Election 2015: Last chance for Ed to show his NHS credentials

The reason why Labour strategists want to make the NHS the centrepiece of their election campaign is obvious. The party retains its historic lead in the polls on the NHS, an issue always near the top of voters’ priorities and one whose salience tends to peak near elections.

Yet the NHS is not a straightforward win for Labour.

Incisive Health’s polling shows that as many people say they trust no party on the NHS as say they trust Labour. Most worryingly for Ed Miliband, the public’s trust in him personally to manage the NHS lags some way behind trust in his party.

• HSJ Live: Coverage and reaction to Ed Miliband’s conference speech

Getting personal

Indeed, among the respondents trust in Miliband is lower than trust in David Cameron. This is worrying for party strategists. Labour may be leading in the polls, but the margin is nowhere near as wide as they would like.

‘Ed does not yet look prime ministerial. Trust, even on core issues, remains a weakness’

Events in Scotland show that Labour – and its leader – continues to struggle to convince people even in its heartland. Ed does not yet look prime ministerial. Trust, even on core issues, remains a weakness.

Labour’s conference next week provides a platform to demonstrate his commitment to the NHS and the personal priority he would place on improving it.

Leading the charge

If he does this correctly, he can use the issue to shore up wider public trust in him as a leader. If Labour is to put health at the heart of the election battle, then Ed will need to lead the charge.

The task is pressing and it is not one that can be devolved to his health team in the way that other policies have. Nor is it a mission that can be accomplished simply by railing at the Conservatives.

‘He needs to set out in personal terms what he would change and how it would benefit the public’

Instead he needs to set out in personal terms what he would change and how it would benefit the public; abstract discussions about privatisation alone will not cut it; those who are opposed to the Health and Social Care Act are (by and large) in Labour’s camp already. He must not confuse applause lines in the conference hall with cut through in the country.

Postcodes, not predistribution

Now is not the time for wonk speak. Announcements need to mean something to ordinary people. Think postcode lotteries, not predistribution.

‘Now is not the time for wonk speak. Announcements need to mean something to ordinary people’

For a party that has been focused on health systems and processes, this will be a shift from Labour’s recent comfort zone.

Funding for the NHS will be a dominant theme on the fringe. On this, Ed will be receiving two strong but opposing sets of advice. Both sides of the argument already appear to be making their case through the media – hardly a helpful sign of party discipline.

Conference call

Although it may have lost the element of surprise that is so critical to successful party conference announcements, promising a tax rise would demonstrate his personal commitment to the NHS in a manner that few other policies could match; if you are going to fight a bruising battle on tax, then you may as well fight it on your territory.

‘Promising a tax rise would demonstrate his personal commitment to the NHS in a manner that few other policies could match’

Yet conventional wisdom – seared into Labour’s psyche since 1992 – says that the party never wins elections by talking about tax rises.

The advice he takes on tax will of course go a long way to defining the battle lines for the next election.

However, this dilemma cannot be used as an excuse for Miliband to delay setting out his stall on health. Labour’s week in Manchester provides perhaps his last opportunity to do just that.

Mike Birtwistle is a founding partner at Incisive Health.