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The UK’s next general election hangs on NHS waiting lists

Good morning. British politics is simple: the Labour party does well when general elections are about public services, the Conservatives do well when they are about literally anything else. Today, we explore one reason why 2024 may be a public services election, and discuss how targeted ads sometimes pay off, but carry several risks. However you spend it, I hope you have a lovely weekend. I’ll be back on Tuesday: get in touch at the below email address.


Inside Politics is edited by Georgina Quach. Follow Stephen on Twitter @stephenkb and please send gossip, thoughts and feedback to insidepolitics@ft.com.


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Ill fares the land

The NHS isn’t being privatised, but the treatment of Britons is. That’s the inescapable conclusion of our data reporter John Burn-Murdoch’s fantastic column on healthcare in the UK. John shows how, as waiting times have risen, great and growing numbers of Britons are turning to the private sector to skip the queue. Many have had to resort to US-style GoFundMe campaigns to finance their treatment.

The biggest reason why the then-prime minister Theresa May came a cropper in the 2017 snap election is that a contest that she hoped to fight on Brexit became, instead, a public services election.

And one reason why Boris Johnson won a big majority in the 2019 election was that his opponent Jeremy Corbyn was unable to fight that contest as a public services one: instead, he had to fight it on Brexit. There are many reasons for that, but one is as simple as this: in the 2017-19 period, then-chancellor Philip Hammond increased the amount of money going into the core public services, which reduced Labour’s ability to pivot away from Brexit and on to social policy.

According to health charity The King’s Fund, people’s satisfaction with the NHS dipped in 2017 and rose again in 2019. And now it has fallen to the lowest since 1997, as our chart shows:

I’m not saying that the next election is going to be a 1997-style victory for Labour. The opposition party now has to come from a lot further back, as far as seats in the House of Commons are concerned, than it did after 1992.

But one reason why it remains my view that we should assume that we are heading back to a hung parliament is that I don’t think the picture shown in The King’s Fund’s survey or in John’s column is favourable to the Tory government. That remains the case even if you assume the global and local factors causing the UK’s economic difficulties will have eased by the end of the parliament, which feels like a very large assumption to make.

Ill fares the Sunderland

Sunderland has an outsized influence on how local elections are covered in the UK because the local authority declares its results very early. The northern port city has very often the only set of full results that journalists and politicians can talk about in the hours immediately following the close of polls.

In recent years, this has been very embarrassing for Labour, because there are specific reasons and challenges for the party in Sunderland that have caused it to underperform in local elections even when they have done well across the UK. That said, the local authority has in several important ways turned a corner: the children’s services that were recently rated as “inadequate” are now rated “outstanding”, the councillor convicted of abusing four children is now in prison and the former council leader who had been dogged by accusations of murder is now dead.

Voters have long memories, however, and Labour will probably continue to underperform in Sunderland next week. In places like Sunderland, where one of the big parties has made mistakes locally, the Liberal Democrats tend to act as a pressure valve. The party wins votes not because of its national policies but because of its local role as good government enthusiasts and neighbourhood campaigners.

Understand that, and you understand the thinking behind this anti-Lib Dem advert in Facebook’s advertising library, unearthed by Insider’s Henry Dyer. It attacks the Lib Dems for the party’s liberal position on drugs and its (historic, now abandoned) opposition to the UK’s nuclear deterrent.

© Henry Dyer

Eagle-eyed readers will notice two things about this advert, which started running this week. The first is that, given the Lib Dems’ liberal stance, these takes on drugs and nuclear weapons are not surprising. The second — and the two things are linked — is just how small the ad spend on this advert is. Even by the standards of UK politics, this is chicken feed.

That’s because the aim of Labour ads that attack the Lib Dems for their (unsurprising) liberalism is to discourage Conservative voters from voting tactically in places such as Sunderland, where the party’s appeal against Labour has a lot less to do with the Lib Dems’ policy positions and much more to do with the performance of specific Labour councils.

However, if these ads are distributed at a national level, they highlight reasons that are very appealing for liberal-left voters flirting with a vote for either Labour or the Lib Dems. What you schedule on Facebook in Sunderland may not stay there.

Regionally targeted campaigning is a political tactic as old as the hills, but a complicating factor in the age of the internet is that not only can the voters you want to see your messages see them, so too can everyone else. If you are unlucky, the harm from having your message picked up nationally may outweigh the benefit of sharing it with a view to a specific contest — even when that contest has disproportionately significant national influence due to its prominence on election night.

Now try this

I watched The Unbearable Weight Of Massive Talent last night, an adorably silly action film in which the actor Nicolas Cage (played by the actor Nicolas Cage) is recruited by a pair of bumbling CIA agents to spy on the head of a global crime cartel. Read FT film critic Danny Leigh’s review here. If that’s not to your taste, here are five other films to watch this week, all reviewed by Danny. (The best of the bunch is Playground, an arresting thriller about an entirely ordinary event, though parents of young children may wish to give it a miss.)

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