In which IDS eats out of his fridge for a week and straight to the Lords

A couple of things. For a start, I’m not all impressed with this “let’s see if Iain Duncan Smith can live for a week on JSA”.

Of course he fucking can; he owns his home, he pays his bills on monthly direct debits, his fridge is probably full, and if he’s any less daft than he looks he’ll fill up the car ahead of time. Of course he also has the use of a government car and driver, can take his calls at the office, and he’s married, so failing all else he can bum off his wife. The £53 would just be beer money.

The only possible outcome of this is that he comes up in a week’s time smelling of roses, and you know, you know the media will lap it up. Consider the vast unearned political capital gain he got from just walking around an estate in Glasgow in two-thousand-oatcake, smiling and nodding. He’s still dining out on that now.

Further, it’s been done, repeatedly, in the 1980s and the 1990s, and on every occasion the results were the same for the same reasons. If I were a Sinister Tory Spin-Doctor, I would confidently advise IDS to go for it, and I’d accompany him in person to make damn sure he didn’t fuck it up. I might even use Gove’s missus’ e-mail to sign up for Change.org and start a petition. I’m not sure that hasn’t already happened.

That said, I can think of one thing that might work here; if he does it, wait a quarter and then FOI his expenses.

Secondly, if today you stop a red bus the hard way, you will be scooped off the black top by a big white taxi, resuscitated, conveyed to the hosp, and treated, and you won’t pay a fucking penny. Like yesterday. Also, the entirety of your treatment will be carried out by the public sector as well as being paid for by it. Given that, I am really not convinced that the wider public will believe anyone who tries to tell them that the “NHS is dead” or has been “abolished” today, and I suspect that anyone who tells them that might come across as a little bit strange and overexcited. Especially if, having failed to convince once before, they hit on the obvious solution of SHOUTING.

Going from “OMG THEY KILLED KENNY!!!” to “Well, actually, it will still be a single-payer free-at-the-point-of-use system with universal coverage funded by general taxation, and probably about 90+% of it will be provided by the public sector because when did you last see a giant new private general hospital going up in your area, but they’ll do more contracting out, a bit like ISTCs in the mid 2000s or fundholding in the 90s” is the sort of argument that doesn’t carry conviction.

I’m also sceptical that quite so many people outside the trade really care intensely about NHS internals, much as I doubt many readers even of the Guardian read its hyper-detailed coverage of BBC management ego wars. NHS people tend to be emotionally attached to its being a civil service line managed organisation. As the experts, their view ought to be respected, but that doesn’t necessarily mean they are right. And from a point of view of tactical politics, how many people who don’t work there actually care?

This is of course an important point about the Act. It’s all about internals. And, of course, < save-our-thing campaigns are specifically beside the point. The H&SA is a hellishly awful policy, and it must die. But save-our-thing won’t work and neither will trying to pretend that the NHS doesn’t exist any more, because it looks silly. The problem is that either option is easier than trying to understand and master the comitology – a handy word from the European Union – of CCGs, CSOs, NCBs, H&WBs and gum it up good and proper.