Political decisions will always be made, but are unlikely to be representative if certain people don’t wish to be part of the political process.

It is hard to know what has caused a decline in political engagement, but politicians not appearing to listen might be a major factor. The social media has empowered a plurality of opinions, which means that it is less easy for politicians to speak with a collective voice on issues. The traditional narrative is that people ultimately care about the economy, as economic competence is the sort of issue which can make or break political parties. However, it’s very likely that residents of Lewisham care about local hospital closures, and hospital campaigns can gain momentum and traction whatever the state of national politics.

Voices of Labour who are interested in social justice, solidarity, equality, equity, solidarity or cooperation are not in fact in a minority, whatever the current state of the Blairite arm of the political party. While think tanks prioritise concepts such as ‘accountability’ and ‘co-production’, authentic voices on the left do not feel that their brand of politics is irrelevant. The question inevitably arises – if the current party is doing what you want to do, why should you stand for election? It is possibly the case that many people will nonetheless vote for Labour, despite reservations on the ‘welfare cap’, because the modern political system does not offer them any realistic choice. ATOS were contracted to do welfare benefits in the last government, and it is likely that some other outsourcing company will assume the mantle.

Labour clearly will state that it is insufficient for political parties to lose elections for others to win them, and they should formulate coherent policies of their own. But likewise nobody will expect Ed Miliband to reveal his hand until much closer to the election. Many people do not come into contact with the NHS when young, although there are many who do, and it is possible that Labour will wish to hone its offering on general health issues as well as the National Health Service. The recent Clegg v Farage debates have highlighted some appetite for single issue politics, when charismatically explored in ‘leaders debates’.

The forthcoming European elections will give a good indicator as to the relevance of the NHS to people’s lives, arguably. The fate of Louise Irvine and Rufus Hound will possibly provide good clues as to whether people in the general public care as much about the NHS as much as NHS campaigners clearly do. The National Health Action Party – NHAP – to be national will need to have coverage throughout the country, but there has always been concern about whether they might realistically gain enough seats to prevent Labour from winning an overall majority. Nonetheless, this Party feels serious that the NHS is a major political issue, and it is a genuine policy issue what they feel they can achieve over and above what a Labour government might. It is possible that that the NHAP might prevent a Labour MP from being elected in Stafford. I met someone recently who was adamant that, with the right resources, NHAP could win in Stafford. Likewise, it’s possible that Clive Peedell could win against David Cameron in Witney, where arguably Labour do not have a realistic chance of winning.

With the second rabbit to come out of George Osborne’s hat in the form of pension reforms, the first being inheritance tax, it’s possible that Labour can’t take the running of the economy as a vote winner in the 2015 general election. Some people still blame Ed Balls as too intimately implicated in the economic policy of the last administration. It is therefore counterintuitive to imagine then that Labour will wish to ignore its potential strengths such as social justice. Despite the concerns over ISTCs and PFI in previous Labour government, and the events running to Mid Staffs, it is still controversial whether people feel strongly enough about Labour’s record not to vote for them. Even hardened Socialists might be keen to contribute to the election of a Labour government than to see the continuation of a Conservative one.

The £2.4 bn top down reorganisation resulting from the Health and Social Care Act (2012) is a major faultline in national policy. Most seasoned pundits are aware of the calamitous effects of competition on national policy, but it is far more likely that members of the general public are unconcerned about ‘section 75′. As sure as night follows day, it’s likely that Labour will oppose privatisation, but the logical conclusion of this is that it supports state ownership. Its inability to call for this publicly speaks volumes. And the people who argue that this country is fundamentally right-wing know they’re being economical with the truth. Unpopular policies from the right have included the astronomic pay of certain investment bankers, the cost of energy bills, the general failures of privatisation policies, perceived attacks on the welfare state, and an enthusiasm to introduce tuition fees in universities denying access-to-education. Whilst Labour is unlikely to voice loudly that ‘capitalism kills’, Labour potentially can make some political weather on the NHS and on health issues such as ‘whole person care’. This will require some strength in the leadership of the Labour Party, but it should not be thrown off course by the equivalent of gale-force winds.