Focusing on the NHS is the opposite of the strategic dead-end Milburn claims

The oddest and most annoying moment of the General Election campaign for me so far occurred two weeks ago on 27 January.

That was the day Ed Miliband and Andy Burnham launched our NHS Pledge: “Build an NHS with time to care: 27,000 more nurses and 8,000 more GPs. Join up services from home to hospital, guaranteeing GP appointments within 48 hours and cancer tests within one week.”

A strong pledge on Labour’s strongest policy area.

But instead of the focus being on our pledge, we had a self-inflicted wound.

Our former Health Secretary Alan Milburn, who as a former Party Chair knows about the need for message discipline during an election campaign, chose to give an interview the Guardian described as “saying Labour is is running a “pale imitation” of its losing 1992 general election campaign as it retreats to its “comfort zone” on the NHS”.

Former Cabinet Ministers know that when they speak during a campaign it will be reported. And they know about the timing of pledges and statements and that the media will seize on anything that looks like division.

So charitably one could say that Alan has genuine deeply felt policy concerns and has forgotten that the time and place to express those is not on the day the policy is launched, when it is too late to change it.

Uncharitably one might say this is a pretty gratuitous piece of mischief making aimed at damaging both Ed and Andy for having had the temerity to do some serious rethinking about what did and didn’t work in the NHS in our time in office and to reshape our policy approach.

Personally I learned in studying Labour history that the moderate wing of the Party which I identify with was supposed to favour an intellectual approach known as “revisionism” – re-examining old dogmas and theories and adjusting them to fit current political and economic realities, whereas it was the Hard Left of the Party who stuck dogmatically to a particular, outdated line.

In this context it strikes me that Ed and Andy are the intellectually self-critical revisionists and modernisers rethinking Labour’s position, and Alan is in this case carrying forward the dogmatic intellectually rigid approach he learned as a Trotskyist running Newcastle’s Days of Hope bookshop, and applying it to defending the line he took as Secretary of State. He’s a clever man who can and should make a more positive and constructive contribution.

Incidentally, I have very clear memories of the 1992 General Election as it was the first one I actively campaigned in. It wasn’t our NHS policies that cost us the election (though we were knocked off track by the mess up over the Jennifer’s Ear Party Political Broadcast). Our NHS policies were the bit about Labour the electorate liked. It was our tax and spend policies, which they thought they could not afford (because of effective Tory attacks), that cost us the election in 1992. We have not made the same error this time.

In policy terms the NHS approach Andy Burnham is advocating isn’t just to chuck more money at the system. It’s all about reform.  But there are other types of reform than a crude version based on privatisation and marketisation.  Nor does reform have to mean reorganisation on the wasteful model we have just seen with the Health and Social Care Act where large numbers of expert NHS managers were disruptively made redundant at great cost, taken away from the roles they knew best, then reemployed in new roles in expensively reconstituted new structures.  Reform should, and will under Labour , mean transforming the way services are delivered.  For example, using preventive care to keep people at home for longer and to let them get home quickly (and safely) after a hospital episode. Labour’s proposals will deliver the kind of reform that will actually improve care for patients: integration and collaboration.

In his speech Andy correctly said competition has gone too far and “we will call time on the market”. The government is forcing the tendering out of NHS services whether or not it is proven that that will help improve care. Labour will have the NHS Preferred Provider which gives the public stability, but we will not tolerate poor quality care and so there will be a role for the voluntary and private sectors – either to add capacity, work in a supporting role, or to deliver services where the NHS can’t or won’t.

Labour’s NHS vision was set out by Andy as a 10-year journey.  We know fundamental reforms to a huge organisation can not be done overnight otherwise the system will fall over.  Labour will set a clear direction and endpoint and our legislation will be enabling.  The national role will be to set out what  people’s entitlements to health and care are and then how this is delivered will be devolved so that these entitlements are met in a way that is suitable to the demographics and geography of each locality.

So the policy is radical and smart.

But the politics works as well.

Six months ago I was sceptical about the campaigning focus on the NHS. And then people walked me through why it makes campaigning as well as moral and policy sense. Because the segment of the population most likely to be interested in our NHS policy are older voters, who are by far the most likely to turn out and vote, and at the moment the weakest section of the electorate for Labour and the strongest for both the Tories and UKIP. And interest in health policy affects all classes in a way that economic policy, workplace rights, jobs and pay, whilst they are as central to our mission, do not.

So this is not Ed and Andy playing a core vote strategy.

This is Ed and Andy deliberately focusing on a core Labour policy strength that happens to be immensely important not just to motivating our core vote to actually turn out (vital in a close election) but also to winning over Tory and UKIP switchers.

The proof that this focus on the NHS is working, despite Alan’s unhelpful intervention, is in the latest polling on issues resonance from Ipsos MORI, released on Friday. This shows a huge 12% jump in the number of voters mentioning it as an important issue for their family, to 45%, pushing it from third to first place as key issue, above immigrants/immigration and the economy. Some of this is because Tory mismanagement has been shown up by the A&E crisis with the worst waiting times in a decade, but some of it is because Labour has relentlessly hammered home our positive message. It shouldn’t take an electoral genius to work out that an election where Labour’s strongest issue is the main one people are concerned about is more winnable for Labour than one where everyone is talking about issues that are perceived to be other parties’ strengths. But sometimes you have to state the blindingly obvious.

So the NHS is now a bigger issue for voters than at any time since 2006. And the most concerned voters about the NHS are Tories (54% – up 22% – vs 43% for Labour voters), middle class AB and C1 voters (57% and 48% versus38% and 35% for working class C2 and DE voters), voters in the marginal Midlands (47%), and the less-likely to be Labour 55+ age group  (52%, up 15%).

So focusing on the NHS is the opposite of the strategic dead-end Alan Milburn claims. It’s the opposite of a core vote strategy. If we win it will probably be because we chose to focus on the NHS. We have the right, thought-through, carefully revised policy. It is the right thing to focus on morally because it is of fundamental importance to the well-being of the people we seek to represent. It is energising and motivating our activists. I’m sorry if Alan Milburn can’t see this or is putting some narrow factional game of undermining Ed and Andy above what is right for the party, but I am glad they can see it and are doing the right thing.