Talking about the NHS is toxic for the Tories. Any time they mention it, it reminds the electorate that it continues to trust the Labour party far more with protecting its health service than the party behind a wholesale restructuring, “privatisation” by the back door, closing hospitals, an A+E crisis, and cuts to other public services.
So a story in the Independent this morning, in which a high-profile Tory backbencher has been secretly recorded suggesting the NHS budget may have to be cut, is damaging politically to the Conservatives – and a treat for Labour on the day of the Autumn Statement.
Kwasi Kwarteng MP, a clever and respected figure from the Tories’ 2010 intake, who is behind the new, radical Tory right-wing vanguard, was reported saying:
We have always been very clear that deficit reduction is absolutely important and if you are going to reduce the deficit then everything should be put on the table and considered equally . . .
It’s common knowledge that there has been a consensus on international aid . . . that we should ring-fence that, [and] on health spending. I think that consensus will be under a lot of strain given the budget realities. That will force change in the political discussion.
Kwarteng, who was speaking at a meeting held by the right-wing think tank, the Institute of Economic Affairs, stands by his remarks: “If you are going to be serious about deficit reduction, you might have to look at everything.”
Although he is a backbencher who has not quite made it to the ministerial ranks, despite often being tipped as a “rising star”, his views do expose an ideological split in the Conservative party over the health service.
There are those uncompromisingly hard-headed Tory MPs, like Kwarteng and his co-authors of radical right-wing books such as Britannia Unchained and After the Coalition imagining a smaller state and a Conservative party espousing truly free-market economics, who have little patience for government budgets that must remain ring-fenced for political reasons.
The Westminster wisdom is that it could well be electoral suicide to cut health or education spending, or, to a lesser extent, the international development or science budget. But those Tories driven more by ideology see such ring-fencing as restrictive and ultimately arbitrary.
This makes life difficult for those who have more of a stake in practical governmental decisions, such as the Prime Minister and policy review chief Oliver Letwin MP. Indeed, I hear from a Cabinet Office source that David Cameron’s Implementation Unit, a body he set up in 2011 staffed by civil servants rather than political appointees, was told the “NHS is the thing”.
Bending the rule that civil servants should be working apolitically, apparently the PM was all too aware that his government would benefit from palatable policies on the NHS, and tasked his inner sanctum of officials with supporting this idea.
There is clearly both an ideological and politically pragmatic gap in Cameron’s party on the health service, and it will only become more pronounced the more the Labour party exploits it in the build up to the general election. Indeed, the shadow Cabinet Office minister Jon Ashworth has already leapt on the Kwarteng story, commenting: “It just proves what we’ve always said: You can’t trust the Tories on the NHS.”