NHS Spending and Tax Cuts

If the Chancellor, Gordon Brown, had time to glance at the Guardian on the morning of Budget Day, perhaps as he ate the frugal breakfast the price of which he apparently had to borrow from a colleague, it might just have raised a smile. For there, in ICM's poll, the mass of the public were saying they wanted him to do very much what he was proposing to announce that he would do. Most of them wanted him to use any spare cash to help the Health Service, and more than half thought a rise in duty on tobacco was the most acceptable tax.

But the poll also told the government, as has every other one on the subject, that the bulk of public is not interested in tax cuts. More than three-quarters said that "thinking about the people you know", they thought most people would prefer extra NHS funding to tax cuts, and two in three also thought that more money to the NHS was more likely to win the next election for Labour than a tax cut. Does Mr Brown agree? Though he managed to find money for substantially increased NHS investment he also confirmed his earlier promise of one-point cut in the basic rate of income tax as well.

Many politicians and commentators, perhaps including Mr Brown and probably including most of the opposition front bench, don't believe that the voters will really stand for increased taxes, however laudable the spending that results; they feel they've heard that one before, and take with a pinch of salt polls that seem to suggest the converse. The people only say that to interviewers because they are embarrassed to admit being tightwads, they argue; maybe, but in an interesting and under-reported experiment last year, Milton Keynes Borough Council rather than taking an opinion poll organised a binding referendum of their residents, and were given a direct and convincing mandate to increase council tax so as to improve services. Or, it is sometimes argued, the voters don't understand what 1p in the 163 income tax means, and think the sums involved are much more trivial than is the case; but in fact surveys spelling out the cost to each taxpayer or household find similar endorsements of higher taxation to fund the NHS.

There is a myth in Labour circles, and perhaps in Tory ones, that Neil Kinnock lost the 1992 election because he promised to raise taxes, and Tony Blair won the 1997 one because he promised not to. There is a gaping flaw in this argument: Tony Blair may have made his famous "Five Year Pledge: No Increase in Income Tax Rates", but the key voters didn't believe him anyway. In MORI's final pre-election poll for The Times, 63% said they expected that a Labour government, if elected, would increase income tax, only 3% lower than the 66% who had expected a Kinnock government to do so in 1992. What is more, they still don't believe him: in the ICM/Guardian poll this week, more than two-thirds of the electorate, and almost half of Labour's own supporters, say they do not trust Labour to keep its promise on tax.

So why did Kinnock lose in 1992 and Blair win in 1997? As far as the tax issue is concerned, the polling evidence from the British Election Survey strongly suggests that the sticking point for the key voters was responsible spending. It was not so much the threat of higher taxes in John Smith's Shadow Budget that 'middle England' rejected as the fear that the money would simply be wasted. Of course, 'Black Wednesday' (when sterling fell out of the European Exchange Rate Mechanism) shortly afterwards destroyed all Tory claims to fiscal credibility, and made it much easier for Labour in 1997 to be considered a serious alternative. Trusting Labour's tax pledges really didn't come into it.

Which is just as well for Labour, because it is clear that distrust of politicians spreads a great deal wider than the tax issue. Before the election, two in five, 42%, expected a Blair government to keep its promises but almost as many, 40%, did not; and two-and-a-half years on (according to MORI's December poll for The Times), 49% think that they haven't - a statistic unlikely to have improved in the interim, especially with David Blunkett's "Read My Lips" fiasco, which will have done no more for his administration's trustworthy image than it did for President Bush's.

The sad truth is that politicians, parties and the whole political process have allowed themselves to fall into disrepute. Last month, in a poll for the BMA, MORI found that only one in five of the public, 20%, say they generally trust politicians to tell the truth, and just 21% trust government ministers. Only journalists score worse. By contrast, in a period when a series of medical scandals reported in the media culminated in a doctor being convicted of murdering countless numbers of his patients, 87% trust doctors to tell the truth. Although both politicians generally and ministers are scoring a little better than during the Conservative government, these are dismal figures.

But if governments can no longer get themselves re-elected on an image of integrity and honest endeavour to improve the country's lot, then they are going to have to start getting results. (That is a lesson that the Blair government could learn from President Clinton, who rode out the Lewinsky scandal and severely embarrassed his opponents in the mid-term elections fought over impeachment, on the credit the voters gave him for maintaining the country's economic health.) Labour is not delivering yet. MORI's December poll for The Times found that 69% thought the government had not helped to improve their own living standards, 61% that it had not improved law and order and 57% that it had not kept taxes down; NOP for the Jonathan Dimbleby Programme last week found two in three believe that there has been no improvement in the NHS. Yet around half are consistently satisfied with Mr Blair, almost as many with Mr Brown, and Labour still rides high in the voting intentions.

For the moment, memories of the last government and correspondingly low expectations for the present one, will help the government hold the fort. But it must be very doubtful whether the mere knowledge of money being spent, without a visible recovery in the state of the health service, will suffice for long. In a poll reported in January, 80% of doctors said they no longer believed in a sustainable free NHS service. The government needs to prove them wrong - given such a free hand to spend, if the NHS continues in its long-term decline then ultimately the credibility of the Labour Party must eventually, and perhaps terminally, follow it.