That well-known anarcho-syndicalist Sir Richard Lambert, the outgoing Director-General of the Confederation of British Industry, has made a damning indictment of the Coalition Government's performance in office in his valedictory speech.

One line in particular rings out with relevance to health policy: "when it comes to micro policy initiatives, politics appear to have trumped economics on too many occasions over the past eight months".

Hard to argue.

When organisations ranging across the board - from the BMA to the RCGP to Civitas to the Kings Fund to the Nuffield Trust to the NHS Confederation to the Conservative-chaired health select committee to the Department of Health (see the impact assessment for the Bill) - are warning that the degree and pace of reform pose significant risks to the possibility of coping with NHS funding growth that will, cumulatively, be £15-20 billion lower than once planned over the next four financial years, politics are trumping economics.

When the Government plans not to evaluate the overall reform changes (only the transfer of commissioning from abolished PCTs to new consortia), politics are trumping economics.

When new draft Treasury guidance on PFI basically says 'don't do much, chaps - don't go making waves', politics are trumping economics.