The Tories are asking good questions about health; Labour should have positive answers

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After a lacklustre opening to their campaign for the still-unannounced election, the Tories suddenly have the wind in their sails. Thanks to "the battle of Margaret's shoulder", they have bounced health policy to the top of the agenda and forced the Government on to the defensive in an area - the NHS - it had long assumed was its own. The mini-manifesto rushed out yesterday by the Prime Minister and his Health Secretary was its emergency response.

After a lacklustre opening to their campaign for the still-unannounced election, the Tories suddenly have the wind in their sails. Thanks to "the battle of Margaret's shoulder", they have bounced health policy to the top of the agenda and forced the Government on to the defensive in an area - the NHS - it had long assumed was its own. The mini-manifesto rushed out yesterday by the Prime Minister and his Health Secretary was its emergency response.

And, like so many emergency responses, with or without waiting time on trolleys in corridors, it was a preliminary, short-term effort that may have staved off a crisis but did not tackle the real cause of the trouble. The fact is that, having done its best to co-opt many of the Opposition's traditional strengths - stewardship of the economy, law and order - it finds itself vulnerable on subjects where it seems not to have anticipated a challenge - prime Labour territory such as education and health.

Iain Duncan Smith in his time sensed as much, but chose his examples poorly and was unable to follow through. With Margaret Dixon's oft-postponed shoulder operations, the high incidence of MRSA, thrombosis and other illnesses brought on by hospital conditions- not to speak of the statistical manipulation spawned by the Government's obsession with targets, Michael Howard has much ammunition for his attack.

True, personalised examples are luxuries more available to the opposition than the government of the day. There may be thousands of people who have had successful shoulder operations which were not postponed, and hundreds of thousands of others who did not contract post-operative infections. But it will always be the individuals with less satisfactory experiences who capture the headlines. And it is disingenuous of ministers to complain, as John Reid did yesterday, about the Tories' use of "human shields" to make their point. This was a ploy as often used by Labour when it was in opposition. Stealing presentational techniques, as with policies, goes both ways.

In one respect, personal experiences are what election campaigns are all about. Derived from anecdote it may be, but the feeling is widespread that the Government has little to show for all the extra money it says it has pumped into the NHS. Waiting-lists may be shorter, but few trust the figures and many suspect targets have been met only by displacing the wait elsewhere. This is why Mr Blair stressed the 18-week wait, from GP's surgery to operating theatre, that would be Labour's next big health target.

The risk is, however, that select examples simply give rise to slanging matches, diverting attention from the bigger arguments that need to be had and that elections are also about. In office for eight years - a US President would be facing the end of his mandate - and with the benefit of a huge parliamentary majority for all of that time, Mr Blair has disappointed. The lack of visible improvement in the health service is at least partly to blame.

The good thing that has happened over the past week is that Mr Howard and his shadow ministers are belatedly starting to do the job of an opposition - probing the Government on its record and searching out the vulnerable spots. The inability of successive Tory leaders to wound Mr Blair in the Commons have all too often given the Government a free pass when it needed to be called to account. Now, Labour's loud worries about a Tory victory may not only be a tactic to scare their supporters into voting; they may also be real.

But the Tories' new confidence has also exposed a highly negative aspect of the Government's early campaigning. On issue after issue, it has combined statistical recitation - which now carries little credibility - with defensiveness. Where is the big picture, the vision, the enthusiasm - on Europe, on the economy, on modernising the public services - that brought Labour its landslide in 1997? If the Opposition has finally learnt how to attack, the Government needs to relearn the art of the positive campaign - and fast.

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