Labour's search for a fourth term: the Health Mandate perspective

Posted by Martha Burgess at Mon, 12/04/2010 - 3:08pm in Health Mandate commentary, Political commentary

Labour's election manifesto, published today, is pinning its hopes on patient entitlements and a return to the Blairite agenda

Manifestos announced by any party in the modern era tend not to make big new announcements. Equally, ‘events' can derail the clearly-laid plans set out in them - no mention was made of the nationalisation of the banks in Labour's 2005 manifesto, for example.

But what they do is give us an indication of the direction of travel the policies of a party elected to government may take.

Given this, what can today's manifesto tell us about a possible fourth-term Labour government? This is always hard for a party that has been in office for so long. Speaking from a hospital in Birmingham (and, in a change from tradition in manifesto announcements, surrounded by cheering Labour members), Gordon Brown was obviously eager to demonstrate the changes that have been made to the NHS in the last 13 years - but this had to be tempered by the risks that any new announcements would be framed by the cries of, ‘why haven't you done this in the last 13 years?'.

The manifesto today has a focus on ‘personal' and ‘accountable' services - a focus designed to show how a Labour Government would continue to progress along the path it has trodden for 13 years - with schools, police and hospitals the headline areas for reform. And, with a self-imposed restriction on new spending commitments, the focus has been on spreading excellence in the public services: in the NHS, delivering services closer to the patient; delivering dedicated nursing for cancer patients; and allowing high performing hospitals to take over those that are struggling (whether high performing hospitals would want to run this risk remains to be seen - many failing hospitals have issues which go far beyond poor management).

These announcements were pre-briefed this morning as a return to the ‘Blairite' agenda - and the announcement itself was peppered with references to ‘New Labour'. Could it be that, though the polls are tight, Labour believes that it is vulnerable with the ‘Blairite Tories' in the electorate and wants to shore up this vote? Certainly, the manifesto pledge to "support an active role for the independent sector working alongside the NHS in the provision of care" is straight out of the Blairite textbook - and could it even be seen as a change from Andy Burnham's recent statement that the NHS is the ‘preferred provider'?

Entitlements and rights also take a central place in the manifesto - with a pledge to guarantee in law the right to cancer test results within a week of referral, maximum 18 weeks' wait for treatments and the right to choose a GP that is open at evenings and weekends. This is explicitly designed to draw a key dividing line with the Conservatives, who have pledged to remove such ‘process targets'.

Other announcements of note include no ‘top-down' changes to PCTs and SHAs, a refocus of capital investment on primary and community services, and plans to create at least one million skilled jobs by 2015, coming from industries including the life sciences. Although constituting only five of the 76 pages in the manifesto, health has been central to today's announcement. If one is to take any message from the manifesto on health then (and the following is certainly what Labour's pre-briefing would want us to believe) it is that Labour has rediscovered the Blairite zeal for public services reform. Whether ‘events' allow them to do so is yet to be seen.

Tagged with: NHS, Labour Party