There is no easy way out of the toxic combination of already-high taxes, corrosive inflation, low productivity, and a Health Service funded exclusively by the taxpayer.
To make progress over the coming year, the Party needs to reach out to more voters and the danger is that fighting culture wars just puts people off.
The expensive subsidy creates a domestic training bottleneck, whilst this country’s demand for healthcare workers is met through immigration.
A modest (if growing) list of technocratic interventions will not be enough for the electorate, no matter how good they are in their own terms.
We are still trying to clear the backlog created by Covid-19; industrial action will mean more delays and more preventable suffering.
Foreign labour is an alternative to ministers facing up to how successive governments have gummed up domestic training and recruitment of medical staff.
Where there is need, front line staff like doctors and nurses are underpaid, relative to what they should receive, and where there isn’t, a whole host of people are well paid.
When I was responsible for the £600 million a year London Development Agency, I was shocked at how much management focus was just on getting money out of the door.
Pay for medical staff is set centrally and restrained whilst boards give administrators generous awards.
It has real democratic authority including with the Lords which might not be so inhibited from voting down new measures which didn’t feature in that manifesto.
Voters aren’t used to a world of rising prices and interest rates, and their hearts and minds are up for grabs.
The waves of strikes we are seeing punish patients, children, and commuters. Acceding to the inflated pay demands of the unions would punish us all by making our inflation problem worse.