Clegg will have to say something bold to win votes on the NHS

The Liberal Democrats are back in Scotland tomorrow for the final UK party conference before voters hit the ballot boxes in May next year.

‘The private members’ bill debate will expose divisions in the Lib Dems, with some privately vowing to vote with the opposition’

Of all of the planned conference debates, there is one on Sunday likely to prove the most contentious for the Lib Dems. Policy paper 119, or Protecting Public Services and Making them Work for You, has caused some controversial amendments to be tabled. Pressed for by a faction of the party who want to undo the Health and Social Care Act 2012 and end the purchaser-provider split, the ensuing discussion over the amendments will pick over a scab the party leadership would rather leave well alone.

While this debate will expose the Lib Dems’ scars, by contrast Ed Miliband’s NHS rhetoric united his party faithful in applause. At Labour’s conference Miliband’s most audience friendly pledge was one shadow health secretary Andy Burnham has made many times before, but that Miliband was reticent to include in his speech last year – a promise to repeal the Health and Social Care Act 2012.

Regardless of your views on the health reforms, there is growing disquiet that Labour’s promise has the potential to cause the very chaos and upheaval that those in the NHS wish to forget.

Compromise politics

Neither the Lib Dems nor the Conservatives want to challenge Labour on this because it would force them into a public debate. But Labour’s private members’ bill on repealing the competition elements of the Health Act will be debated in Parliament next month.

‘People in the NHS want politicians to publicly recognise the scale of the funding challenge’

The private members’ bill debate will expose divisions in the Lib Dems, with some already privately vowing to vote with the opposition – their ears bashed by constituents while out campaigning. The Conservatives will be happy to stand back and watch Labour and the Lib Dems tear each other apart. After all, while health secretary Jeremy Hunt’s speech was light on new policy announcements, but heavily imbued with a sense that he is determined to win the communications battle on the NHS.

Yet much of the political sparring over the NHS in recent months has been Burnham accusing the Tories of talking down the NHS. Hunt’s response has been to accuse Labour of brushing aside poor care, leaving the Tories to step in and solve these problems over the past four years. So the fight to lay claim on Superman’s “NHS cape” will inevitably rumble on between Burnham and Hunt.

It is doubtful Nick Clegg can snatch that cape away from them unless he makes a bold announcement. There are plans to commit the party to around £1bn further real terms investment for the NHS, followed by more money once the deficit has been removed.

Paying for this is likely to come from measures targeted towards additional rate taxpayers. This compromise between the Tories’ message on the need for a stronger economy to shore up the NHS and Labour’s recognition of extra cash flow is clever politics, but I’m doubtful it will pass muster in health policy circles.

Clegg’s clarion call

Next Tuesday another Lib Dem conference motion will propose an NHS “care footprint” to make patients more aware of the cost of their care, a minister for ageing, as well as free end of life social care and extra paid leave for carers. While the Lib Dems don’t want to mandate how to integrate care, the party looks set to push for a consultation on a legal duty to pool local health and social care budgets.

‘Clegg will want to play to the crowd by sticking the knife into the Tories, but leave the door open for any potential negotiations in May’

As with all party conferences, what grassroots members want to hear might not always be what the party leadership wants to say. It is always a delicate balancing act of semantics and oratory.

Similarly, people in the NHS want politicians to publicly recognise the scale of the funding challenge, while addressing social care head on. Neither Cameron nor Miliband have succeeded in doing this so far and the jury is out on Clegg.

When the deputy prime minister faces the crowd on Wednesday afternoon he will issue a clarion call to all those wavering Lib Dems. He’ll want to play to the crowd by sticking the knife into the Tories, but leave the door open for any potential negotiations in May. If he can do this while taking the NHS with him it will be all the more impressive.

Jenny Ousbey is an associate director at Lexington Communications and was a political adviser to former Liberal Democrat health minister Paul Burstow