The NHS could become the coalition's biggest headache again

Patient care is set to worsen next year, warn NHS finance directors.

The NHS didn't receive a mention in Nick Clegg's speech yesterday, but the state of the service is likely to become one of the government's biggest headaches in 2013. The latest King's Fund survey found that 40% NHS finance directors expect patient care to "worsen over the next few years" and that two-thirds believe there is a "high" or "very high" risk that the service will not achieve efficiency savings of £20bn by 2015.

Although spending is ring-fenced, healthcare inflation is significantly higher than the general rate, so the NHS will be continually forced to do more with less, particularly if, as expected, George Osborne carves out £1.7bn from its budget in order to pay for social care reform.

The political problem for the government is that while it could have blamed the service's problems on the fiscal situation, its inept reforms (for which it had no mandate) mean that it will now take the flak. Patient satisfaction fell from 70% to 58% last year, the largest annual drop since 1983 , a trend that is likely to continue this year. The number of patients who are waiting for more than four hours in A&E, for instance, is at its highest level since 2005. And David Cameron's decision to appoint Jeremy Hunt as Health Secretary provides the media with every incentive it needs to highlight the NHS's failings.

Health Secretary Jeremy Hunt will struggle to prevent a further fall in patient satisfaction. Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

Photo: Getty
Show Hide image

Who will win the Copeland by-election?

Labour face a tricky task in holding onto the seat. 

What’s the Copeland by-election about? That’s the question that will decide who wins it.

The Conservatives want it to be about the nuclear industry, which is the seat’s biggest employer, and Jeremy Corbyn’s long history of opposition to nuclear power.

Labour want it to be about the difficulties of the NHS in Cumbria in general and the future of West Cumberland Hospital in particular.

Who’s winning? Neither party is confident of victory but both sides think it will be close. That Theresa May has visited is a sign of the confidence in Conservative headquarters that, win or lose, Labour will not increase its majority from the six-point lead it held over the Conservatives in May 2015. (It’s always more instructive to talk about vote share rather than raw numbers, in by-elections in particular.)

But her visit may have been counterproductive. Yes, she is the most popular politician in Britain according to all the polls, but in visiting she has added fuel to the fire of Labour’s message that the Conservatives are keeping an anxious eye on the outcome.

Labour strategists feared that “the oxygen” would come out of the campaign if May used her visit to offer a guarantee about West Cumberland Hospital. Instead, she refused to answer, merely hyping up the issue further.

The party is nervous that opposition to Corbyn is going to supress turnout among their voters, but on the Conservative side, there is considerable irritation that May’s visit has made their task harder, too.

Voters know the difference between a by-election and a general election and my hunch is that people will get they can have a free hit on the health question without risking the future of the nuclear factory. That Corbyn has U-Turned on nuclear power only helps.

I said last week that if I knew what the local paper would look like between now and then I would be able to call the outcome. Today the West Cumbria News & Star leads with Downing Street’s refusal to answer questions about West Cumberland Hospital. All the signs favour Labour. 

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.