When civil servants start talking about “supply-side reconfiguration” it is clear that they are grasping for a bureaucratic euphemism. In this case, what the health officials were discussing on May 12 with Patricia Hewitt, the Health Secretary, was the closure of wards, clinics or even complete hospitals. And closures are deeply unpopular, as Labour has found to its cost. Few party strategists have forgotten the extraordinary ousting of a sitting Labour MP by Richard Taylor, an Independent campaigning on the single issue of the proposed removal of an A&E department from Kidderminster Hospital in 2001.

There is something deeply cynical, however, about calling meetings to correlate the cutbacks in the National Health Service with “heat maps” showing marginal Labour seats where hospital closures could cost vital votes. For although almost no voter would support cuts in health service provision or the removal of a local hospital, taxpayers do generally recognise that resources must be used rationally. Whatever the emotional attachment to some ancient or even modern hospitals, especially in large cities such as London, voters recognise that needs change: some areas have more hospital beds than needed, whereas other new centres of population growth do not have enough.

Rationalising hospital provision is painful, controversial but sensible. What is wrong is to announce an overall readjustment on the grounds of cost and fairness, but to make changes informed by political opportunism that is cynical in the extreme. If it is right to close a hospital in a Labour safe seat in Wolverhampton and to concentrate resources and expertise in Birmingham, why is it not right to go ahead with similar plans in two other cities simply because the redundant hospital lies in a marginal constituency?

Given its poll ratings, it is little wonder that the Government is sensitive to the issue. Cuts and closures must be made, David Nicholson, the new NHS Chief Executive, admitted this week, because the health service has run out of money. Despite a big increase in funding since Labour came to power, the NHS is currently £500 million in debt. Suddenly, after hard-pressed managers could see an end to years of skimping and shortages, they are again being told to cancel operations and lay off staff. Charges of government mismanagement and failed reform are again filling the airwaves.

Secondly, the Government has recently performed a spectacular U-turn on the future of cottage hos-pitals. Many of these small, old and cherished local institutions were scheduled for closure, with treatment to be concentrated in large regional hospitals. But in January, the Government announced that at least 100 cottage hospitals under threat would instead form the core of a new community care system to bring health provision closer to people’s homes. This decision raises the question why previous plans to scrap the buildings were pursued with such obduracy and in the face of such determined local opposition.

The lesson is not lost on the public — or on Labour. The party has clearly decided not to risk confrontation, and to let politics rule over logic. The public has concluded that determined opposition can stay even the most logical closures. Political heat maps are hardly the most reliable guide to the health of the nation.

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