A young Indian MP told me a story about the Communist chief minister of the state of West Bengal, Jyoti Basu. Basu’s policies weren’t always popular, and there would often be large demonstrations and sit-down protests outside his office by the disaffected. Basu’s way of dealing with these outcries was to join them. He would slip unobtrusively into the crowd and eventually be found sitting among the protesters, holding a placard or chanting a slogan denouncing his own follies.

Perhaps Mr Basu’s disconcerting tactics have had a wider press than I realised, because in the past few weeks his approach seems to have caught on among British ministers. The Labour Party chair, Hazel Blears, has joined protests in her constituency aimed at saving the local maternity unit from merger. The Chief Whip, Jacqui Smith, has been trying to defend the status quo at the Alexandra Hospital in Redditch, and — perhaps most bizarrely — the junior health minister, Ivan Lewis, has been doing the same with regard to facilities at the Fairfield Hospital in Bury.

The national policy, of course, is to move some facilities to centres of excellence, which would provide a higher standard of medical care. Inevitably, because this involves shutting down smaller local units, the policy becomes the focus of local campaigning which — in Britain — is usually devoted to stopping something from happening, and exercises our native ingenuity at full stretch in discovering reasons as to why it shouldn’t.

Naysaying can sometimes be costly. A recent report from the Institute for Public Policy Research argued that successful resistance to the closure of some local A&E departments might well compromise patient care and lead to preventable deaths. “If heart attack victims are taken by ambulance past their local hospital to a specialist centre, they will be more likely to survive,” said the IPPR.

Which is why the Government, of which these three are members, supported the policy. Mr Lewis still does, but not in Bury. Ms Blears does, but not in Salford. Ms Smith does, but not in Redditch. Unsurprisingly the public has noticed that the policy seems to be right in general but wrong in all its specific applications. A BBC poll last weekend registered 72 per cent believing that it was hypocritical for ministers to campaign against the local consequences of their own national policies.

So we are at a strange moment in the recent history of the NHS, its strangeness emphasised because just when there ought to be a sharp political debate about its future, the Conservative Party has decided that it too will join the movement against change, and sit Basu-like on the steps.

By 2008 the Government will have raised the proportion of GDP spent on health in this country from 6.5 per cent to more than 9 per cent, and doubled expenditure in real terms. For that money it has managed a significant reduction in waiting times, an improvement in some key health indicators, a huge increase in numbers of NHS employees and a whacking great pay rise for doctors. Such a government funding bonanza couldn’t last, and the rate of growth will now slow substantially.

Last week we were told by Sir Michael Rawlins, head of the National Institute for Health and Clinical Excellence (NICE), that healthcare spending would have to rise above 9.3 per cent of GDP in the future to deal with medical inflation and the ageing population. “It is the elephant in the room, really,” he said. PricewaterhouseCoopers has estimated that there is a tax or an expenditure-cutting crunch coming some time soon if we are to keep up with the desire to maintain or improve health outcomes.

The obvious answer, to judge by yesterday’s news story, is for everyone to get a dog. The even more obvious answer is for everyone to eat properly and take exercise. So we won’t do that. Sections of the Labour Party, looking to its next leader, have begun agitating for a substantial rise in taxes, while simultaneously wanting an end to targets and a reduced reliance on involving the private sector in health. Which will leave us with the GPs’ contract story in spades, whereby we spend lots more money and don’t get much more work.

This should be the cue for the entrance, like a fragrant wind over a stagnant pool, of Mr David Cameron. Yesterday the Conservatives unveiled some of their new thinking on the radical policies needed to deal with the funding gap and get us all looking at health in a different way. Mr Cameron might well have noted that many of Labour’s early failures in health were as a consequence of suggesting, before 1997, that just by changing a policy (in Mr Blair’s case, the internal market), and spending a bit, lots of resource would be made available for patient care. Labour is still paying for that approach.

Mr Cameron must admire the early Blair because he seems hell-bent on repeating the error. First with his absurd Stop the NHS Cuts campaign, in which petitioners can “call on Gordon Brown to stop his mismanagement of the NHS”, and not — note — to provide any extra money, as if this absence of “mismanagement” will magically stop trusts running deficits. And, secondly, with the notion, promulgated yesterday, that all will be well if you just get rid of Labour’s “national top-down” waiting-list and other targets and replace them with Tory health outcome targets, to be called “objectives”, and somehow to be local and bottom-up. The difference is, of course, that everyone in the public sector knows that targets must be hit, while an objective is something you make progress towards. If you can. And if you can’t . . .

As to money: “Tony Blair’s great pledge,” said Mr Cameron, “was to raise health spending in Britain to the European average. Our aim is different — we won’t just concentrate on the money going in, but on what comes out as well.” So nothing about raising money from individuals by extending the scope of charging, which will shift some of the burden away from tax, and which is done in many European countries. Nothing about funding following the patient. Nothing at all, really.

Mr Cameron may well believe that his best chance of power comes from neutralising the fears of a Conservative government, only to be radical once in power. But history suggests that you can only do that if your radicalism goes with the grain of your assault on power. For their own long-term good, and ours, the Tories should be offering what Labour may be too conservative, too hidebound to suggest. They aren’t; and — for all the Basu-like nonsense from his leading colleagues — there still seems to be more chance of radical policies from Gordon Brown than from the Opposition.

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