You can always depend on the NHS. It’s always there for you.

I’m not talking about how the NHS looks after you from the moment you are born to the moment you did. I am talking about the purely selfish way in which the NHS is regarded by some within Labour. They are not a majority, I feel, but a sizeable minority for me to get irritated about.

It’s the school of philosophy which says, ‘We invented the NHS’. If that is taken literally, it may not be true, in that while Labour implemented in the NHS the blueprint from it was from a Liberal, Sir William Beveridge, Master of University College Oxford.  At the other extreme, few are advocating embalming the NHS for posterity, or cryogenically freezing it, or any other banal image you wish to think of. It is not a ‘natural religion’, but likewise people who believe in its values should not be criticised for being ‘crackpots’.

While Ed Miliband goes on his walkabout with the air of belle indifference to flying eggs, and while Chris Bryant is not completely sure of the location of his Tesco distribution centre at the centre of his immigration scandal, the NHS is always there for them. Never a topic of debate. Andy Burnham MP will proudly defend Labour’s record over Mid Staffs, and talk about his ‘big idea’, integrated whole-person care. However, as with much policy from Labour in general, no-one knows for certain Labour’s direction of travel on this.

Labour is obsessed about ‘proving itself on the economy’. You sense this is because Gordon Brown was adamant about presenting himself as a ‘serious politician for serious times’, ‘fiscally responsible’. And yet the public perception amongst some quarters is of a manic shopper going mad with his credit card. Labour’s problem is that it is not, as such, thanked for the record satisfaction over the NHS, and many voters think if the NHS is good in their area that they happen to be ‘one of the lucky ones’.

Ed Balls MP is desperate to prove he has something to say on the economy. The narrative had always been ‘you’re cutting too fast and too deep’, and yet he wanted to stick to the same spending plans. And, for his next trick, now that the economy may be on a path of sustained recovery, Balls & Co. wish to establish that the economic recovery is indeed fragile and there has been a precipitous drop in ‘real living standards’. This narrative would be perfectly plausible if there was nothing happening on the political scene, but this is far from true. Disabled campaigners feel  that Labour on the whole does not speak for them, some blaming Labour for signing the fated contracts with ATOS in the first place. However, they loathe the current ministers for disability in the Cameron government, so soldier on regardless. Concerns about workfare appear to fall on deaf ears, and Labour are not shouting from the rooftops either about their plans to backpeddle on the ‘Bedroom Tax’.

Apparently. Ed Miliband, as a social democrat, feels a deep sense of justice as a social democrat. Actions speak louder than words. With the decimation of legal aid, and the introduction of private competitive tendering, there has been an armageddon in the legal landscape, to which both Miliband and Sadiq Khan look like ‘silent bystanders’. Miliband and colleagues were also unable to stop the juggernaut of private competitive tendering in the National Health Service, meaning that the private sector would end up taking control and management of lucrative contracts in the name of the NHS. They also do not have a settled position on the continuing financial obligations of NHS Trusts challenged by their PFI loan interest payments. They campaign on, but do not seem to make much headway, on stopping the cuts in nursing which seem to have ideologically resulted from the McKinsey efficiency savings. Any clinician in the NHS involved in frontline care from the last decade will know clinical wards and acute emergency rooms have been stripped to the bone leading to NHS CEOs being effectively rewarded for failure; in some places, dirty and unsafe hospitals, financially keeping afloat (or not as the case might be), in the name of ‘efficiency savings’, while Jeremy Hunt still describes the NHS as ‘scandalously inefficient’. Finally, integrated care could be the New Jerusalem of making healthcare ‘affordable’ while ‘thinking differently'; or it could be a way to fiddle the figures by offering substandard care in a totally unrecognisable form.

Such turmoil has led an umitigated amount of crap to be written and said about the NHS in the last few years. Recently, Keogh and Cummings have called for another set of reforms as  the model of the NHS is ‘unsustainable’.  Too late. The politicians decided unilaterally to impose a £2bn top-down reorganisation leaving the NHS totally buggered backwards, but allowing private health providers to come into the NHS like true ‘rent seeking’ vultures. The agenda of the ‘hospital standardised mortality ratio’  has been blown out of the water as a means not to look at clinically negligent care, which can only be done through meticulous expert analysis of the case notes. It has been exposed as a mechanism to induce moral panic for the public to become angry at ‘unsafe hospitals’, and their staff, with anger, for them to become foaming at the mouth with vitriol and hatred. The HSMR can be praised for being a ‘smoke detector’ for the worst performing Trusts, but a problem which the regulators themselves do not wish to tackle is why they seem to be so resistant to investigating even the most outrageous claims of unacceptable medical care. The healthcare regulators have only scored a pyrrhic victory by not investigating them, as the individual cases are very vocal indeed on Twitter and elsewhere.

All this feeds into the idea that Labour does not have any vision. It is more concerned about winning elections than having a clear roadmap of where it is going. For ages, inane critics have been saying that it is too early to flesh out any details in policy. These happen to be the same morons who deny any economic recovery at all, simply saying it is a debt-fuelled boom in the housing sector. Labour appears to have divided itself into two camps which are increasingly not communicating with one another. The one camp which feels that Ed Miliband is not providing inspirational leadership and the whole Party should return to its pre-Blair socialist roots. The other camp which feels it’s fine, no panic is warranted, and so long as Labour doesn’t say anything overtly, it’ll win the election. But, even if Labour get that far, it’s what happens next which matters.