Ed Miliband, and his wife Justine, leave after voting in the local and European elections at Sutton Village Hall this morning. Photograph: Getty Images.
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Why a strong result in the local elections is so important for Labour

The party needs large gains to demonstrate that it can win the general election and to compensate for possible defeat to Ukip in the Europeans. 

For months in Westminster it was assumed that David Cameron would be the leader under pressure on the day of the European and local elections. The prospect of the Tories being beaten by Ukip and finishing third in a national election for the first time was expected to send his party into a tailspin. But today, against expectations, it is Ed Miliband who faces the greatest challenge. 

Weeks of careful expectation management have ensured that a third-place finish in the Europeans has been priced into Cameron's political share price, with potential rebels appeased in advance. Over the same period, the narrowing of the national polls has reassured Conservative MPs that they can win the next general election, while inspiring fear among their Labour counterparts. "We’ve been defying gravity and now we’re falling to earth," one of Miliband's MPs tells me in my politics column this week. 

Among the PLP and some shadow cabinet members, there is consternation at what many regard as the party's failure to take the attack to Ukip earlier in the campaign. Others have been dismayed by a campaign that included the much-derided "Un-credible Shrinking Man" election broadcast and a poster erroneously attacking the coalition for raising VAT on food (which is exempt). Miliband has announced no shortage of radical policies - the banning of exploitative zero-hours contracts, a cap on rent increases, a 48-hour GP guarantee, the linking of the minimum wage to median earnings - but many feel these have been undersold by the party at large and, in particular, the shadow cabinet. One MP told me that some members had effectively "gone on strike". 

For all of these reasons, a good result in today's elections, and the locals in particular, is essential. Should Labour be beaten by Ukip in the Europeans, becoming the first main opposition party not to win the contest since 1984, the party's strategists will note that the election is rarely a reliable indicator of the general election result and often produces anomalous outcomes. In 1989, the Greens finished third with 15 per cent of the vote. In 1999, the Tories won the contest but suffered a landslide defeat to Labour two years later. Ukip won 16 per cent of the vote in 2004 and 17 per cent in 2009 but polled just 2 and 3 per cent at the subsequent general elections. Defeat to Farage's party in what David Axelrod calls the "age of alienation" does not mean Labour cannot triumph in 2015.

But in order to make this argument convincingly, the party needs a strong result in the locals. Labour's test of choice is how well it performs in those seats it needs to win to achieve a majority next year. It is here, one strategist tells me, that the party has concentrated its field resources, which allowed it to win a "1992 share of seats on a 1987 share of the vote" in 2010.

In an attempt to manage expectations, Labour says that "a good night" would see it gain 150-200 seats (and 25 per cent of the vote in the Euros). But the pollster John Curtice argues that nothing less than gains of 475-500 is acceptable for the main opposition party at this stage of the electoral cycle.

Today, Labour needs a strong result both to demonstrate that it can win the general election and to act as a firewall against the backlash that would follow defeat to Ukip in the Euros. 

George Eaton is political editor of the New Statesman.

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Is anyone prepared to solve the NHS funding crisis?

As long as the political taboo on raising taxes endures, the service will be in financial peril. 

It has long been clear that the NHS is in financial ill-health. But today's figures, conveniently delayed until after the Conservative conference, are still stunningly bad. The service ran a deficit of £930m between April and June (greater than the £820m recorded for the whole of the 2014/15 financial year) and is on course for a shortfall of at least £2bn this year - its worst position for a generation. 

Though often described as having been shielded from austerity, owing to its ring-fenced budget, the NHS is enduring the toughest spending settlement in its history. Since 1950, health spending has grown at an average annual rate of 4 per cent, but over the last parliament it rose by just 0.5 per cent. An ageing population, rising treatment costs and the social care crisis all mean that the NHS has to run merely to stand still. The Tories have pledged to provide £10bn more for the service but this still leaves £20bn of efficiency savings required. 

Speculation is now turning to whether George Osborne will provide an emergency injection of funds in the Autumn Statement on 25 November. But the long-term question is whether anyone is prepared to offer a sustainable solution to the crisis. Health experts argue that only a rise in general taxation (income tax, VAT, national insurance), patient charges or a hypothecated "health tax" will secure the future of a universal, high-quality service. But the political taboo against increasing taxes on all but the richest means no politician has ventured into this territory. Shadow health secretary Heidi Alexander has today called for the government to "find money urgently to get through the coming winter months". But the bigger question is whether, under Jeremy Corbyn, Labour is prepared to go beyond sticking-plaster solutions. 

George Eaton is political editor of the New Statesman.