laid down by Sir David Nicholson last year. They have already ring-fenced the health department’s budget so that £1 in every £7 taken in taxation goes straight into its veins. But that money is being stretched.
People are living far longer. Drugs are more expensive. Treatments and technology cost a fortune. And crucially, we all expect – no, we demand – more from our NHS.
The PM must constantly reassure voters that he believes in the NHS. His pollster Andrew Cooper knows only too well that Conservative leaders must work ceaselessly to convince a sceptical public. Floating voters are 90 per cent more likely to back the Conservatives in an election if they are reassured that Mr Cameron can be “trusted” with the NHS, studies show.
Women voters, too, are a part of this conundrum. They are more likely than men to be exposed to the NHS and are the first audience for health professionals complaining about budget cuts. So Cameron believes he must meet the practical needs of patients by listening to and working with doctors and nurses.
Last year’s difficulties over the Health and Social Care Bill took ministers by surprise. They were taken aback by the scale of opposition they faced.
Many of those organisations Lansley canvassed before the 2010 general election had seemed in favour of what was proposed. This communication failure might have cost another cabinet minister his job. But Lansley retains the PM’s confidence.
Insiders point out that trying to reform the NHS wholesale is virtually impossible.
You only have to look at Labour health secretary Alan Milburn’s doomed attempt to bring in foundation hospitals to realise how hard it was to change just one aspect.
Reshaping the entire service in a comprehensive bill has opened the government up to opposition on multiple fronts, with everyone demanding a say. So an operation is underway to reset the narrative post the bill.
The PM is passionate about the NHS from a patient’s point of view. He and wife Samantha know more than most parents should about the NHS, its strengths and its challenges.
George Pascoe-Watson is a partner at Portland Communications