Cameron needs to come clean on the NHS

You may remember a while ago I attacked Gordon Brown for claiming spending was going to go up under a Labour Government, and the danger this meant if Labour were to win the next election on the basis of 'no budget cuts' only to have to make budget cuts - and therefore be without any popular mandate to make them.

In the interests of being fair and balanced (unusual for the blogosphere, I know), I feel obligated to then say the same to David Cameron. Cameron has been cleverly avoiding the flack over the NHS comments by Daniel Hannan and others by saying that a Conservative Government would not cut spending on the health service. However, now the Tories have gone further, claiming they would not only not cut the NHS budget, but would also increase NHS spending more than Labour would. This risks destroying the Conservative plans to make the necessary and vital spending cuts to decrease Britain's dreadful fiscal deficit. The NHS accounts for close to 30% of the public budget, and by ring fencing it (let alone increasing it) it becomes much harder to achieve serious savings. And NHS spending is not the only issue.

Opposition parties must be very careful, since they can sometimes have a tendency to go after the government on a number of spending issues - mostly implying they would spend more. So the Tories have now committed themselves to increase NHS spending, as well as increasing defence spending (they can hardly cut it after the amount of airtime they have had criticising government spending on defence). They also face an increased welfare budget thanks to the economic crisis and higher unemployment. It will be immensely difficult for the Tories to cut spending in a meaningful way unless they can find savings in the NHS.

Now, there are arguments that Cameron hasn't given a timeline for NHS ring fencing (so possibly in his mind he'd ring fence it for a year and then make some cuts in the second year of his government). But this semantic point will not carry weight with voters. If Cameron goes into an election campaign saying he will not cut spending at all in the NHS, he will have no popular mandate to do so. Any attempts to turn around two years into his term and say "we ring fenced the NHS spending, but now we feel we have fulfilled our promise and will now cut with wild abandon" will not fly.

Cameron needs to be honest with the public. If he ring fences the NHS spending then the debt crisis that George Osbourne mentions at least twice a day cannot be solved. If he is going to really deal with Britain's indebtedness there will have to be either serious reform of the NHS or cuts to its budget. Cameron's shadow cabinet needs to pick a side and stick to it. The big difference between Opposition and Government (that few Tories have first hand knowledge of nowadays...) is that you cannot have your rhetorical cake and eat it too.