I’ve been honing my political antennae. I may be sticking my neck out a bit here, but perhaps now is a good time to start asking what the Tories would do to the health service.
We’re officially allowed to call them Tories now, by the way. Andrew Lansley’s press officer even refers to himself as such. They are out and proud and coming to a second - no first - no second - constituency home near you.
So what will they do with the NHS? I snatched 10 minutes with Mr Lansley after his speech to the Royal Society of Arts last week.
He assured me that the Tories will mainly just be doing nice things to the NHS. No really: there will be “reform, but no reorganisation”. Stop worrying.
And although the public finances are screwed, the Tories are “committed to real terms growth in the NHS budget”. Let’s brush aside the idea that with deflation looming, cash cuts could, theoretically, be presented as real terms increases. That’s just too cynical.
Anyway, Mr Lansley intimated his desire to see real terms growth twice in our 10 minute chat; although the first time around he actually said “rising real terms consumption of healthcare”, which isn’t quite the same as rising real terms public spending.
We could get paranoid about that “consumption” if we wanted to. For starters, we might remember the Conservatives’ 2005 election manifesto which said they would give people paying for private healthcare a 50 per cent rebate, in recognition of “the tax they have paid towards the NHS” and their defacto contribution to reducing NHS waiting lists.
You could be mistaken for thinking this policy is already in effect in some NHS hospitals, as my investigation last month revealed NHS hospitals are undercharging private patients by up to 70 per cent. No great conspiracy; they just haven’t been working out their costs adequately.
Of course, the Tories have said they have turned their back on the “passport” policy and fully support a tax-funded NHS (although a version of the policy was raised in an amendment to the current health bill by the cross bench hereditary peer Lord Palmer earlier this year). So we should ignore comments from the likes of Daniel Hannan, their current MEP for the South East who is their first candidate for re-election this week.
Mr Hannan is one of those trendy young Tory politicians who knows the value of media engagement and YouTube.
Speaking on US TV earlier this year, he unleashed a prolonged rant against the NHS, calling it a 60 year “mistake” which “began with the best of intentions… because people thought it was wrong for those who weren’t well off and couldn’t afford the best healthcare to be treated differently and everyone thought, well, it’s a nice togetherness solidarity thing if we all take part in this experiment.” (He subsequently appears to have posted the episode on YouTube, so you can view it all here: - it’s five minutes and 20 seconds into the video.)
With a position like that, you might want to be thankful Mr Hannan’s main sphere of influence up to now has been EU fishing policy.
But the other great Tory fear – as in what people fear from them - is they will introduce some kind of blame-based criteria for rationing NHS care.
Under that, the “undeserving sick” - fatties and faggers and those with a penchant for dangerous sports - wouldn’t qualify for free NHS care. Bizarre, prejudicial and probably unworkable, you may think. But it’s the sort of policy proposal you can still find fervently discussed amid the Tory “grassroots”.
Tim Montgomerie, former chief of staff to Iain Duncan Smith when he was Conservative leader and now editor of the Conservativehome blog which proclaims itself as “representing the grassroots”, has recently argued just such a policy is needed if Britain is to tackle the growth of “lifestyle illnesses”.
So in the context of a real need for an imminent public spending squeeze – and Mr Lansley telling us he cannot even guarantee next year’s NHS allocations are safe - it’s hard not to wonder if these ideas have spread further up the Tory food chain, especially when Mr Lansley’s RSA speech last week made significant play of the importance of individual responsibility, which he said went “to the core of all the changes we will seek to make”.
He said a Conservative government would seek to build the NHS to deliver world class healthcare. “But if we are going to [do that] we all need to do our bit,” he added, continuing:
“All of us need to face up to what’s behind so much of the demand on the NHS, and start to take responsibility for improving such things as our diet, activity levels and alcohol use.”
Of course, it’s just motherhood and apple pie stuff without the background noise from the grassroots, senior MEPs, official advisers and, er, their last election manifesto. But if the prospects of a Tory government are beginning to scare you, just remember: they are much more scared of you - dear back-office NHS bureaucrat - than you are of them.
Oh, by the way, some helpful soul I will forever be grateful to told a recent HSJ focus group the names given to our in-house bloggers were “embarrassing”. Tell me about it. Our web editor imposed this one on me after deciding I had been too slothful in coming forward with my own suggestion.
Thanks to Wikipedia I know it’s not just embarrassing, but a God damn hostage to fortune, so I am more than happy to belatedly join the focus group generation and ditch it.
Suggestions as to a replacement are welcome, I think.