Michael White on the shadow health secretary

In his speech to the Conservative faithful in Blackpool on Monday, the shadow health secretary told us more about his own family background in order to refute Labour claims that the Tories don't really understand the public services.

Readers of this column knew that his father ran an NHS pathology lab at the East Ham Memorial Hospital for 30 years. Mr Lansley himself was a civil servant in Whitehall before he caught the politics bug. I certainly did not know that his eldest brother trained as teacher - past tense - nor that his middle brother has been a police officer for 30 years.

I mention this because biography matters in politics, just as personality does. In the Tory public services debate in Blackpool on Monday, Mr Lansley got the standing ovation, although his shadow colleague Michael Gove outdid him in the family stakes: his dad worked in the Aberdeen fish trade.

Either way it gave some context and authenticity to Mr Lansley's assertion that Cameron Conservatives recognise the NHS is a great asset. 'In a fragmented society it is a foundation of social solidarity. We will not, must not tolerate the inequalities in access to health which mars US healthcare.'

If we accept that Mr Lansley means it, and I do accept it, then his analysis can be seen as a contribution to debate on the NHS, not a threat.

Having chaired a session with him at the Health Hotel on Sunday (as I did with Norman Lamb at the Lib Dem conference), I was again reminded how much he knows his stuff. Mr Lansley constantly invokes hospitals he's visited, staff he's spoken to, reports he's read.

It makes for some long answers but I always learn something. No-one knows what we spend on public health, let alone on sexual health, he said, because the money is raided by primary care trusts to fund more urgent care - although the long-term costs of this are often higher.

He made the same point about National Institute for Health and Clinical Excellence assessments of drugs: the guidelines should take account of the non-medical, social costs of a decision to withhold a drug. We can also do better to match healthcare (free) with social care (means tested).

There is much in that vein on the conference fringe and much of it was reflected in his main speech. As you may have read, he wants choice and competition to drive local decision-making and greater responsiveness to patient needs by the health professions.

They need more power to take those decisions - and must be accountable for them in return. Britain is worst among peer nations for giving patients information about healthcare options, he told the audience at the Health Hotel, just as its young people seem more susceptible to (bad) peer pressure - drink, drugs, sex - than they are in an otherwise similar Netherlands.

Stroke care, cancer care (why are our outcomes still so bad when we are Europe's leading cancer research state?), the Lansley list for a shake-up is a long one and potentially expensive, as his critics will be quick to point out. You can't pay all the bills by cutting bureaucracy and red tape.

But as I type I can hear Mr Gove briefing a colleague in the press room, explaining the need to spread best practice - in schools and the NHS. There is nothing wrong in promoting activist government to do so. President Sarkozy has no problem with it - nor should British Tories.

He cites the LSE's Professor Julian le Grand, on the progressive side of the debate, to say that 'voice' favours the articulated middle class, while 'choice' is more democratic. The NHS is not an inherently left-wing project in its values, Mr Gove insists.

I doubt if Mr Lansley would disagree. Despite the battering that Labour hopes to give them if Mr Brown dares to risk an election (health secretary Alan Johnson shares my view that he should not), the Tories are in better heart in Blackpool than pre-publicity suggests.

I still cannot believe we are entering an election period because I cannot see the national (as opposed to party) interest case for one. We should know in a few days.