Tories must be honest about national issues

This promises to be another critical week in the fortunes of the Conservative Party and the political life of the country. The local elections in England on Thursday are expected to be disastrous for the Tories, potentially triggering a fresh internal debate over the leadership.

The apparent aim of some plotters is to trigger a vote of confidence in the Prime Minister, which he would probably win but be so wounded that he would have to quit, allowing the coronation of an alternative to take place.

With just a few months before a general election there are some in the party who believe that dropping Rishi Sunak and choosing the sixth leader and prime minister in nine years will revive the Tories’ fortunes. Others beg to differ.

The defection of Conservative MP Dan Poulter to Labour has helped spur this speculation, but also highlights the unreality of the current discourse. Dr Poulter, who works part-time in healthcare, says he has left because he feels the Government no longer treats health as a priority. “The NHS deserves better,” he says.

But what does that mean? It is not the NHS that deserves better but the people who fund the health service. Dr Poulter seems to exhibit precisely the problem – the NHS is somehow seen as the entity that needs preserving rather than standards of health care that need enhancing.

It is now surely beyond argument that the cause of falling health standards, poor outcomes, intolerable waits and a broken primary care is the NHS itself. More money than ever is being thrown at it to no avail.

If Dr Poulter meant to call for radical reform of the health system to make it work as well as those overseas, which are also under great demographic and financial pressures, then he may have a point. But since he apparently seeks to perpetuate a nationalised structure that is failing to deliver, despite record levels of funding, his criticism is hard to fathom.

The irony is that he is joining a party with a health spokesman, Wes Streeting, who is at least talking about reform even if he will have a battle to persuade his colleagues to back him.

Those Conservatives manoeuvring against Mr Sunak claim to have a shadow manifesto ready to put to the country by an unidentified successor. It includes the promise of tax cuts, migration controls and unspecified pledges on the NHS. What might they be?