The Conservatives: an apology. Members of Her Majesty's Opposition have taken me to task for misrepresenting the party and its important policy work. They have a point. I may have given the impression that Michael Howard had at least turned Conservative Central Office into a professional, competent organisation. I now accept that this was mistaken.
Last week, Howard asked the Prime Minister a devastating question in the House of Commons. Why, he asked, should one of his constituents "wait 20 months to get radiotherapy treatment for her breast cancer"?
On the day before John Reid, the Secretary of State for Health, was to launch the five-year - sorry, the NHS Improvement - Plan, this was a devastating case. Reid was to announce a target for the maximum wait for all NHS operations of a mere four months - and this on a new, more honest, definition of waiting time that runs from the moment of the first GP consultation.
Tony Blair did what he could. He could not be expected to know the details of the case of the Right Honourable and Learned Gentleman's constituent, he said, but he did know that, overall, breast cancer treatment had improved over the past seven years. Within hours, Howard's attack had collapsed. Central Office had failed to make the elementary check that journalists now made, by ringing the Maidstone and Tunbridge Wells NHS Trust, which covers the Tory leader's constituency. It quickly emerged that Howard's constituent had misheard; the wait was in fact 20 weeks, not 20 months.
It was an astonishing blunder - far worse than the Labour Party's failure to research thoroughly the case of Jennifer Bennett, whose Ear became a central feature of the 1992 election campaign. Far worse, too, than the Conservative Party's failure to research thoroughly the case of Rose Addis, the 94-year-old cited by Iain Duncan Smith two years ago, who, it turned out, might have refused treatment. Both those cases were at the centre of media firestorms that raged for several days. This one was barely noticed. That was partly because the Tories admitted their mistake promptly, and partly because Howard did another thing right: he did not name his constituent. There are two other important reasons, however. One is that, despite the flurry over Blair's future last month, the press does not think he will lose the next election. Conservative views on the NHS, therefore, are hardly more important than those of a think-tank. (Which is why the demotion of Tim Yeo, spokesman on the two central public services, health and education, attracted so little coverage.)
The other reason, though, is that Howard's story did not ring true. It simply did not reflect commonly held views of the state of the NHS, which have changed even in the two years since the Rose Addis case. The failure of the press to be excited about this story is telling evidence that public opinion is coming round to the idea that the health service is getting better.
However, the Maidstone and Tunbridge Wells NHS Trust went on to say that the maximum wait for "low-risk cancers" had recently fallen further. No one on its books is currently waiting more than 14 weeks. But 14 weeks is still a terribly long time to wait for cancer treatment. This is not a party political point because it is presumably an improvement after years of underinvestment. Howard's supplementary question was therefore a fair one. Why should his constituent not have the right to choose an NHS hospital that could treat her more quickly?
But both the main parties agree about the answer to that; the only question is how to organise it. And the main criticism of the Labour Government is that it has taken so long to get to this point. I say "both the main parties" because Charles Kennedy for the Liberal Democrats went for the populist soundbite last week. He asked the Prime Minister in the Commons if he agreed that "what people want are quality public services available to them locally, not a false debate about choice". This is what Philip Gould, Blair's polling adviser, calls a "nodalong". It is the kind of declaration that works well on the BBC's Question Time, because it sounds good and people think they agree with it. But they don't, if they think about it. You only have to imagine Kennedy saying: "People want their council house doors repainted regularly, they don't want a choice of colours." The question begged by Kennedy's easy rhetoric is: how do the Liberal Democrats propose to provide "quality public services"? All three parties agree that the NHS and schools need more money, but they all agree that money alone cannot guarantee better services. So the argument is all about the right balance of centrally set targets, professional autonomy and consumer choice - which, in the case of Tory policy on health, extends to subsidising people to go private, including £1.2bn for people who would go private anyway.
These are supremely technocratic questions, so it is no wonder that our supremely technocratic Prime Minister looked more comfortable last week than he has for some time. In the Commons, he set out his political strategy for the next election. "I am rather happily placed," he observed, between Howard, "who wants choice to get out of the public service", and Kennedy, "who does not want choice within the public service". In the week that the former president was back on our screens, this is Bill Clinton's old trick of triangulation. Blair has often been quite open about his tactic of positioning himself between right and left - with the Liberal Democrats serving as a useful proxy for the true views of most of the Labour Party.
Beyond Howard's disaster, however, there is more to Blair's confidence. Because the other easy criticism of "choice" in public services is that it requires spare capacity. That is indeed why the Thatcherite internal market in the NHS failed - there simply weren't any empty beds in the system. But now there are. Policy advisers in No 10 have figures showing that 98 per cent of the population is within an hour's drive of at least 100 unoccupied NHS beds. That means that over the next year before the election the pace of change, driven by choice, will accelerate. And that means it will be harder and harder for Howard to come up with telling cases of NHS incompetence. Instead, Howard has looked foolish, and given Blair another chance to exhibit his remarkable resilience.
During the fuss over Rose Addis in 2002, Blair said in an interview: "If the NHS is not basically fixed by the next election, then I am quite happy to suffer the consequences." It seemed like an extraordinarily reckless thing to say. What is even more extraordinary is that, this time next year, the NHS may indeed be visibly on the way to being "basically fixed". Then that will be a big test of my pessimistic assumption that voters tend not to reward politicians for getting things right, preferring to punish them for getting other things wrong.Reuse content