As the politician most closely associated with the “£350m a week for the NHS” Brexit bus, Boris Johnson went into the 2019 general election campaign making a series of big-spending promises on health, as well as education and policing. Prof Rob Ford, of Manchester University, co-author of the definitive British General Elections of 2019 book, says these pledges were part of a strategy by the Tories to “neutralise” public services – where Labour tend to be strong – as an electoral issue. Theresa May’s team had been taken aback two years earlier during the close-run 2017 general election by the extent to which cuts, including to school budgets, resonated with the electorate. In the run-up to the 2019 election, the state of the NHS had repeatedly come out as the top policy area in Ipsos’s regular “issues index”, which asks voters about the most pressing challenges facing the country. Johnson had an answer to these voters’ concerns – more nurses, more hospitals and more GP appointments. Those promises may have helped create the space to fight a successful campaign to “get Brexit done” but, four years on, voters are likely to feel as if public services have become worse rather than better. “If you ask voters what the Tories promised to do, they say: ‘Brexit and spend money’. And that is where the failed policies become important, I think, because the people who noticed Johnson’s promises to spend money will also notice and resent the fact that it doesn’t seem to have happened,” says Ford. “And that provides Labour with a really big hook for getting their campaign focused on public services.” He adds: “There’s no way they’re going to run a big-spending campaign next year. So they won’t be able to neutralise public services – which puts them at risk of being exposed.” That may help to explain why Rishi Sunak and his cabinet are spending so much time talking about “stopping the boats”, and reversing a putative “war on motorists”, in the hope of shifting the political battle on to territory they hope may be more fruitful for them. Migration climbed to its highest reading in six years on the Ipsos issues index for September – which could have been influenced by concerns about small boat arrivals, or a concerted effort by the Conservatives to push the issue up the agenda, abetted by the rightwing press. Labour frequently focuses on the NHS as a central campaigning issue, but for that to succeed as a strategy, voters have to agree that the service is in trouble – and trust Labour to manage it better. Tony Blair won a landslide in 1997 after warning voters they had “24 hours to save the NHS”, and subsequently raised national insurance to help fund a significant increase in its budget. But in 2015, with the Conservatives still blaming Labour for the state of the economy, Ed Miliband had little luck trying to “weaponise” the NHS, as he reportedly told BBC bosses he hoped to do. In the run-up to next year’s poll, the situation looks very different. Not only do the Tories look likely to break Johnson’s specific policy promises on the NHS, but objective indicators such as waiting lists confirm the health service is in a parlous state and many voters will have first-hand experience of struggling to get the healthcare they need. And with headlines about crumbling schools, understaffed prisons and overwhelmed police forces, Labour should be able to weave a wider narrative about mismanagement and underfunding of public services. The Tories’ stock response to such claims used to be: “but Labour would crash the economy” and Conservative chair Greg Hands still mentions Liam Byrne’s “there is no money” note from 2010 at every opportunity. But that message looks unlikely to find favour. YouGov polling shows the public now consistently rates Labour as better at handling the economy, with a clear crossover point last autumn, when Liz Truss was berating the “anti-growth coalition”. Against that backdrop, Sunak’s chances of “neutralising” the NHS as a campaign issue next year look slim indeed.