Election Healthcare Debate: Three Parties, Broad Consensus

By Isabella Sharp, Senior Associate, APCO London

The setting of Thursday’s healthcare debate, hosted by the NHS Confederation, Kings Fund, British Medical Association and the Royal College of Nursing had the air of a policy seminar rather than an X-factor audition. The wonked-up style rather suited the slightly more erudite approach to health issues generally taken by the three spokesmen. What was lacking was an obvious distinction in policy; UK political parties are nowadays crowded around the centre ground.  There was broad agreement on the key areas – keeping the public onside when making reform, instigating reform from a local level, giving professionals more control and making them more accountable to patients.  Andy Burnham claimed that it was a measure of Labour’s achievement that all three parties had arrived at a relative consensus around a goal of a well-run and sensibly funded NHS. For Andrew Lansley it was not merely a case of ‘I agree with the Lib Dems’ but ‘occasionally I agree with Labour’ too.

Instead of policy, points of argument focussed either on disagreements over detail – almost semantics over when policies had been implemented and to what extent, or on wider party flashpoints playing out in the campaign as a whole. All three men diverged frequently from the questions to make political points. Lamb accused Lansley of funding discrepancies in his office, Burnham accused both Lansley and Lamb of using emotive campaigning over hospital closures and Lamb took the default Liberal Democrat position de jour of accusing Labour and the Conservatives of arguing too much.

One example which illustrates the dichotomy between the closeness of the policy and the conflict between the parties was the thwarted alliance between the parties on the provision of social care. All three parties have acknowledged that they have broadly the same approach. But rather than focussing on policy, the participants jostled to claim credit for instigating the alliance and over Lansley’s decision  destroy it . Lansley justified his decision saying that there needed to be a clear divide to help the public decide between the parties at the election. But this objective was not achieved here.

Perhaps more interesting was the position of the four host organisations. The BMA argued against the involvement of private sector providers, claiming that the public were on their side – a position no longer shared by any of the parties and a potential flashpoint, whoever wins.  The Royal Collage of Nursing worried about job cuts for nurses. All three spokesmen were quick to reassure that nurses were key to healthcare outcomes and that efficiencies would be made in back office areas, but keeping the confidence of professional bodies may be harder when the difficult choices on reform and efficiencies are actually made.

It struck me that the parties will have more difficulty convincing some of the professional groups hosting the debate than they will each other.   The cross party agreement may help if there  is a hung parliament, although today’s debate also showed that politicians will still find points to disagree on, even where there is a broad consensus.