Don’t let the party tear itself apart by in-fighting on Europe and neutralise the NHS: two lessons Cameron and Osborne took from the long years of post-1997 wilderness.
The first is now very publicly on life support. The second isn’t as bad, but it is getting a stern warning from its GP with news today that public dissatisfaction with the NHS is at a 10-year high. The diagnosis is far from terminal, but it is a wake-up call.
Today’s British Social Attitudes data, collected by the National Centre for Social Research and analysed by the Kings Fund and Nuffield Trust, shows that public satisfaction has fallen 6% in the last year. Dissatisfaction is the highest since 2007 and near double what it was in 2014.
The top reasons given by the public are that it takes too long to get an appointment, there’s not enough staff and funding and the impact of ‘government reforms’. Satisfaction with GP services is at its lowest since the survey began in 1983.
It is easy now to forget how hard Cameron and Osborne tried to neutralise the perception that their party could not be trusted with the NHS. In the coalition years the NHS was spared the worst of austerity, despite this entailing deeper cuts for nearly everything else. There was the infamous promise of no more ‘pointless reorganisations’.
Cameron was so committed to changing his party’s image on the issue that rather than shy away from it, his 2010 election campaign was launched with the statement that he now led 'the party of the NHS'. By contrast, Labour got so good at attacking the Conservatives on the NHS that they’ve been dialing it in for years; 2017’s day before polling slogan that there's ’24 hours to save the NHS’ was a carbon copy of nearly every Labour polling eve leaflet since 1997.
But by 2010 those Labour attacks were losing their force in the face of Cameron’s new tack. The strategy worked; NHS satisfaction was largely stable for much of the coalition years despite an initial dip in 2010.
Perhaps because of this, the NHS slowly dropped down the list of issues the public thought were important to the country and some polls even had more people trusting the Tories than Labour to run the service.
The data today shows those days are now gone. The NHS has shot back to the very top of the issues we most care about, the Conservatives lag well behind Labour on the issue and crucially public satisfaction is falling.
However, this isn’t yet terminal. Satisfaction is down but it’s still higher than it was in 2007. The data also points to two areas that might help turn things around. Firstly, the starkest drop in satisfaction is in GP services; the part of the NHS people engage with most. Arresting that decline, especially when the government was so prominently involved in GP-associated reforms, much be part of improving the overall picture.
Secondly, people do recognise that the NHS needs more money and indications from the BSA show they might just be prepared to pay for it. Last year the proportion of people who want to see more tax and spend overtook those who want to keep things the same for the first time in a decade.
Now, wanting more tax in principle and being happy to actually cough up are two very different things. But it does show that the tide is turning, and with Labour promising significant investment in the NHS, it might be one the Conservatives cannot afford to resist.