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The latest Irish Times/TNS mrbi opinion poll confirms something this writer has long suspected – that support for the Fianna Fáil/Progressive Democrat option is softer than we have been led to believe. But the Rainbow alternative, while consolidating its improving levels of support, is still in danger of being left out in the political cold.

Although this latest poll does not address voter perceptions and intentions with regard to the health services, surveys by others confirm that health is the most serious concern for the electorate, and will be a key battleground in the general election.

In fact, the latest Euro-barometer Survey highlighted the healthcare system as the greatest concern for 50 per cent of our people, compared to an average of just 15 per cent across the EU. The conclusion is inescapable — either the services and/or people’s perceptions of them are getting worse, or the message about the improvements that are being made isn’t getting through.

That should be expected to work against the governing parties. The problem for the opposition is as it has been for many months- there is no convincing evidence that the voters believe they will be any better in directing the health services. And that may yet prove to be the tipping point that discourages the electorate from switching.

With Labour now openly courting the prospect of an unholy alliance with Fianna Fáil, the gains which Fine Gael would hope to make on the health issue are being seriously threatened.

Listening to concerns

More than any other party, Fine Gael has staked its reputation on being able to convince the electorate that it is listening to their concerns on health, and that the strategy of running doctor candidates will cement its credibility on that issue. All of this assumes that the fundamental direction of the policy is right, that it’s being communicated in terms that reflect people’s understanding of the problem, and that ‘medicalising’ the slate of candidates is actually a sensible strategy.

The issue here is that doctors are increasingly seen by a sceptical public as part of the problem. In any event, the medical profession has no greater claim than any other group in society to represent the public interest, when its main focus is generally perceived to be to push its own professional interest. That is not to say that the two can never coincide — only that it’s hard to find many examples of where they do.

The Government rightly draws fire from the public for many of the failings in the health service, but its decision to confront hospital consultants on the issue of contract talks is resonating with the public and underscoring the chasm between the two sets of interests.

So if the voters are now framing the problem in a different way, is the issue for the opposition parties that the policy platform they are now offering is timid or misdirected? And if that’s the case, what difference will the doctors make?

I have argued previously in this column that the opposition parties have it within their grasp to really set the election alight, by being imaginative to the point of recklessness, in terms of the distance to which they are prepared to go in addressing the health issue from a policy perspective, as it is now being framed by the voters.

The Tánaiste’s trenchant rhetoric that it would do no good to come on television looking concerned about the health services but not play a part in solving their problems, gives some hint of the tough fight which lies ahead for the medics who have been drafted in specifically to get elected on a health service ticket.

All the evidence suggests that the voters will take some convincing, the more so because none of the parties in the Rainbow alternative is communicating a clear, focused policy to fix the problems as people see them. For most voters, reform is about getting the basics right and ensuring the service user always gets a fair deal.

In the absence of such clear policy, it will take enormous political skill for doctors on the doorsteps to convince voters that they are prepared to contribute to the diminution of the influence of their own profession, when their natural instinct would be – and be seen to be – to maintain the status quo.

Plenty of goading

Yet the electorate will expect and accept nothing less. And you can rest assured that voters in the various key constituencies will receive plenty of goading from all of the non-doctor candidates, who will be fishing furiously in the same pool and spreading doubts about the doctors’ ability to address health and non-health issues.

Goldsmith may have had a general election in mind when he remarked, “It’s a damned long, boggy, dirty dangerous way”. But politics is nothing if not a blood sport.