This week I am going to write a series of articles on what differences there might be depending on who governs after May 7th. The main media concentrates on the spin lines from the major parties, which tend to hype differences. They follow the daily diet of mistakes, gaffes and set ups which characterise a modern media driven election. Some of these should not matter and are usually trivial and of no lasting significance. My objection to David Miliband was not that he once carried a banana, which many others have done with no harm to their reputations. My objection was his uncritical love of the EU. My objection to Gordon Brown was not his unfortunate facial expressions when waiting for an interview in a studio when tired, but the way his banking and economic policies put us into the most violent boom/bust cycle since the 1930s. These articles will ask what difference will there really be? What matters?
Labour have sought to put the NHS at the centre of this election. They mean by that health in England. This General election will make no difference to the way the NHS is run in Wales or Scotland, where it is a devolved matter under their Assembly or Parliament.
Labour claim the NHS is only safe in their hands. There are no grounds whatsoever to take this view. The management of NHS England say it will need an extra £8billion a year by the end of the next Parliament. The Conservatives and Liberal Democrats have both promised to find this. Labour has promised less, but I assume were they to be in office they would also find the money. The UK bureaucracy is usually good at extracting money for public budgets, and will doubtless make a strong case. It seems unlikely that there will be a lot of difference on total NHS England spending between the parties.
Labour say they will stop people making money in the private sector out of the NHS. They do not of course mean this in most cases. It was Labour who set up a lot of the most expensive PFI schemes when in office, encouraging the private sector to profit from providing new NHS facilities. They will not be able to get out of these. Any government will have to buy drugs and medical supplies from with profit companies. All will stick with the system that most GPs are private sector contractors to the NHS. The NHS has always been a mixed economy system, a partnership between leading pharmaceutical and medical supply companies, doctors under contract, and directly owned hospitals with state employed staff. No main party is proposing any change to this pattern.
Labour dictates the terms of the debate on health. This debate prevents discussion of reform or change. This has been a very conservative election on health, with all main parties competing to keep it as it is, with more money.
Conservatives have promised to recruit more GPs to offer longer opening hours and week-end service. This would help relieve pressure on A and E if more people could get an appointment with their GP to deal with the things that do not need hospital treatment. That would be a practical change to offer a better service to patients, and to save money at A and E departments. I conclude there would be little difference to the NHS whoever wins, but Conservatives do have an attractive policy of improving access to GP services which I think could be a beneficial change. It has also taken a Conservative Secretary of State in the coalition government to expose the problems in some hospitals properly that had occurred under Labour, and to get improvements.