In the wake of the two party leaders slugging it out over the NHS yesterday, it’s worth glancing at three recent polls for a sense of what voters think about the health service – and its politics.

First, the extensive Lord Ashcroft poll published earlier this month.  It found that 29 per cent of respondents believe that the Conservatives have “the best approach to the NHS” and that 47 per cent believe that Labour do so.  Furthermore, 30 per cent believe that the Government’s NHS reforms are “part of a plan to privatise the NHS”, and 45 per cent that David Cameron is “wrecking” it.

Grim for the Conservatives.

However, having “the best approach” is one thing, but delivering on it is quite another.  And when it comes to trusting the parties to manage the NHS, Labour’s seems to be much smaller.  A ComRes poll last month found that 22 per cent of trust the Conservatives to do this, and 25 per cent Labour.  The question gives a strong sense of the degree to which the public distrust any of the parties’ management of the NHS.

Rather better for the Party – at least when lined up against Labour.

Finally, a ComRes poll from earlier this week found that more respondents trusted David Cameron than Ed Miliband to “ensure the NHS has enough money”.  True, this was only by a squeak – 29 per cent to 28 per cent.  A survey by the same firm last month made a similar finding about the two parties, showing Cameron ahead of Miliband on managing the NHS by 22 per cent to 20 per cent.

Better news still, despite the very low ratings both men scored – and the questionmark over the degree to which voters’ views of leaders rather than parties matters at the ballot box.

Downing Street and CCHQ will have clocked all these numbers, and be clocking others, and are likely be be drawing three big conclusions.  First, the NHS matters in this election: all polls find it among voters’ top issues.  Second, their trust in any of the political parties or leaders to deliver is low.  Third, Labour lead on values, but are in danger of lagging on delivery.

This helps to explain why a senior Minister told me last year that, when it comes to the NHS, the Conservatives play a defensive game – but with counter-attacking moves.  There are two main ones.  The first is on Andy Burnham over Mid-Staffs.  The second is on Labour in Wales over their dire record of running the service.  (There are also Miliband’s remarks over “weaponising” the service.)

In short, the declining reputation of politicians is bringing Labour’s NHS ratings down to near where the Conservatives’ was in the first place – at least when it comes to managing the service.  None the less, it can be argued that the views of voters are sympathetic to solutions that are usually associated with the right – as the scale and the depth of the Ashcroft polling reveal.

79 per cent of respondents said that the Government should “definitely or probably” consider charging for missed GP appointments.  68 per cent gave the same response over cutting back on non-clinical staff; 50 per cent offered it over charging patients for some treatment, and 42 per cent recommended that the Government should consider a health insurance scheme.

The paradox is that for electoral reasons the Conservatives have a greater incentive to reform slowly.  I suspect that radical change to the service – “privatisation”, if you insist – is most likely to be brought about by the combination of a Labour Government and a financial crisis.

In the meantime, Labour’s own record of outsourcing in government – defended this week by Alan Milburn and John Hutton – fading memories of the Attlee settlement, and voter antipathy to politicians are eating away at the party’s traditional healthcare vantage.