Dave has a wobble

Much talk in the press, e.g. the pink 'un, over Dave Cameron's 'wobble' over tax relief for married couples. This is the sort of item that attracts the attention of the 24/7 news agenda: who has made a gaffe, how have they made it, and what's the recovery strategy. 24 hours of point scoring between the main parties (with Nick Clegg getting his oar in by saying the Lib Dems can't be bought cheaply) and I am already getting tired of it. What must less interested voters think?

The Conservatives clearly think they are on to a winner with Dave and the NHS. Posters are going up round the country with Dave looking serious and reassuring and making his pledge to increase NHS spending in real terms (which means cuts of up to 20 per cent elsewhere). Interestingly, there is no mention of the Conservatives on the poster, but that adds up when Dave is running ahead of his party in the ratings.

On a more serious note, I do have a serious concerns about the Conservative plan to 'repoliticise' decisions on the NHS by involving ministers more. NICE has been the subject of considerable criticism, some of it justified, and it is, of course, a quango. But the reason for setting it up was to get away from a NHS agenda driven by the pharamecutical industry and pressure groups. Indeed, research shows that there are often close links between patient groups and companies selling drugs.

The pressures on the NHS are immense: an ageing population, continually improving technology, constantly rising patient expectations. Some day we are going to have to think the unthinkable and consider whether some services will have to be charged for. Politically, of course, that's a very difficult nettle to grasp, especially in an election campiagn.

In practice, it has already happened with dental treatment. You can find a NHS dentist, but it's not easy. Private dentists don't come cheap. In many ways, it's not a good model for the future. But someday someone is going to have to face up to the dilemmas. The electorate may demand that the NHS is treated as sacrosant and I'm sure it's good electoral politics. But is it good policy?