Take a blank canvas. Talk to 1,500 NHS staff. Spend 12 weeks thinking hard. And then come up with the ideas you first thought of.

That, in a nutshell, is a brutal but not inaccurate summary of Lord Darzi’s review of the NHS, published today.

Astonishingly, it identified as problems exactly the same things the Prime Minister and the Health Secretary have themselves been boring on about for months: access to family doctors out-of-hours (Gordon Brown) and MRSA (Alan Johnson).

Surely, in a system that now costs £90 billion a year, employs 1.3 million people and treats a million patients a day, Lord Darzi might have identified some issues not already flagged up in a hundred tired political speeches?

To a tiny degree, he did. He correctly points out the glacial slowness of the NHS to adopt new ideas or buy into new technologies. He then goes on to propose the wrong solution, a centralised Health Innovation Council to “champion” change.

Such bodies have come and gone as swiftly as the dew on an autumn morning. Remember the NHS Modernisation Agency? Or the NHS Institute for Innovation and Improvement? (One of them is still around, not that you’d notice.)

In a document that says local NHS organisations have the responsibility for change, Lord Darzi has proposed another top-down, London-based, all-the-usual-names body in a misguided attempt to impose it.

The NHS does not change because the incentives are not there. Managers who innovate take risks, If they go wrong, cost money, or produce headlines in the newspapers, the Department of Health can be relied upon to provide no backing. The trick of survival as an NHS manager is to change nothing and balance the books.

Lord Darzi also correctly identified stroke as a disease where the NHS has failed, miserably. He might have added allergy, liver diseases, osteoporosis, or a host of other equally deserving conditions. The system is fundamentally unresponsive unless it is kicked. And kicking is no longer in fashion, so heaven knows how change will occur in future.

His report also mentions health inequalities, which are widespread and growing. But both he and Alan Johnson appear to believe that such inequalities can be put right by a greater provision of health care.

Of course it is right that everybody should have roughly the same chance of seeing a GP. But tons of evidence, over many years, shows that the actual provision of doctors has little impact on health inequalities.

In a new NHS that is supposed to be evidence-based, Lord Darzi has ignored all this evidence, which points to the need for better education, nutrition, and ante-natal care, among other things. Instead we will have GP clinics open 12 hours a day, seven days a week, to satisfy the Prime Minister, while the gaps between rich and poor in expectation of life continue to widen.

Perhaps the most depressing thing of all is not what the report says, but the reaction to it. Almost all the great and the good who have backed every half-baked intitiative for the past decade emerged to say how pleased they were.

Not only has the NHS stifled good healthcare; it has bought off those who are supposed to act as candid friends, and made them complicit in its perpetuation.

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