Tories struggle to make their own room in the centre ground

Their latest health policy document certainly has a winning title: The Patient Will See You Now, Doctor neatly encapsulating the Conservatives' promise of a more patient-centred NHS.

It replaces the government's emphasis on targets with the language of minimum standards and entitlements, but their latest pronouncements demonstrate the difficulty of carving out distinctive policy space for themselves in the centre ground.

Much of what they promise - better out-of-hours primary care, allowing us to register with a GP near work, providing more dignity and choice in end-of-life care, giving clinical priorities primacy over top-down political interference - is all but indistinguishable to the general public from the policies now being pursued by Labour.

The Conservatives are also fighting the government over patient safety, with shadow health secretary Andrew Lansley trumping prime minister Gordon Brown's 'deep clean' with a 'search and destroy strategy' to tackle hospital-acquired infection.

Bearing in mind that transmission by people is one of the more intractable infection issues, one shudders to think what search and destroy might imply.

But for all his policy difficulties, Mr Lansley should not be underestimated. He has succeeded in burying any vestiges of the belief widely held by Labour voters in the 1980s that the Conservatives want to 'destroy' the NHS.

He has demonstrated a sure touch in developing the party's health strategy, winning respect among prominent figures in the health world for his grasp of the issues and his willingness to listen and engage.

The charm offensive of the new government, by contrast, faltered badly at Labour's own conference last week, leaving several health organisations feeling snubbed and angry after ministers failed to show their faces at key meetings. These are precisely the organisations the media will be asking to adjudicate on the rival health policies if an election is called.

Both Labour and the Conservatives have put health at the heart of their offering to the voters. Labour has a fight on its hands.