Health was the issue of 2015 – and it will be for 2020

It should come as no surprise that David Cameron’s first speech as Prime Minister since the election was on the NHS.

Throughout the election campaign and for much of the past six months, polls had suggested health had been the most important issue for voters.

Look beyond the headlines of a seven-day NHS and the central message of the Prime Minister’s speech was that he would ‘protect the NHS’ during this Parliament.

The need to make such reassurances tells a story in itself of David Cameron’s recognition that the public’s trust in his party’s handling of the NHS has been deeply harmed over the past five years.

It is easy to forget that at the 2010 election David Cameron had effectively neutralised the NHS as an issue, with the Conservatives tied with Labour as the best party on the health service.

By 2015, however, Labour had decisively regained its lead on the NHS. Indeed, less than two weeks out from election day, a ComRes poll commissioned for Incisive Health found Labour well ahead of the Conservatives as the party most trusted on the NHS – doubling its lead since February.

This shift in public opinion followed the controversies surrounding the passage of the 2012 Health and Social Care Act and a deterioration of performance standards – culminating in January’s headlines of ‘third world A&Es’.

Labour’s relentless focus on the NHS in the final months leading up to polling day helped steer them to a strong lead on the issue and (in the eyes of the pollsters) winning the health election. No small achievement given David Cameron’s personal commitment towards the issue.

However, winning the health debate did not translate into votes in the way the party had hoped. The party sought to put the future of the NHS on the ballot paper, but it is clear the electorate voted on other issues – most notably economic trust.

Fast forward five years and – excusing any significant economic downturn – health is likely to remain at the top of public concern. It is imperative therefore that during this period of post-match analysis we reflect as a party about why health was the number one issue of concern, but people did not vote on this basis.

Labour’s election campaign on health has to be considered in the context of the leadership contest. Two out of four of the declared candidates are in the shadow health team – this rises to three out of five if you include Jamie Reed.

Andy Burnham deserves credit for reenergising the tone and debate on health after returning to the shadow post in October 2011. History will one day record how close he came to stopping the Coalition’s Health and Social Care Act from becoming law. Andy has a track record of effective grassroot campaigning, which will undoubtedly serve him well in the weeks and months ahead.

However, a lesson for Labour’s 2020 campaign is that winning the ground war is not enough, we must also ensure people clearly understand what the party’s offer means for them and their families.

No matter who comes out on top of Labour’s leadership contest, the NHS is unlikely to dissipate from public concern.

David Cameron knows that if the Conservatives can succeed in getting a grip on the pressures in A&E and problems with GP access, then he can make life difficult for Labour on the NHS once again. But if he can’t, then the Conservatives may well remain vulnerable on the issue of the health service from now until 2020.

Ben Nunn is a specialist health policy consultant