Michael White on YouTube politics

I don't know whether Patricia Hewitt read the Sunday papers over the Easter weekend. But one of them claimed the health secretary had proved an unexpected hit on Labour's new platform on YouTube, the video-sharing website.

Apparently the clip in which she extols the achievements of the NHS is proving popular. Whether or not this is good or bad news in the topsy-turvy world of internet politics may not be clear until the local election results are counted on 3-4 May.

But politicians have to be optimists by temperament or conviction, so Ms Hewitt must take comfort. In the choppy weeks ahead she may need it. The last opinion poll I read, in The Observer, recorded 27 per cent of voters calling the government's record on the NHS 'poor' - and 32 per cent writing it off as 'very poor'.

Only 19 per cent thought their local service had improved against 52 per cent who thought it had deteriorated. These results, like many pollsters' findings, are rubbish. They are doubtless accurate in that people did say it all, but most of them must have been people in a hurry who haven't had something nasty go wrong with them lately.

But that's not the point, is it? If voters think these harsh things they are likely to vote against the party they blame. We caught a flavour of this in the Budget debate when Labour MP for Blaydon David Anderson set out to answer the NHS's 'where's all the money gone?' question and rattled off a wholesome list of improved services and extra staff since 2002.

His only complaint was that the biggest increase was in managers and senior managers up from 29,000 to 55,000. 'What are they doing?' Mr Anderson wondered.

To which the answer is surely 'trying to get a bigger bang out of the NHS buck' the key question as the Brown administration squeezes public spending.

That it will do so was common ground between the two speakers on either side of Mr Anderson - Lib Dem Dr Vince Cable and our old chum, Ken Clarke, both very clever. Dr Vince said spending had moved from 'famine to feast to diet' since 1997. Mr Clarke wished Alistair Darling, his tip for Number 11, good luck. He said he looks forward to 'a little less spin'.

That is the measure of Ms Hewitt's challenge when she uses Labour's campaign 'NHS week', starting 13 April, to try and sell the positive case for what the government has done, now that the unglamorous task of restoring financial discipline is ending.

In this she may be helped by the decision that 28 errant trusts will no longer be caught by the 'double whammy' of resource accounting and budgeting rules. It is also now clear that the modest 2006-07 surplus can be used by strategic health authorities to start repaying top-sliced funds to PCTs earlier and more generously than first thought.

It may - may- embolden Labour MPs to emulate Mr Anderson despite the latest assault on Tony Blair's 'tragic' NHS record at the Royal College of Nursing's annual conference this week, by new general secretary Peter Carter.

Labour has a long uphill struggle to regain the initiative against a revived Tory party, the more so because many opinion-formers, like the Confederation of British Industry or the Murdoch press, which like to be on the winning side, sense it is no longer Labour.

One even more pressing challenge will be the much-delayed and changed Mental Health Bill, due to face its Commons second reading after MPs return on Monday. Ms Hewitt will use the debate to mix conciliation towards some Lords amendments with a determination to reverse most of the peers' changes.

The national suicide strategy, out this week, is part of the process of educating a wary public of the need to impose community treatment orders on vulnerable people, for their own as well as the public good.

Some 50 of 200 patient suicides a year are among people who should have been taking their medicine, so are 50 murders, more than those killed by guns which currently so alarm us.

Ministers have also been emboldened by the insistence of mental health czar Professor Louis Appleby that clinical practice should never be defined, let alone constricted, by law, for mental health or anything else.