The poor performance of the NHS relative to government targets is turning into a major headache for the PM.
The point is that Johnson and the Vote Leave team won the EU referendum largely on the basis of their controversial promise to invest £350m a week into the health service. They were acutely aware that money for a public health service matters hugely to poorer people and matters disproportionately more than for those on higher incomes – who have the double benefit of being able to afford both private healthcare and healthier lifestyles.
Johnson’s consigliere and Vote Leave campaign supremo Cummings has often said it was the £350m promise wot won it for Brexit.
So Cummings will now be deeply troubled that the incipient crisis in the NHS could lose the election for Johnson and see the fight for Brexit lost at the last – quite simply because Labour is pledging more generous funding for the health service than the Tories and because historically it has been more trusted than the Tories as stewards of the NHS.
He will be aware that the stats on long waits for surgery, or in A&E or for life-saving cancer treatment are not just numbers. They capture the dispiriting experience of both medical staff and doctors.
This is how one dedicated and long-serving consultant put it to me:
““It’s imploding. No new nurse or doctor recruitment is possible at the moment because of Brexit [anxiety about free movement], the pension issue [doctors retiring to prevent a big tax bill on their pension contributions] and the NHS bursary [less money for nurse training]. The figures reflect exactly what we see on the ground”.
The government has announced plans to sort each of these problems – with, for example, a new immigration system that would give preferential access to the UK to those with the medical skills the country needs.
But none of the remedial action has yet had an impact. So as far as voters are concerned these are no more then pre-election promises.
The conundrum for Cummings and Johnson is whether in the Labour heartlands they need to gain MPs to form a stable government their mantra of “get Brexit done” is synonymous with “we can be trusted to fix the health service”.
There fear would be that leave-supporting erstwhile Labour voters may instead hear “for the three years since we voted to exit the EU you conned us on rescuing the health service”.
Or to put it another way, to win this election Johnson may have to characterise himself not only as the alternative to Labour but as the opposition to and critic of Theresa May’s government – which failed to pledge a significant funding increase for health till NHS performance was already severely impaired.
Of course he was a senior member of that government for much of it. But it wouldn’t be the first time he said “not me guv” and turned on erstwhile allies.
Robert Peston is ITV’s Political Editor. This article originally appeared on his ITV news blog