Why May's NHS gamble could be a defining moment in her premiership
A land-grab for a public service so deep into Labour territory is a bold move from a typically timorous prime minister.
Monday 18 June 2018 19:38, UK
Theresa May's decision to make the NHS her "number one spending priority", and tell the British public that the low-tax Tories will ask them to pay a bit more for it, could prove to be a defining moment in her premiership.
It's a big decision - and a big risk. Her predecessor David Cameron calculated he could never beat Labour as the party of the health service; at best he could "neutralise" the issue at the ballot box.
Mrs May has decided something quite different; she wants to win.
The 3.4% increase in health spending is slightly below the historical average and comes after a decade of austerity.
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Practitioners are already saying the £20bn-a-year extra by 2023 is not enough, but it is nevertheless a huge commitment for Mrs May.
Paying for this will almost certainly will involve backsliding on her manifesto commitment to cut personal taxation - but she's taken a calculation that the public will forgive her that, if she brings them a health service they can trust.
Mrs May has made this commitment personal, taking ownership of the NHS and reminding her audience that the health service "does not belong to a single political party" but was in fact born of a "national determination that the country we would build after the war would be a fairer and more civilised nation".
But a land-grab for a public service so deep into Labour territory is a bold move from a typically timorous prime minister.
"Look at the risk she's taken," said one government source. "This is a big decision for her."
The risk is obvious: failure to materially improve the service will fall at her door.
But Mrs May and her team must know too that they cannot fight Jeremy Corbyn at the ballot box on Osbornomics.
The 2017 snap election offered a window on just how fed up with public are with austerity. They want better public services and the NHS tops their list.
But those cabinet ministers who are hoping that this might be the loosening of the funding tap are to be disappointed.
Mrs May was clear in her speech that her government will "stick to our fiscal rules, reduce our debt but prioritise our NHS within in public spending".
One government source told me today that the NHS commitment was "an utterly ring-fenced goal" and warned that demands for more spending on defence, schools, housing and the police would be rebuffed.
The huge win for health secretary Jeremy Hunt will leave cabinet colleagues jostling for position - and money - in cabinet.
And for her MPs, some will worry that politically unpopular tax rises could tarnish the Tories' reputation as the party of low tax.
But she is bound by the promise that the Vote Leavers painted on the side of that bus.
She is the prime minister who has promised to deliver Brexit and part of that compact with the people is to deliver a better NHS too.
It's a huge gamble, but it's one that she, and her party, have to take.