Can't listen? Won't listen!

Politicians consulting on NHS bill

Our democratically elected leaders have developed, over the years, a disturbing ability of selective hearing. They only listen to the voices they want to listen to, and as a result the siren voices will call them over into dangerous waters.

Over the course of the last 14 years (at least), health policy has been driven by an inner coterie of "special advisers" who have their own and their employers' interests to promote, and they have done this ruthlessly. The organisations advising successive Governments include members of the private healthcare industries, and those who have a direct interest in privatisation of the NHS.

Opposition to these constant changes has been patchy, and few people have actually consistently pointed out that the direction of travel is to break-up and eventual destruction of the NHS as a service, paid out of taxes, accessible by all citizens on the basis of medical need.

As in all privatisations, or part-privatisations (railways, postal services, utilities) the end result tends to be worse service at higher cost.

Some people will eventually see the writing on the wall, and understand what they have done. Others will prepare the way, and then leave the service to enrich themselves (this is a long and shameful list, headed by former health secretaries like Alan Milburn and Patricia Hewitt). The MPs have now just realised that PFI is a scam and a dreadful waste of money, and even a zealot like Alan Maynard (Professor of Health Economics) is coming to the view that the politicians do not have the service's future as their first imperative.

Meanwhile, Jobbing Doctors see the gradual deterioration of the service apparent for all to see. The worsening quality of entrants into General Practice training, the stampede to work in Australia and New Zealand, the pensions changes causing many doctors to retire, and the crashing morale of everyone working in healthcare.

Meanwhile, the Prime Minister thinks everyone supports him (look at this diagram, David - thanks to Johnathan Tomlinson for the link), and ploughs on with his dangerous and disruptive bill ignoring all criticism.

David Cameron will be remembered as the Prime Minister who wrecked the NHS. He will have all the respect that Tony Blair has (none) and will be cursed for a generation. All because he will not listen.

Some advice from an old political bruiser (Denis Healey): when you are in a hole, stop digging. Has Mr Cameron the brains, integrity and judgement to stop digging?

Early indications suggest that he hasn't.