NHS questions for Cameron

When public spending was slashed, Mr Cameron promised that the health service would be protected with above-inflation rises in funding – a pledge disputed by a health select committee which argued rising inflation would render it impossible.

It puts the Prime Minister in a difficult position as he pushes through controversial health reforms. Not only is he fighting ideological opposition to the changes which would see GPs take control of the vast majority of NHS spending, but also accusations he is failing the organisation at the centre of his election campaign.

In Yorkshire well in excess of £400m of savings are being made – with £250m coming from hospitals. Access to some routine hospital care may be restricted and officials have warned treatments that have limited benefit will be axed. The situation has led to Mr Cameron’s judgment being questioned on two counts – should he have waited for the economy to strengthen before making sweeping changes to one of the Government’s most expensive departments? And was it necessary to use legislation to impose the reforms?

Leading figures in the health service have said it was a mistake to trigger the biggest-ever NHS shake-up at the same time as the savings programme. This, coming so soon after a number of health organisations attacked the plans for reform, is clearly very damaging.

Mr Cameron may also regret putting the changes through Parliament at all. The NHS was a prominent part of the Tory election campaign, but so was education reform. Whether or not people agree with Education Secretary Michael Gove’s plans for schools, he has achieved major changes to the system without allowing the policy to be ripped apart in the Commons.

The Prime Minister believes both the public and health professionals are behind him. If he is wrong it could cost his party the chance of a majority at the next General Election.