Ramping up his recent attacks on the coalition's controversial health bill, Labour leader Ed Miliband today told nurses at the Royal Bolton Hospital that the NHS will be a:

defining issue

at the next general election.

He was instantly mocked for saying so by the usual suspects [2]. I'm not sure why. As I said on Twitter this morning, it's not rocket science. The polls [3] have Labour ahead of the Conservatives on the NHS (and the Opposition has doubled its lead over the Tories on health since the election); the health bill has so far been a PR disaster for the coalition (Cameron's "poll tax [4]", in the helpful words of one of his Conservative cabinet colleagues); Miliband bests Cameron in PMQs every time the NHS comes up; and Cameron, of course, used the NHS to try and "detoxify" his party ahead of the last general election so there's no reason why Labour can't now use the health bill to try and retoxify the Tories.

Some on the right recognise this point. As the Spectator's Peter Hoskin observed [5]:

If the NHS is the closest thing we have to a national religion, then the Labour leader is hoping to stir up some sectarian fervour.

And as ConservativeHome's Tim Montgomerie [4] put it:

The NHS Bill is not just a distraction from all of this but potentially fatal to the Conservative Party's electoral prospects.

Or is it? Some have argued that the NHS doesn't win Labour general elections. That's arguable. Others say that the economy should be the "decisive issue". But, hold on, Miliband didn't say health would be "the" defining issue at the next election; he said it would be "a" defining issue. Get the difference? There's absolutely no reason why the economy (growth, jobs, living standards, vested interests, etc) and health can't both bedefining issues come 2015.

YouGov's Peter Kellner [6] says:

It's possible the saga of the NHS could resemble that of Thatcher's privatisation: people, if asked, say they are against change, but not to the extent of switching their vote. The verdict that will matter will come after reform, when people can judge by results. If the Health Bill is enacted, patients and their relatives will be able to cast their votes at the next election on the basis of experience. If the much-maligned Andrew Lansley is proved right, and the NHS provides a better service, then there is no reason why the Tories will suffer.

However, if the Bill's critics are right, and the NHS deteriorates, then the electorate may exact fierce revenge. David Cameron has fought so hard to dispel old fears that the Tories don't really care about the NHS: those fears may come rushing back. If Ed Miliband has managed to restore at least partially Labour's reputation for competence, then we could see something that has happened only once before in the past 80 years: a Government being booted out after just one term in office.

Here's hoping, eh? And, indeed, as the False Economy [7] website argues in a new factsheet, the health bill will lead to more bureaucracy, longer waiting times and "a postcode lottery on a scale not seen before". Good luck Dave!

On a side note, here's a link [8] to my column in today's Independent, headlined: "Follow Obama, Ed, and get in touch with your inner populist". Enjoy!