So in one bound, the coalition has leapt triumphantly into embracing a wholly different series of NHS reforms. Instead of GPs driving forward the commissioning process, there will be appointees representing hospital doctors, nurses and others.It is not so much that I was an enthusiast for Andrew Lansley's plans. It's more that I believe a party that has been out of powers for 90 years ought to arrive in government some ambition beyond maintaining the status quo.
The brave new compromise looks a great deal more like the old PCTs, which are still twitching away prior to being dead and buried.
David has one intriguing idea for what a Liberal Democrat health policy should look like. My own is that it should receive an infusion of localism and democracy along the lines advocated by the 2002 Liberal Democrat document Quality, Innovation, Choice - otherwise knows as the Huhne Report.
This was one of the best things the party has ever produced, but it seems to have disappeared altogether. There used to be a copy on Chris Huhne's website, but that has gone now. I discussed it briefly in a post from 2005.
It is interesting that two local health issues I have written about frequently both have their roots in a lack of local scrutiny. They are the St Lukes Hospital debacle in Market Harborough and the row over Ayelestone Meadows in Leicester. In the latter case NHS Leicester decided to put £2 million into a scheme that would probably have decreased exercise levels in the city.
That is why we need more democracy and local accountability in the health service. It is the natural Liberal solution and it is the one we should be campaigning for.