Are we any the wiser about a future Conservative government’s intentions towards the NHS? I think we are and, being determined to ignore those two great 2009 panics, piggy flu and Labour leadership flu, I plan to focus on those here.
After all, they are more likely to affect most of our lives than the other two. I will only observe in passing that I have a theory as to why Britain seems to have more swine flu than EU neighbours.
Is it, I wonder, only partly about global travel habits? What about greater transparency and openness (both painful) in the public sphere, reinforced by a 24/6 media routinely prone to encouraging mass hysteria?
Thus, German economic statistics are notoriously subject to revision because the experts tend (wrongly) to accept what officialdom tells them. Thus, until President Sarkozy’s heart scare this week, the health of French leaders was famously secretive. Did they really have no CJD, no foot and mouth disease?
Conservative leader David Cameron and his Treasury team are making a virtue of openness about tax-and-spend policies, not least because Gordon Brown’s instinct is, as ever, to be secretive. He wants to hammer home the contrast. Chancellor Alistair Darling is trying to avoid the trap.
Last weekend, shadow chancellor George Osborne’s deputy, Phil Hammond, gave a revealing interview to my Guardian colleagues Patrick Wintour and Nick Watt, the one in which (Darling said later) he seemed “almost wallowing” in the prospect of becoming the nation’s hate figure - the face on the dartboard.
On Sunday sofa TV, Cameron again ruled out NHS cuts. “I don’t want to see charging extended in the NHS,” he added.
But both he and Hammond - whom you may remember as junior health spokesman (1998-2001) - went out of their way to complain about poor public sector productivity.
Crafty Cameron didn’t single out the popular NHS (that’s why he’s leader), Mr Dartboard did. In a globalised world a high-tax, inefficient public sector, 70s-style, is no longer an option, he believes, because jittery markets won’t lend to a debt-wrecked government.
I sense that Mr Hammond, an entrepreneur who used to sell medical kit to the NHS, wasn’t as keen as Dave to ringfence an NHS free at the point of use. But he’s stuck with it. But don’t think that as chief secretary to the Treasury Mr Dartboard will let the service off the hook.
Right wing Tories want the NHS cut back. He notes that productivity (always hard to measure, Phil!) has declined 4 per cent in the boom years and wants it reversed. On a £100bn budget a 4 per cent increase equals £8bn worth of extra funds for frontline services.
They’re going to need better productivity, whoever wins the 2010 election.
Why? Mr Hammond acknowledges the obvious reason: the demographic pressures of an ageing population. That’s why NHS savings will have to be reinvested in the expanding NHS.
It would be “morally unacceptable” to squeeze other departments without putting pressure on the NHS to raise its game, the trade-off for its privileged status, Mr Dartboard argues.
That pressure will also be on pay. Mr Cameron plans to publish all forms of public spending over £25,000 and all public salaries over £150,000, in the name of fairness. Transparency makes people behave better, including remuneration committees, he says. Oh really? The City?
The Tories don’t quite have it in the bag yet. Their instinct to cut spending and cut it yesterday is not endorsed by all free-market economists. They worry that they will cut too much, too soon and jeopardise that fragile recovery. Wary voters are not masochists.