In many ways John Healey has the easiest job out of all the health frontbenchers this party conference season. His party are fairly united in their opposition to NHS reform and he is most able to tell activists what they want to hear. However, if I was advising the Shadow Secretary of State for Health, I would suggest that he avoids this easy option.
There may be plaudits to be won in Liverpool, but no elections are at stake. Instead – nearly a year into his tenure as Shadow Health Secretary – John Healey needs to begin the process of framing the health debate for the coming year and beyond.
Outright opposition to the reforms might win applause now, but it won’t create the credible health policy which will be needed to win elections later. In terms of health reform, the genie is out of the bottle. For better or for worse, Andrew Lansley has unleashed some irreversible changes. Whatever happens to the Health and Social Care Bill, many of the changes have already occurred or are occurring. Labour will have to respond to the world as it is and not the world as they would like it to be.
So a job for this autumn is to lay claim to parts of the reforms, demonstrate commitment to implementing them and challenge the Coalition to go further. I suggest – as a starter – the focus on information transparency, clinically-led commissioning and earlier diagnosis. By demonstrating their commitments to these concepts (all of which Labour can claim to have initiated at various points in the last decade), John Healey can become a champion of their implementation. Every time the Government fails to release data, Labour can argue that it has gone soft on the Information Revolution. Every time clinical commissioning groups complain about the dead hand of the NHS Commissioning Board, Labour can argue they are on the side of giving professionals greater autonomy. And every indication there is that GPs are being encouraged not to refer or investigate patients, Labour can argue that the reforms are leading to increased rationing (of course linking the issue to that of waiting times). By stating what you agree with, your opposition can be stronger. John Healey should use his time in Liverpool to prepare the Party for this.
By necessity much of 2011 has been devoted to scrutinising and opposing the Health and Social Care Bill. With the limited resources of opposition, Healey and his team have had little option but to focus on legislation. But they must now move beyond the Bill, seeking to identify and highlight the failings in delivery which will be more meaningful to the public. Beyond the issue of waiting times (now regular and increasingly comfortable fare for Ed Miliband at Prime Minister’s Questions), John Healey has made only limited progress on this. He should use the conference season to place the spotlight on the difficult decisions being taken up and down the country to limit access to some services and treatments, setting the tone for what could be a testing autumn for the NHS.
One area in which some Labour Party members have been less comfortable with John Healey’s approach is in the lack of policy detail he has set out. Given that many members either work in nor around the NHS, this lack of detail does not sit comfortably (it should be pointed out that there is, at present, a wider lack of new thinking on health in Labour circles: for example the new ideas on the NHS are conspicuous by their absence in the recently published Purple Book).
Healey can resist calls for a comprehensive health policy at this stage – there will be plenty of time for that – but he does need to start sketching out his broad approach to health and how he will approach the post-reform NHS environment. How would the NHS be different from life under the Coalition? Indeed, how would it be different from life under the previous Labour Government? He can do this by setting out some symbolic policies which begin to bring to life the direction of ideological travel, doing so without creating the hostages to fortune which all opposition’s fear. He should resist the temptation to make commitments now – such as limiting the scope for private sector involvement (a conference applause line if ever there was one) – which, although popular with members now, could store up problems closer to the election.
This conference season will not be the most testing for John Healey, but it is nonetheless important. Labour must use the mid-term to lay the foundations for what will be a critical battleground as the next election approaches.