This is a first: never before, outside of conference season, have I posted four times in one day.

The impetus for this is a story from the Conservative Party suggesting that (at the slight risk of breaching 'fair use' copyright) 'the NHS has been asked to plan for efficiency savings of £15-20 billion against its 2010-11 budget. The Department of Health has refused to confirm whether these savings will be available for reinvestment in the NHS - if they are not, it will equate to a real terms annual cut to the NHS budget of 2.3 per cent'.

Lansley is reported to say, "if Labour will not match our commitment, then these ‘efficiency savings’ are hypocritical and code for ‘cuts’ ... We are determined to drive greater efficiency in the NHS and we welcome any genuine savings but these will be reinvested in the NHS as we increase health spending year by year. At the moment, it sounds disturbingly like Labour are planning to cut the NHS budget.”

The public battleground
It is interesting to see that the Conservatives still feel that the political battleground is about who is promising to spend more on public services. Nor need this be a bad thing. There is a reasonable argument (reflected on this website for some time) that there is a need to retrench spending, but not too quickly.

Despite considerable recent evidence to the contrary, Lansley is not a stupid man. Nor is he ill-informed abput the real issues in the NHS.

This makes the emphasis on spending alone as the significant proxy measure for success or failure problematic, and Lansley (and we) know.

It is not necessarily all about money, In the words of a man who jacked in a well-paid, comfortable job at the centre because he wanted to tell his truth, "any sugestion of real reform has been a deceit; working patterns, practices and customs are at the heart of many capacity issues, and have never been challenged" (Aidan Halligan).

This evening, a wasp stung me in the garden. I killed it as it did so, and took some satisfaction in so doing. I don't believe this will deter any other wasp from stinging me: it just makes me feel a bit better about being stung.

That is how politics tends to work. You don't really prevent disagreeable things from happening to you in future; you just make yourself feel better about getting stung.

Lessons only get learned very slowly.