Oh no, not again. Not the health service. Not as the Government’s top priority. Please.

It was an odd paragraph in Gordon Brown’s opening leadership speech: “Education is my passion. A priority for the coming months will be the NHS. In advance of the spending review in the autumn, I will meet with those on the front line of the NHS, patients and staff, as we shape the next stages of our plans for our health service.” Education is my passion, but I’m going to focus on the NHS for the next few months.

Just like Tony Blair. Except he ended up focusing on the NHS for years and years, and education fell by the wayside. Please not another prime minister paralysed in the headlights of the health service.

Every health minister I can remember has gone on a listening tour, or held an expensive consultation exercise, round and round the roundabout, and they got the same answer: patients want shorter waiting lists, a GP who will visit them, an A&E reasonably near by. Health service staff want more pay and fewer reorganisations. Who do you listen to?

Labour has increased annual spending on the NHS from £35 billion to £92 billion. Health outcomes have improved, although not as dramatically as the injection of funds would suggest. Death rates among every age group have fallen, by roughly 1 per 1,000 population across the board (ie, in 1996, in the East Midlands, there were 10.7 deaths per 1,000 people; in 2005 it had fallen to 9.8). Waiting lists are clearly down and still falling.

We have had new types of hospital and a far wider use by the NHS of private treatment centres, walk-in centres and NHS Direct. Everyone has had new contracts, with nurses taking on greater responsibilities, consultants taking on extra money and GPs devolving responsibility for out-of-hours services to others (while taking on extra money). There has, generally, been a public consensus supporting all of this. Taxes have risen a little to fund it.

And then Patricia Hewitt came along, brandishing a Bold Reform Agenda that encompassed closing down much-loved hospitals across the country in the name of “care closer to home”, greater efficiency and super A&Es not yet established. At the same time the Treasury cracked down on previously hidden debts and, hey presto, like a too busy consultant magicking a private appointment out of his diary, the Government magicked defeat out of triumph. Its ratings on the NHS have plummeted and with them trust in the Government, and the Tories have taken the lead – despite having no health policies to speak of at all.

You can see why Mr Brown wants to address this. It is absurd for Labour to have lost the public’s trust on the NHS and he must be desperate to regain it. Until last summer, the Tories had never led Labour on health. In the past ten years Labour turned a 49-point lead over the Tories on health into a lead for the Conservatives.

So now Mr Brown says he wants people to have better access to GPs in the evening and at weekends. I wonder how he plans to achieve that. Is the Chancellor really prepared to take on Britain’s GPs by trying to renegotiate a contract that was signed only three years ago? I doubt it. And I hope not. The contract was overgenerous, offering a 22 per cent pay rise and an opt-out from providing out-of-hours services, but it would be time-consuming and morale-destroying to redraft it.

It would place the Brown government head to head with family doctors as the next election approached. Walk-in centres (often staffed by nurses) and pharmacies can take on some of the work currently done by family doctors – all present government policy – but that still doesn’t deliver out-of-hours GPs.

It’s not at all clear what Mr Brown’s plan for the NHS is (other than to change those opinion polls). He has been dropping contradictory hints: he isn’t sure about the NHS market, but he is certain that foundation hospitals have been a success. He doesn’t like all these debts, yet he wants us to be offered better access to services. He wants “maximum local autonomy”; but remember, hospitals are monopolies.

Here I quote directly from an interview he gave at the weekend, because it expresses his muddle quite clearly: “As far as the health service is concerned, you’ve got to understand it, it’s different from any other form of activity because you’ve got people who rely on the doctors for advice. I can’t normally diagnose myself.

“You’ve also got hospitals in an area that are essentially monopolies because they have accident and emergency and you’re not going to find an accident and emergency facility very near to where you are, and you’ve got maternity services, you’ve got emergency services including the accident and emergency. So healthcare is quite different from any other activity in the economy.”

Anyone have the faintest idea what he is talking about? I will make a wild guess: Mr Brown is going to reverse the hospital closure programme that has been frozen while the local elections were under way. Why do I think that? First, because it is phenomenally unpopular. If there is a case for it, it has not been made. Secondly, because if he carries on with it now, the closures will collide neatly with the next general election. Thirdly, because I cannot think what else he was getting at with all that stuff about A&E and maternity services, the very areas which are most under threat.

And then he should leave well alone. There are leaner times ahead for the NHS, but it is still massively better funded than it was ten years ago and new Labour has forced the Conservatives to guarantee to continue that. That is revolution enough for now. Let the Brown government focus on something else.

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