Last week brought back memories of the 1997 Tony Blair highly effective pre-election pledge card as Labour made a raft of policy announcements in health. Back then the focus was on reducing waiting lists for hospital treatment – 15 years later the party offer guarantees for GP consultations and the end of 15 minute care visits for the elderly.
Could both these be auditioning for an appearance on a 2015 pledge card? Both fit the mould of being tightly focused consumer-led healthcare policies that focus on timely universal access to services. Miliband has some previous at trying to reprise the technique with an unfocused effort in 2012 as he sought to define the squeezed middle.
What these new pledges indicate is that politicians continue to thirst for simple, totemic health promises which take one aspect of healthcare delivery as a proxy for demonstrating improved standards across the piece. Reduced waiting times were a fine idea – but were controversial in practice, some feeling the NHS with limited resources created a lot of damage to care for the critically ill trying to hit a mean average. Likewise, will offering guaranteed GP appointments for the largely well and young take resources away from the critically sick?
The Conservatives meanwhile wish for health to be a non-issue at the next Election and are talking in generalities rather than specifics. These new Labour pledges are designed to place the government under pressure by inviting voters to reflect on key aspects of how they experience the NHS now. It puts them on the defensive as funding restraints have created creeping erosion of services and offer little room for manoeuvre. To counter, Jeremy Hunt’s well established focus on placing himself alongside patients and inviting NHS staff to be personally accountable for dignity of care will remain the likely narrative over the coming months. Aiming to remind the electorate that the major publicised failings on this front happened on Labour’s watch, at least in part due an over-emphasis on narrow targets.
Measurement and evaluation