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Labour and Tories set out their stall as general election looms

‘He’s a politician. He might be lying.’ Thus read the note left by one anonymous delegate at the NHS Alliance conference last week.

By Steve Nowottny

‘He's a politician. He might be lying.' Thus read the note left by one anonymous delegate at the NHS Alliance conference last week.

It was picked up and read out in the last session with a certain amount of glee by the event's compere, Dr Phil Hammond, who was on mischievous form.

Whether the note referred to health minister Mike O'Brien or Tory shadow health secretary Andrew Lansley, who both appeared on Wednesday, is anyone's guess.

But the back-to-back key note speeches from O'Brien and Lansley was one for the Kremlin-watchers, and a study in contrasts.

Andrew Lansley, who will have been in his current role for six years next month, is something of a master of his brief, and plunged straight into the fine detail. Should the national tariff be reformed? What is the future of commissioning?

Mike O'Brien, just a few months into the job, concentrated on the bigger picture – the likely impact of the financial crisis on the NHS, the increased investment in the health service overall since 1997.

What was noticeable, in fact, was just how different the two speeches were. In recent years, Conservative and Labour health policies, while philosophically very different, have in practice essentially been different shades of grey. Expansion of patient choice here. Increased freedom to commission there.

Now - and this very much follows on from health secretary Andy Burnham's recent comments on preferred providers - the fault lines are forming. Mike O'Brien said several times in his speech that he made no apology for being ‘political' about the NHS. And speaking after he addressed delegates, he made a point of telling me exactly how Conservative policy differed from that of his party – not least where the significant rise in investment since 1997 is concerned.

‘We created the NHS,' he said. ‘Nothing better symbolises what Labour is about than the NHS.'

The Conservatives, for their part, are drawing up plans which appear more radical the more we hear about them. After Mr Lansley spoke at the Family Doctor Association conference a few weeks ago, its new chair Dr Peter Swinyard told me that a Tory government would mean ‘potentially one of the biggest changes in my practice lifetime.' Plans for real budgets, greater competition and writing commissioning responsibility into the core GP contract – which we report on this week – will mean massive upheaval.

The context, of course, is the looming general election next year. And with fundamental differences in health policy becoming increasingly apparent, it seems the NHS – and GPs – will once again be a key battleground.

By Steve Nowottny: Political fault-lines are forming By Steve Nowottny: Political fault-lines are forming

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