Lansley offers reassurance

After Gove, a minister whose agenda has gone less smoothly — and it showed. Andrew Lansley's speech to Tory conference was part re-re-restatement of the case for reform, part massage for any residual tensions left over from the summer. Here's a five-point summary of the things that stood out to me:

i) An appeal to NHS workers. Lansley began not just by paying extended tribute to NHS staff, but by encouraging everyone else to do the same. "I want to thank them," he said, "and I know we all want to thank them" — to which the audience duly responded with applause. Although this was designed to sweeten some of the less romantic rhetoric later on, it was still telling that Lansley should be quite so effusive at the start. There does seem to be growing concern among some Tories in Manchester that not enough is being done to reassure public sector workers, let alone attract their votes.

ii) Spending, spending, spending. One for the folder marked 'Unsurprising': Lansley made free and frequent mention of the Tories' plan for real-terms spending increases in the health budget. And he stretched the point even further: "Labour's plan would have meant cutting the NHS by £30 billion [by 2015]," he said, "Just think about the damage that would do." We don't need to dwell on the problem that equating "cuts" and "damage" might create for the Tories, but it is worth returning to Andrew's post from earlier. Fact is that, on current trends, the Tories' health spending pledge is looking very precarious indeed. Lansley may require more money from the Treasury if he isn't to break it.

iii) Labour, Labour, Labour. Of course we ought to expect a flurry of attacks on Labour at Tory conference, but Lansley's speech still stands out as one of the most pugnacious so far. The Opposition were mentioned a good dozen times, and in particularly unequivocal terms. For instance: "Labour and their trade union puppet-masters can push out their ludicrous lies all they like, and we will fight back with the facts."

iv) Not much policy… Which is understandable enough, given that the Health Bill is still crawling through the legislative chambers

v) …but a few treats for patients. Among which was the announcement that 50,000 more people will be given their own "personal budgets" for healthcare, through which they will have more control over their own treatment. As I've suggested before, the expansion in these personal budgets is one of this government's great, unheralded decentralising acts — and one that could also save the Exchequer some cash. Expect to see them deployed more extensively in the years ahead.