Incisive Health analysis of the fourth national poll in just over four years. 

With the House of Lords’ impending agreement to the Early General Election Bill, voters can now look forward to marching to the polling stations on 12 December in the latest attempt to reboot our political system.

It is the fourth national poll in just over four years, and so voters might be forgiven for wondering if this one will help matters any more than the last ones did. Expert predictions of what may happen are becoming passé, but for the sake of completeness we will recount what we know here.

To start, analysts are united in their conclusions that the UK electorate is characterised by unprecedented volatility – with voters switching between the parties in historic numbers – and that our first-past-the-post electoral system will not cope admirably with four parties polling in double digits.

This reveals very little as far as anyone can discern. A Conservative landslide is considered a remote possibility, as is a Labour landslide, but a government led by either seems quite likely. The betting markets suggest that a Conservative majority government is the most-supported outcome, albeit with virtually the same odds as a hung Parliament – and given the former is likely to lead quite quickly to leaving the EU and the latter is likely to lead to remaining in it (or at least to having a second referendum), we can probably resolve to be certain of our uncertainty. It is still not clear to observers in which seat our Prime Minister will choose to stand for election, even. He may not be clear either.

We’ll thus leave our crystal-ball gazing on the outcome of the election, and instead stay on the safer ground of speculating about what may happen during the campaign.

PMQs today was a dress rehearsal for that, and showed that the election – beyond Brexit – looks set to be a fiercely-fought contest on the NHS. There is at least a rational reason for this: both main parties are fighting over the same group of Labour-leaning, leave-supporting voters largely residing in the north of England – and these voters care more about the NHS than anything else.

Boris Johnson has known this from the start of his premiership, of course, which is why he has been handing out new hospitals like sweeties. Or at least announcing them. We can expect to hear many more announcements of this kind in the coming weeks.

For its part, Labour is focusing its attacks on the Government’s pharmaceuticals policy, and feels that these attacks are hitting home, particularly with the voters they need to win over. Conservatives will be nervous in particular of the potential for Labour to link these attacks with the trade-offs which may be required in a Tory-Trump trade deal too, and so are already denying that pharmaceuticals policy will be on the table. President Trump is in the UK for the NATO summit less than 10 days before the election, of course, and may weigh in. Everyone will be interested in what he has to say, the Prime Minister included.

And yet, pharmaceuticals policy seems – well – rather a niche issue to excite voters. The thing which voters really care about, and always have, are waiting times – and it was notable that Jeremy Corbyn went on to raise this issue in PMQs too.

This is where Labour is likely to be on more potent political ground. It is certainly not easy for anyone except the most partisan Conservative to look at the latest NHS performance data and conclude that everything is going well. Deciding on an election and aiming to focus it on the NHS against this backdrop may prove to be one of the more eccentric political decisions ever taken.

This is particularly so if there is a bad flu season. Health-watchers will have read with interest in The Times that ministers have an ‘internal analysis’ showing that the impact of flu on the NHS tends to be most severe after Christmas. Phew. But those with long memories may recall previous governments getting into some difficulty before Christmas.

The 2010-11 winter was a case in point. It saw the third wave of the swine flu pandemic, which was more severe in its effect than the first two waves – something which nobody predicted. There was also a problem with vaccines. The new Government’s controls on advertising meant that there was no flu immunisation campaign.

This detail isn’t important, but the impact on patients was very real, with many falling critically ill. The NHS began to run out of intensive care beds. A politically sensitive decision to accept the cancellation of routine operations – knowing the negative impact on waiting times this would have – was taken. Cabinet was briefed. And all this was by ‘week 50’. Or, this year, election week.

We will find out in a matter of weeks whether Boris Johnson’s gamble of a General Election has paid off – and whether it was an unwise decision or a masterstroke – and what impact it will have on Brexit. But amidst all the unpredictability, one unknown may matter more than anything: the flu season. If the Conservatives head into polling day with a creaking NHS and cancelled operations, the price they pay may be dear. And Ministers should not be banking on an internal analysis to reassure them that all will be fine. There is not enough time to ensure the NHS will cope with what is thrown at it, so they will need to bank on luck.