A wasted chance to save the NHS as it turns 60-years-old

Why do the words 'deckchairs' and 'Titanic' spring to mind as the Government publishes its long-awaited plans to reform the 60-year-old NHS?

According to Gordon Brown, the review is a 'once-in-a-generation opportunity' to turn the service into one of the world's best health systems. And, yes, there is much to applaud in Lord Darzi's proposals  -  if anything comes of them.

Nobody will argue with the need for Nice to speed up its drug appraisals and to end the scandalous postcode lottery under which treatments are available to some patients but not others (though there is nothing in the review about bringing the rest of Britain into line with Scotland).

There may be merit, too, in parts of the new NHS constitution and the plan to introduce personal health budgets to give patients with chronic conditions greater control over their care  -  although we must wait and see how these work.

Other measures, however, sound more like hollow gimmicks than a guarantee of better care. Does anyone suppose 'clinical dashboards'  -  TV screens displaying hospitals' performance  -  will clean wards or improve A&E treatment on a Saturday night? And do we really need a Fit for Work service or a Care Quality Commission?

As for the highly controversial plans for polyclinics  -  supposed to complement GPs' practices, but more likely to replace them  -  how do these square with Mr Brown's pledge of a 'more personalised NHS'? How, in particular, will the elderly adjust to being treated by a different doctor at every visit?

But the greatest objection of all to Lord Darzi's well-intentioned proposals is that they do nothing to address the fact that the NHS is an ever more inefficient behemoth, with a top-down management utterly insensitive to patients' needs.

Indeed, his proposals threaten to make the monster even more bureaucratic.

Over the past decade, NHS spending has nearly tripled to more than £100billion a year, with only marginal improvements in patient care.

As treatments become more expensive and the population ages, how much longer can taxpayers meet its growing demands?

A 'once-in-a-generation opportunity'? Without a major structural rethink, the NHS may not last for another.

Them and us

For a devastating insight into how far the political classes have lost touch with the people, look no further than the latest list of Government-approved priorities for local authorities.

How many of us think it more important for councils to promote contraception than keep our streets safe from violent crime?

How many believe stopping people smoking should be a higher priority than keeping taxes down or weekly rubbish collections?

The councils themselves do, apparently. Indeed, curbing taxes and emptying bins don't even feature in their top 20 priorities, while reducing violence comes a miserable 14th  -  well below cutting carbon emissions (5th) or tackling child obesity (6th).

A picture emerges of local and national politicians obsessed by social engineering and utterly unresponsive to ordinary people's needs and aspirations.

They should remember that those who voted them in can also boot them out.

Lost without physics

Power generation, mining, electronics, engineering, architecture, shipping, aviation...all have one thing in common: they depend on the laws of physics.

With the news that almost a quarter of secondary schools  -  and half in our inner cities  -  no longer have a single specialist physics teacher, what future for Great Britain plc?