IT’S almost a month since the Labour Party launched Build an NHS Fit for the Future, one of five “missions” that are supposed to show clearly what the party stands for. It has gone down like a lead balloon.

That is hardly surprising. The turgid 24-page tract lacks both passion and credibility: it’s like a menu without the prices.

While many of its proposals in themselves are sound, there is no explanation of how they might go from words into action.

Labour wants to cash in on the Tories’ unpopularity after the Tory government’s 13 years of real-terms cuts in spending, reduction in capacity and privatisation. But it lacks the courage to promise more funding, or any steps to roll back privatisation.

The dreaded word “reform” is used over a dozen times, the word “challenge” 15 times: but there is not one use of the “F-word” — funding.

The word “spending” comes up just once — when the document derides the widespread call by campaigners (and in particular the trade union-backed SOSNHS) for a commitment to increased spending:

“Some on the left too often believe that problems within the NHS can be solved with more spending alone.”

Of course, this is untrue (campaigners for increased funding have always coupled the demand to the call for changes to deal with the growing gaps, weaknesses and performance failures that stem from long-term underfunding).

But it also begs the question: exactly what problems does Labour’s leadership believe can be solved without extra spending?

Anyone searching for answers in the statement is in for a disappointment. It does have proposals, which we all know will cost money: it just avoids any discussion of how much.

Up to now, all Labour has promised (again and again) is a massive training programme, to be funded by taxing any non-doms who have not already left the country or moved to the Isle of Man or other tax havens.

Now we hear Labour wants to undertake “one of the biggest workforce expansions in history.” This leaves the much bigger question: the pay bill for tens of thousands of extra staff who would be trained and looking for jobs.

Where is the money for “thousands of mental health staff,” or ending “the shortage of health visitors,” “doubling the number of district nurses” and “10,000 more nurses and midwives and 7,500 more doctors every year?”

The mission claims Labour would address “retention issues,” and again leaves this carefully vague: “Across the health and care sector pay, autonomy, work-life balance, and job flexibility are complex issues that seriously affect staff morale. Labour will act to improve public service workers’ living standards and working lives.”

After months of refusing to support the strikes and demands of nurses, doctors and other staff, Labour now promises to “consider the case for looking more broadly at how public-sector pay is set.”  

But there is no clear commitment to restore the real value of the Agenda for Change pay scales that New Labour negotiated with the trade unions in the early 2000s — and no recognition that any progressive readjustment of NHS pay will cost more money.

There’s a clearer promise to the 1.6 million staff in social care, almost all of which is privately owned and run, that Labour would improve their pay, terms and conditions — although once more the “F word” is avoided.

Of course, pay is far from the only cost in implementing the mission: it goes on to sing the praises of “health technology” and its possibilities, complaining that “the NHS is being left behind” — as if the only problem was stick-in-the-mud managers or consultants, when in fact all of the new gadgets and apps require investment, training and retraining of staff to use them.

The mission bemoans the “crumbling NHS estate” which faces a £10 billion-plus backlog bill for maintenance — but makes no mention of money, and no promise to counter Johnson’s cynical and now discredited pledge of 40 new hospitals.

Extravagant (and quite likely impossible) promises are made for improvements to key services, without identifying what needs changing or how much it costs:

“Labour will … [hit] all NHS cancer waiting time and early diagnosis targets within five years,” “Reduce deaths from heart disease and stroke by a quarter within ten years” and — perhaps most ambitious: “halve the gap in healthy life expectancy between different regions of England.”

And of course, despite all the talk about innovation, and while insisting “we don’t want to repeat the mistakes of the past,” the mission does dredge up one of the worst and most wasteful New Labour policies, and embrace it once again:

“The last Labour government reduced waiting times by using the private sector, increasing staff numbers and spreading good practice. We did this before. We will do it again. […] we will use spare capacity in the independent sector to ensure patients are treated quicker.”

Somehow Labour has forgotten the role of 10 years of real-terms increases in funding, from 2000-2010, and that the NHS did all the heavy lifting in reducing the waiting lists — while a new, parasitic private sector creamed off guaranteed profits for treating only the simplest cases.

Today’s “consensus” of Labour leaders, Rishi Sunak’s government and a private sector hungry for profits all believe the use of private providers is the answer to the growing 7.4 million waiting list.

The Health Foundation, NHS Confederation and NHS Providers have all warned that it leaves the NHS with all of the most complex cases, while vital cash flows out to private providers, who recruit more NHS staff to do the work. The result could be longer delays for those with the most serious needs.

Labour’s statement is so empty of credible commitments, with one of its core ideas simply rehashed from the Tony Blair playbook (and identical to Sunak’s plan).

So it’s no surprise it has failed to “cut through” to voters. Only this week on Sky News Wes Streeting again insisted Labour would be “very, very careful” on spending commitments to the NHS.

Campaigners, health workers, NHS managers and patients are all desperate for some hope of a real change. So unless and until Labour can promise to pay up, they may as well belt up.

Labour’s mission only makes sense with cash committed for a decade to come, and a policy of ensuring that this cash goes to building NHS resources for the future, not lining the pockets of private healthcare bosses.