Same old Tories? The public turns against NHS reform

The health bill could spell serious trouble for the Conservatives, as a poll shows declining support

If you were in any doubt about how damaging the continued controversy over the NHS bill could be for the Conservatives, look no further than the Guardian/ICM poll out today.

The topline figures are typical: the Tories are on 36 (despite opening up a five point lead in the Guardian's poll last month), Labour are up two on last month at 37, while the Liberal Democrats are at 14. These results mirror those in the Populus/Times poll, also out today, which puts the Tories on 37, Labour on 39, and the Liberal Democrats on 11.

It certainly jumps out that the Tories have lost four percentage points in a single month in the ICM poll, although it looks as if that five-point lead was an outlier. The really interesting findings are on the NHS.

An outright majority of respondents -- 52 per cent -- believe that the health bill should be scrapped. Just 33 per cent believe that at this stage it is better to persevere with the reform, meaning that there is a 19 point margin in favour of axing the bill. This is reasonably consistent across social classes, gender, and regions.

While Conservative voters are more likely to support the bill, worryingly for David Cameron, a third of them (31 per cent) would like it to be scrapped. A significant majority of Liberal Democrats -- 57 per cent -- want it shelved. The issue is set to dominate the party's spring conference next month, for the second year running.

Perhaps this is hardly surprising. Yesterday saw a raft of negative headlines about NHS reform, as Cameron excluded health professionals who oppose the bill from a special Downing Street summit and an angry pensioner berated Andrew Lansley in front of TV cameras. Meanwhile, an e-petition calling for the bill to be dropped has amassed over 150,000 signatures.

Amid this growing opposition to the bill, it appears that the role of the private sector in healthcare is actually becoming more controversial than it used to be. Respondents were reminded that private companies already provide some NHS treatments, but 53 per cent still said that competition of this kind undermines the health service, while just 39 per cent believed it would result in higher standards. When ICM asked a similar question in September 2005, the public was more evenly divided, with 48 per cent endorsing more private involvement and 49 per cent opposing it.

There is growing concern amongst Conservatives that the healthcare bill could seriously undermine their chances at the next election and undo Cameron's hard work on detoxifying the Tory brand. The influential website ConservativeHome called for it to be scrapped earlier this month.
Today's poll appears to confirm that damage to public standing: 40 per cent of respondents said they did not trust the Conservatives "at all" to run the health service (compared with 31 per cent in October 2006, a year into Cameron's leadership). Meanwhile, just 25 per cent said they did not trust Labour "at all", down from 32 per cent in 2006.

As the Prime Minister personally throws his weight behind pushing the legislation through, there is a clear opportunity for Labour to capitalise on this loss of trust. Whether they will successfully turn this into a significant poll lead remains to be seen.

Samira Shackle is a freelance journalist, who tweets @samirashackle. She was formerly a staff writer for the New Statesman.

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Time to start fixing the broken safety net that no longer catches struggling families

We are failing to ensure we look after the children of families both in and out of work.

Families on low incomes are once again bearing the brunt of a tough economic environment. Over the past decade, rising costs of items such as food, energy and childcare, combined with stagnating wages and cuts in benefits, have repeatedly put a squeeze on family budgets.

Between 2014 and 2016, some of these pressures eased, as inflation sank to zero and pay started to grow again. But now that inflation has returned, for the first time in postwar history the increasing cost of a child is being combined with a freeze in all financial support for children. The failure to uprate either benefits, tax credits or the wage levels at which tax credits are withdrawn means that inflation is bound to erode modest family incomes both in and out of work.

The gradual fall in living standards that this produces will be worsened by other benefit cuts that come in over the next few years, for different families at different times. For a start, the phasing out of the “family element” of Child Tax Credit (and its equivalent in Universal Credit) will eventually result in all low-income families getting more than £500 a year less from the state than at present.

Since this only applies to families whose oldest child was born in April 2017 or later, it hits families with the youngest children first, with the effect spreading gradually through the population. The restriction of tax credit entitlements to a maximum of two children is also being phased in, affecting only third children born from this year on, but will clobber families much more severely, with a loss of nearly £2,800 a year per child.

Some existing larger families who escape this cut have nevertheless had their income severely reduced this year (by anything up to £6,000) by the reduction in the benefit cap.

My latest report on the cost of a child, for Child Poverty Action Group, takes stock of these trends and the effects they will have on parents’ ability to provide for their families effectively. For some families in work, improved support for childcare and a higher minimum wage partially offsets the losses incurred as a result of the above cuts. But for those relying on benefits as a “safety net” when they are not working, the level of this net is being progressively lowered over time. On present policies, the support that it provides will sink below half of what families need as a minimum sometime early in the 2020s – having in contrast provided about two thirds of their requirements at the start of the present decade.

There comes a point when a “safety net” stops being worthy of its name because it is no longer enough to provide even the bare essentials of modern life. The evidence shows that when income sinks this low, most families can only escape severe material hardship either by going into debt or by getting help from extended family members.

We are about to enter a new parliamentary season, led by a government that survived by the skin of its teeth after a disgruntled electorate failed to give it the clear majority that it sought. Raising family living standards has been at the heart of the political promise to improve people’s lives. The benefits freeze alone seems to contradict this promise by creating a downward escalator for the half of families relying on some kind of means-tested benefit or tax credit, in combination with child benefit.

For those  who are “just about managing”, and particularly for others who are not managing at all, the clearest signal that Philip Hammond could give in his Autumn Budget that he is starting  to reverse the direction of that escalator would be to restore a system of benefit upratings. This would at least allow incomes to keep up with living costs, stopping things from getting systematically worse, and giving a stable foundation on which measures to improve living standards could build.

Professor Donald Hirsch is director of the Centre for Research in Social Policy at Loughborough University