Don't mention the reforms

 
David Cameron with NHS staff The PM has attended listening events with NHS staff to hear their opinions on reforms

Few voters ever understood the government's planned NHS reforms.

Few understand how it's run now.

So, very few will understand the reform to the reforms which the ministers plan to unveil soon.

(If you think I'm wrong, turn to the person next to you and ask them to explain the difference between PCTs and GP-led commissioning. Better still ask them what a PCT is.)

Thus today David Cameron's speech on the NHS looks set to say almost nothing about any of that. Instead, it will focus on what voters do know and care about.

You don't need market research to tell you - although Team Cameron has done a great deal of it - that people want the NHS to remain a national, integrated service with it's funding increasing, waiting lists kept low and no privatisation.

Hence, the prime minister will make those five "guarantees" today. What's more, because voters know that David Cameron's family once depended on the NHS, he will invite people to hold him "personally accountable" for keeping those guarantees.

Labour claim that two of the five have already been broken as rising inflation has undermined the planned real term spending increase and the number waiting 18 weeks for treatment is up.

They say the other three will be undermined by the reforms and point out, rather wittily, that it's curious for the government to pledge to protect the NHS from its own decisions.

The curiosity about all of this is that if you ask senior figures in all of the main parties they will agree - privately - on a great deal.

They will say that the competition and private-sector involvement which Labour introduced has already played a role in improving patient outcomes and putting downward pressure on costs.

They will explain that there are too many expensive hospitals which they, as politicians, find it very difficult to close.

They will tell you that those decisions are better taken by doctors. The NHS reforms were meant to do just that.

Given that you probably don't have the time it may take them to explain how that might work - or how it works now - David Cameron will tell you that he "loves the NHS", Ed Miliband that "you can't trust the Tories with the NHS" and Nick Clegg that he stopped the NHS being privatised.

 
Nick Robinson Article written by Nick Robinson Nick Robinson Political editor

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