In turbulent times this column’s reputation as a non-panic zone serves it well. Swine flu, Alan Johnson for PM, delinquent volcanoes, we take them all in our stride. So too the Lib Dem election surge since Nick Clegg’s quite good performance in the TV debate.
Will it last? I don’t know either. He could just be another Susan Boyle. But Norman Lamb is not going to be health secretary, so you don’t have to worry about their very reasonable manifesto pledge to ensure that no NHS manager earns more than Gordon Brown’s £198,661 annual salary.
It is going to cost rather a lot: £112bn in extra taxes by 2013 to be precise; they all love to be precise
Or about UKIP’s promise to reorganise the NHS on county lines. As with most election manifestos it is easier to spot UKIP’s spending pledges than their cuts, which tend to be less specific. Ditto all the other parties. Thus the Greens’ manifesto promises to reintroduce free eye tests and prescriptions, free dental care and free social care for the elderly.
“If the Scots can do it, so can the rest of us,” say the Greens.
It would cost £8bn but could create 120,000 jobs. Grand, but (as the Scots are wondering) where would the money come from? Much of it from whacking an extra 50 per cent on booze and fags tax as part of the Greens’ preventive health strategy, which involves all sorts of admirable goals: patient safety, dignity, decentralisation and cost effective complementary medicine.
Ah yes, and “more dental care rather than mass fluoridation”. Hmm. I liked the Green manifesto with its stress on the lack of stress in more equal societies like Japan. But it is going to cost rather a lot: £112bn in extra taxes by 2013 to be precise; they all love to be precise.
The Lib Dems’ manifesto (too late for last week’s column) sticks sensibly to health generalisations: higher priority to mental health, cancer (of course), dementia research, maternity, less waste, fewer managers, all familiar.
There is a lot of overlap with Labour and the Tories, empowering patients, beating up GPs, guaranteeing this and that. Even cancelling Heathrow’s third runway will save the NHS money via reduced pollution. So that Iceland volcano is already helping, right?
The Lib Dems’ unique selling point is locally elected health boards to commission services, a proposal which brings them up against David Cameron’s overarching theme: Big Society, Not Big Government, empowering the army of volunteers just itching to take charge.
In NHS terms that means decentralisation, more commissioning power to GPs, less political interference (except to keep threatened hospitals open?), more patient choice and (like the Lib Dems) even more payment by results. In 2010 the emphasis in all the main parties is managerial: they share common goals for healthcare, but disagree over how best to do it; means, not ends.
Or do they? I admire the idealism implicit in Cameron’s belief that society has huge untapped strengths, but doubt if ever-busier citizens, let alone harassed, overpaid GPs, really want to take over the running of schools, hospitals and youth clubs when not voting in/out their local police chief.
A Guardian editorial this week detected a hidden Tory big idea in the promised economic regulator to promote competition within the NHS. Given the militant thrust of EU competition, and the way the Royal Mail regulator damaged the postal service by excessive free market zeal, this could wreak unintended havoc.
Andrew Lansley’s team assure me it ain’t so: “We want to create a level playing field in the NHS, not to undermine it. That was one of our key criticisms of independent sector treatment centres and polyclinics.”
So far the NHS has had a quiet election. No Jennifer’s Ear row yet. Fingers crossed?