Tory blueprint is light on detail as Lansley prepares for power

Indeed, large slabs of text from platform set-pieces and fringe meeting debates could be seamlessly transplanted between Labour and Conservative front bench teams without anyone spotting the join.

New Labour can justifiably argue it has set the terms for the current phase of policy development. Both parties see competition and choice as the drivers for better patient experiences, safer care and improved outcomes.

In an otherwise routine canter through his party's blueprint for the NHS, health secretary in waiting Andrew Lansley unveiled the first Tory target. In his speech to this week's Conservative Party conference spelling out their opposition to targets, he announced a massive expansion of single rooms for inpatients.

Standard priority

Talking to HSJ afterwards, he claimed this was a standard, not a target, and he stressed his "standard" would help clinical priorities such as infection control, rather than distort clinical judgement through process targets.

But call them what you will, it demonstrates that both the main parties will set politically determined priorities for the NHS.

This particular target will be bitter medicine for Labour, which has failed miserably to deliver on its promises to eradicate mixed sex accommodation. It also draws political blood by focusing on poor maternity facilities and the failure, highlighted by HSJ, to ensure the sexual safety of mental health inpatients.

Elsewhere in his conference address Mr Lansley emphasised that the NHS under the Conservatives must not move towards inequality of access. His most important achievement as shadow health secretary has been to largely neutralise the attack that the NHS is only safe in Labour hands. However, the fact that he chose to drive the equality point home shows the debate on the right about alternatives to universal provision still has potency. The fierce arguments over top-ups open up exactly that front.

No details

Two key areas of Conservative policy lack detail. The first is the independent board. The word "independent" should not be taken too seriously. It will in practice be appointed by ministers, and HSJ understands leader David Cameron is already discussing possible positions on it with at least two business figures. The politically appointed board will then work to parameters set by the government.

The second is how the Tory cry of "all power to the GPs" will drive choice and quality. No explanation has been proffered as to what this really means.

The Conservatives need to address one further weakness in their programme. They need to move away from populist misrepresentation of the role of managers and offer a meaningful blueprint for how they want the service to actually be run.

Populist broadside

Despite his generally moderate tone Mr Lansley still deploys the occasional Daily Express style broadside against "the army of administrators" without any explanation of how this should be interpreted. At this week's conference similar sentiments were evident from the front bench health team and party members.

This betrays a lack of coherence in Conservative thinking. If they weaken management while stripping out the 18-week treatment and four-hour accident and emergency targets and handing power to GPs, the painfully, expensively won ground of the last 11 years of all but abolishing waiting lists and the indignity and distress of endless hours in A&E will be lost. These matter to patients.

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