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Just a week left to put health centre stage

The general election will be upon us next week, the primetime debates are focusing on other issues – and there are still a great many questions about health policy that need answering

The Labour incumbent faced demands to publish a secret report from a management consultancy company urging millions of pounds of cuts. The Liberal Democrat candidate pressured his Conservative counterpart to clarify the source of donations to his private office. The Tory launched a robust defence of the programme of efficiency savings that has gripped the NHS, insisting it was possible to take huge amounts of waste out of the system without damaging the front line.

It was a fierce, passionate, hard-fought debate, with an audience held rapt by the arguments. But unfortunately, it was not on primetime TV. This was the health debate, webcast by the King's Fund and on, but largely ignored by the wider world. Meanwhile, in the first two leaders' debates, the NHS has hardly had a mention.

Partly, this has been by design. The Conservatives, in pledging to protect the health service's budget from the cuts planned for the rest of the public sector, have sought to neutralise one of their traditional areas of electoral weakness. Once it became clear that there were no big differences between the parties over NHS funding, the national media seemed to tire of health as an election issue.

That's an enormous shame. We are in a period of great flux in the NHS, with arguments raging over A&E closures, the shift of services into the community, the introduction of a further series of waiting targets in the form of 'patient rights', and fundamental questions over the role of competition and the private sector. Patients and doctors are taking to the streets in protest, and two GP parliamentary candidates tell Pulse this week that health remains a core issue on the doorstep.

It really is about time our politicians starting talking about it.

Part of the problem is that superficially the parties seem so similar on health, each cosily accepting that consumerism will continue to drive NHS policy, without questioning whether we can any longer afford to deliver consumer choice. But there are differences in ethos between the three contenders for office, and what this election needs is some probing questions designed to tease those out.

Do our politicians believe there is any difference between GPs as independent contractors and private firms with shareholders? Do they accept that a nationally driven programme of hospital closures and a shift of services to the community is the only way to achieve the required efficiency savings? What are their views on GP ratings - do they really believe a popular doctor equals a good doctor?

And perhaps most fundamentally of all, do the politicians believe our NHS can increasingly provide patients with what they would like, rather than simply what they need?

It is questions like these that need to be answered if this election campaign is to get to the heart of the debate over the NHS. So far, it has barely scratched the surface - and is letting both GPs and patients down.

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