'Does the first glimpse of the new, kinder Tory health policy amount to much? Blair didn't think so'

You may remember that Tony Blair had a bad day at prime minister's question time last week. He fumbled his answer on Gordon Brown (he should have said 'I love him lots') and at one point referred to foreign prisoners as 'foreign secretaries'.

Not at all like Blair the Smoothie. What went wrong? I'm told by well-placed sources that it was the NHS's fault. Given that the Cameroon Tories were in the middle of their own 'I love the NHS' week, Mr Blair had prepped furiously on health issues. He was disconcerted when David Cameron dropped the subject after one question and moved on.

The Conservatives had a mixed success with their campaign. Some of the week's facts, the Healthcare Commission's hard-hitting annual ratings, new claims about cancelled operations and, of course, the NHS's overall£547m deficit, reinforced their message that a badly managed service is out of control.

Yet Mr Cameron's launch was overshadowed by an even bigger explosion in North Korea and by the weekend it seemed to be running out of steam. I didn't spot anything in the Sunday papers. Blame that talkative general who criticised Mr Blair's Iraqi policy.

More important than the tactics, does the first glimpse of the new, kinder Tory health policy amount to much? Mr Blair didn't think so and sounded as outraged as he did when Michael Howard used to lambast Labour's minimum wage policy in the early '90s.

Legacy remains part of Mr Cameron's problem. Not what happened in the Major or Thatcher era. As Ken Clarke naughtily pointed out in last week's bad-tempered Commons debate, Labour has re-introduced much of his own NHS internal market, circa 1990 - taking us all towards the kind of health consensus 'that I never thought I would live to see'.

No, Mr Cameron's problem is more recent. Since becoming an MP in 2001 he has voted against extra NHS funds and he co-wrote the 2005 manifesto which included Liam Fox's 'patient passport' scheme, which would have shunted money out of the NHS into BUPA with few strings.

Labour MPs, who seem genuinely fired up in the Commons, are eager to remind voters to counter Tory or Lib Dem 'save our community hospital' schemes which threaten their seats. Even the (false) rumours of closure helped defeat MPs in 2005. Next time the Tory cry will blame 'short-term financial mismanagement' for closure.

Mr Cameron, his estimable health spokesman Andrew Lansley and their adviser, cerebral ex-health secretary Stephen Dorrell ('I abhor violence, but my associate Mr Clarke has no such scruples') are promoting a four-principles NHS: partnership with the professions; equitable access; local decision-making; growth in NHS resources.

Fine. And their opening move is to promise an independent NHS board to run the service while the Department of Health concentrates on public health, where it is not doing too well.

Fine again. Plenty of people are thinking that way now, including HSJ 's columnist Simon Stevens and Mr G Brown. The Tory problem is that the party starts from a more difficult position than the others do. For instance, their policy of 'sharing the proceeds of economic growth' with tax cuts is bound to mean less extra money for healthcare.

Labour's sharp counter-attack, trumpeted by Blair, Hewitt and others, further highlights Tory contradictions. Money isn't everything in health or Glasgow would be healthy, as Mr Lansley says. But if the 'disease burden' rather than health inequality is to guide fair spending, then surely poor north Manchester will get more money, not less?

And how will the proposed NHS board maintain financial discipline and avoid cuts while leaving decisions to the locals? And what is the difference between Labour targets (bad) and Tory protocols? In TV interviews Mr Lansley was forced to duck and weave, though on the BBC's Daily Politicshe was cornered on the '20,000 jobs cuts' claim. Not jobs, but posts. In Bolton for instance, two jobs, 130 posts.

I know what you're thinking: MPs exaggerate; they always do, especially when their policies are getting closer. All the same I thought it cheeky of opposition MPs to accuse Ms Hewitt of only imposing cuts in their constituencies while simultaneously condemning those in Leicester: hers.

Michael White is assistant editor (politics) ofThe Guardian .