David Cameron hoped to put an end to claims that the Conservatives were hostile to the NHS when he made as firm promise as leader of the opposition to increase, rather than cut, NHS spending.
It actually meant the Tories were committed to putting more money into the health service than Labour, which had indicated the NHS would not be immune to spending cuts.
Of course, as the NHS accounts for such a high proportion of total government expenditure, this promise also made plans to cut the deficit more challenging.
It’s partly because health funding has been protected, alongside the Government’s reluctance to cut school budgets or most benefit rates, that services which are facing cuts have been quite to badly hit.
Police forces, fire brigades and local councils are paying a price for Mr Cameron’s promise.
And perhaps that’s as it should be, because the British public cares deeply about the NHS. But they also care deeply about a range of other services which have not escaped reductions in budgets.
In any case, a decision was made to protect the health service, and that should have been that. But it turns out that NHS finances are more complicated.
Demand for health services does not remain steady.
It increases, partly as a result of increased life expectancy, and so the health service needs more money just to carry on doing what it is doing.
The NHS is also in the midst of radical reforms – despite Mr Cameron’s promise in opposition not to impose any more top-down re-organisations. These changes cost money.
They have also forced health trusts to get their books in order.
This may have been well overdue in a sense, but it also means health trusts which may previously have overspent are forced to make increased savings as they try to live within their means.
The Royal College of Nursing is fighting a battle to expose the rift between the rhetoric and the reality.
However, while it’s important that the voice of the nursing profession is heard, the RCN’s claims that 1,600 nurses are at risk of losing or already have lost their jobs are not universally accepted.
Hospitals in the region have disupted the figures, and health minister Dan Poulter has accused the RCN of ‘scaremongering’.
One of the problems the RCN has faced is that the fragmentation of the NHS, with local health trusts enjoying increased autonomy, makes it hard to tell exactly what is happening.
Local health trusts are not always the most forthcoming organisations when it comes to revealing bad news.
But there is no doubt that the health service is changing – and some posts have gone.
Will voters believe in the long run that these changes are for the better?
That’s a question that will be answered at the next election.