Ironically, just as Ed Miliband gave his Hugo Young 2014 lecture on “an unresponsive State”, many people in the SW England saw their sandbags being delivered to a different location.

The floods have revealed what many of us have suspected all along.

The response to the floods has revealed a painful fault line in our narrative of ‘The State’.

There’s no COBRA meeting when fourteen Trusts run into difficulties with patient safety, because of the common thread that they don’t have a safe minimum level of safe staffing.

The acute general medical take for many health professionals is a ‘firefighting experience’, with the aspiration of lean management to mean there’s actually insufficient capacity in the system to cope with increased demand.

It is now being reported that some British insurers are unwilling to take on the risks of certain flood areas, feeling that the market is somehow rigged towards only benefitting “cherrypickers”.

It makes us wonder who the postman will be, now that Royal Mail is privatised benefitting hardworking hedgies.

And yet this is precisely the criticism that anti-privatisation campaigners on the NHS have been saying since initial discussions of the Health and Social Care Bill (2011) commenced.

The market is unable to guarantee complete coverage for all scenarios. In the case of private insurance and health, rarer ‘unprofitable’ diseases will just become out of scope. Like Owen Paterson’s ‘badgers’, the location of the goalposts will be redefined so that some NHS interventions are no longer ‘necessary’.

David Cameron’s response curiously has not been to resuscitate his flagship turkey.

You would have thought, if you believed any of Steve Hilton’s hype, that people would fight them in the dinghies as a “Big Society” response.

Or somehow the market could be “nudged” into action, where the market could be realigned with financial incentives to make us want to give a shit about our fellow man or woman now underwater.

Instead, David Cameron has been trying to fatten up the impoverished State.

If you think that the current debate about the actual fall in NHS spending is going nowhere, that’s clearly small change compared to what may or may not been happening to Lord Smith’s Environmental Agency.

For flood victims, the State is not a dirty word (save for those victims who feel profoundly let down by the lack of response by the State). So why should it be for NHS patients?

It’s well known that the current Government considered implementing an insurance-based system but eventually went against it. The implementation of personal budgets has been progressing over the few years, with rather little discussion.

And yet, personal budgets could become a major plank of Labour’s “whole person care”. Somewhat reminiscent of ‘expert commentators’ who were slow on the uptake when it came to uptake on competition in section 75, they appear equally sleepy on the significance of unified budgets for health and social care.

From one perspective, they ‘empower’ persons, and give them ‘choice’. But from another perspective, they actually disempower persons when the State runs out of money, and you have to top up your budgets from some other means.

It’s this two tier nature which causes the most alarm. Already, there’s been much finger pointing about ‘personal responsibility’ of people building homes knowingly on flood plains. The shift of potential blame as well as shift in personal responsibility is a deliberate change of emphasis in policy, and one which Labour must have an open discussion about if it wishes to retain any vestiges of trust.

The whole basis of trust of the public has for some time taken a knocking, with implementation of the private finance initiatives (PFI) and discussion of caredata.

While budget sheets are in the hock of paying off loan repayments, rather than paying for much needed staff to take the level of staffing beyond ‘skeleton’ or ‘extra lean’, the talk about a ‘more responsive State’ is all fluff.

While the NHS complaints system remains unfit for purpose, it’s all fluff.

It may be the fluff which keeps Alan Milburn and Tony Blair happy, but, despite the three general election victories, it has been a policy issue which Labour must revisit.

Proper levels of funding of the NHS and social care have long been popular and populist policies for Labour, and so has effective State planning.

It remains thus all the more strange that the only State that the Labour Party in fact cares about is the Square Mile.