Governments get tired and stale. The media and the electorate grow used to their tricks. They are the focus of blame for those who like to blame the government: so much easier than blaming oneself.

All of this is true in most democratic countries. Yet by any standard experienced in this country, the current administration looks weary. Even in the dog days of the Major years, there was a kind of rude vigour watching the Eurosceptics beat the Conservative Party up. More to the point, four election victories had given birth to a high calibre of MP arrogance, beside which much (but not all) of the current expenses 'scandal' looks relatively small fry.

New Labour then governed like an opposition, believing US political strategy guru Dick Morris' dictum that nowadays, "a government needs a daily mandate". Cue eye-catching initiatives with which Call Me Tony should be personally associated; cosying up to News international; Alastair Campbell, Derek Draper; Damien McBride .. all that jazz (or to be precise, jazz-funk).

It is not surprising that a competent and presentable PR man like David Cameron has found the tail end administration easy meat. The question is, what are Labour going to do about it?

An attempt at finding an answer can be found by a group called Labour Future. Of immediate relevance to us is this essay on proposed NHS reforms by MP and former health policy academic Hugh Bayley.

'Reforming the NHS' suggests a plethora of sensible improvements, that build on the better bits of the past decade's reforms. It starts with the observation that there is much more scope for legislation and taxation to address determinants of avoidable ill-health in obesity and alcohol-related problems.

Using data better
Bayley's chapter points out that crucial aspects of data are coming through that will enable far closer attention to be made to the variations in clinical activity rates and crucially, outcomes. He suggests that a logical corrolary of this may be the abolition of PCTs, with concomitant 'efficiency savings' releasing real cash - though a criticism of the paper (though short) is that it does not speculate which bodies might take over the monitoring and measuring of activity and outcome data.

Another smart marker is laid down on the incompatibility of data from ISTCs: Bayley is unequivocal that their contracts should be altered to require exactly comparable data with the NHS standard.

The paper is succinct and sage. It is devoid of ideological theme-park folly, focusing instead on sensible and necessary improvements.

Whether Labour may be listening to intelligent voices such as this remains to be seen.