Amid the row about the reorganisation of the NHS – on which many coalition MPs have cold feet – it’s easy to forget one simple fact.
The Tories are committed to ring-fencing health; which means even more brutal decisions elsewhere in government. This was a difficult choice (some would say brave) to make in the spending review.
Labour, by contrast, said last summer they would not ring-fence the health service in quite the same way. In fact former health secretary Andy Burnham made a compelling case nearly a year ago as to why it would be a mistake.Burnham admitted it was “counter-intuitive for a health spokesman to be advocating less spending on the NHS.”
Since then – with John Healey as shadow health secretary – we haven’t heard much on what Labour’s policy would now be on this. Unsurprisingly.
Conveniently, as Ed Balls argued on Monday, Labour isn’t writing a shadow Budget and therefore doesn’t need to set out its policies in detail department by department. (I’m told it could be several years before we get a full policy manifesto from Miliband’s party).
In the meantime, however, shouldn’t we presume that Labour would be the party of NHS cuts – in the billions of pounds – if they were in government today? Burnham had promised to maintain spending on “frontline” health rather than the entire service.
UPDATE: Apparently not*.
David Cameron made a glancing reference to this in PMQs today, saying that: “All that has changed is that they are just jumping on every bandwagon, supporting every union, blocking every reform and opposing the extra money being put into the NHS.”
It’s not obvious why he didn’t make more of the ring-fence point; maybe he will next time. Cameron fought for years to win back public trust of the Tories over the health service and ring-fencing its budget was a costly move by the coalition.
The fact is, however, that this core argument is being overshadowed by the row over a reorganisation of the health service which seems to have few friends inside and outside the government.
Some in the coalition still hope that the shift from PCTs to GP-led consortiums can be fudged – perhaps by keeping PCTs, giving them a different name and giving GPs more sway over them. Whether it’s too late for a partial U-turn of this kind is not my area of expertise.
UPDATE at 5.13pm: A debate is going on in the Commons right now over health reform. I’ll update later if any coalition MPs express misgivings.
* FURTHER UPDATE: A Labour aide points out that Alan Johnson said – on the day of the CSR – that the party would ringfence the NHS after all. That major U-turn did not get much publicity on such a big news day. It does make it harder for David Cameron to attack Labour on this; but is it good for the opposition party’s fiscal credibility?
Jim Pickard
Kiran Stacey