I don’t know what the point is of getting rid of one layer or managers (in PCTs) only to replace them with doctors – how many hours have GPs already spent on commissioning palava in England?

Whenever the NHS and politicians interact there is a consistent problem. No one ever values the core aspects of the job – GPs and patients consulting, consultants treating or operating, nurses actually nursing. All that politicians seem to want GPs to do is something else. Nurses are not valued by politicians unless they are ‘specalist’ ‘management’ or ‘consultant’. Meantime, care assistants, who can extend both the quality and quantity of people’s lives are paid at/just above minimum wage.

The end of NICE’s powers will, in tandem with local commissioning, make health inequalties worse. Health does not operate as a simple market system. Politicians seem to ignore the evidence on this. Meantime, time, effort and cash goes into more reforms, which are not evidence based or even evidence-looking.

Perhaps the AV will make room for a party who want to make the NHS an apolitical organisation, transparent, management light, accountable, run on evidence; we could still vote on how much we wanted to spend on it. We should know, pound for pound, how much of which bit of the NHS goes into administration money (just as we do for charity donations.) The Coalition still fail to realise that goodwill fuels the NHS, and that can run dry.