Michael White: we're entitled to be sceptical of Labour's plans

Labour is ahead in most opinion polls, though not far enough to feel comfortable about the 2015 election (says me). The party is always far more trusted on the beleaguered NHS by voters than its coalition rivals, at least in England. In SNP Scotland, Labour Wales and coalition Northern Ireland, healthcare is taking its own distinctive path to joy and grief.

‘Burnham offered a Labour remedy from the world of “now you see it” funny money of Whitehall macro numbers’

So what are Labour politicians saying about their plans for the service as George Osborne squares up (“I’m afraid this will hurt you more than it hurts me”) for his latest spending squeeze? And what has what the shadow chancellor said this week revealed about Labour’s version of austerity after that elusive victory in 2015?

Diane Abbott, shadow public health minister, recently attracted rare headlines in the mainstream media for her thoughtful speech about the “crisis in masculinity” for many young British men without skills or prospects, much of which I would endorse, though it’s not our theme here. Suffice to say the nihilistic murder of Drummer Lee Rigby in Woolwich and the brutal murder of a young woman in North Wales underline Ms Abbott’s concerns.

Andy Burnham, who occupied Jeremy Hunt’s NHS hot seat until 2010, chipped in with a now familiar (“coalition’s toxic medicines”) diagnosis of the A&E crisis: it was 98 per cent fine when I left it, he said, but the first quarter of this year saw a nine-year high. He offered a Labour remedy from the world of “now you see it” funny money of Whitehall macro numbers, the promise to use £1.2bn of the £2bn health “underspend” Mr Osborne sort of took back to help balance the Treasury books.

Reordering priorities

Handy Andy’s bundle would be used to help older people, frail and ill, be cared for in the community, both more cheaply and safely. In other words, to offset the impact of cuts on local authority care budgets, cuts that push patients into A&E. It could provide an extra 70 million hours of home care − for 65,000 more oldsters − over the next two years, he calculates.

‘Burnham assures me that his £1.2bn care pledge has been signed off by both Eds’

That makes humane sense − it’s what families usually want − and squares with the “whole person care” speech, which his shadow care colleague, Liz Kendall, made to the Fabian Society last month. But how does it fit with Ed Balls’ bid to sound realistic about the finances he might inherit in 2015?

Naturally, Balls ignores the latest signs of economic recovery in his proposal that a Miliband-led regime would not increase total government spending, but reorder priorities to growth‑and-job generating capital projects like roads and housing?

More for less

We understand what he means (“Look after jobs and the deficit will take care of itself,” said the great economist John Maynard Keynes), but are entitled to be sceptical while the debt burden of his old boss, Gordon Brown’s PFI-funded hospitals, remains so onerous. Perhaps that uneasy memory helps drive Mr Balls’ effort to sound like an iron chancellor, imposing zero-sum budgeting on colleagues and − the bit that got the headlines − hinting he will end some universal benefits for the better off.

Fair enough, but winter fuel payments are trivial compared with care costs. Mr Burnham assures me that his £1.2bn care pledge has been signed off by both Eds and “squares perfectly” with integrated, home-based services for the elderly.

It’s the kind of change Liz Kendall was explaining to the Fabians as Labour’s “care covenant”: a single annual budget like the personal budgets which Labour pioneered in office for those with chronic conditions, strokes or diabetes. Torbay, Greenwich and Lambeth are among those on this road, she says.

This is all part of Labour’s rethink of sustainable public services to “get more in an era of less”, explains her boss.

Michael White writes about politics for The Guardian