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Over to you, Nick

Jobbing Doctor argues that only one man has the power to send the Government's health reforms back to the drawing board

We are approaching an important period of time. There is a momentous situation where decisions that are being made behind closed doors could influence the healthcare of a whole generation.

I know that this is somewhat apocalyptic language, but there are many who believe we are approaching a crucial decision. That decision needs to be made by the MP for Sheffield Hallam, Mr Nick Clegg.

Before the last election, virtually nobody had heard of Nick Clegg. Indeed, if ‘champagne' Charlie Kennedy had not admitted that he had an alcohol problem, then Nick would never have become the leader of the minority third party, the Liberal Democrats. He would have been an obscure front bench spokesman in a party that few would take the time to listen to: Now he is like Warwick the king-maker.

Nick has a problem. It is the fact that his ministerial portfolio and privileges are completely at odds with the fact that his party has decided, this weekend of all times, and in Sheffield of all places, that they cannot support the new NHS white paper. The rank-and-file of the party are pretty definite about their view: They are against.

What to do, what to do?

Nick needs to decide whether to follow the mandate from his party, or vote for the bill: He has already supported the bill during its second reading in the House of Commons, he and all the front bench team members from the Liberal Democrats. Now his party is telling him not to.

There was no mandate for Mr Lansley's new bill. It did not appear in any manifesto. It was quite a shock to many when it suddenly appeared. We should not have been surprised, as the ground work was done by special advisers brought in from the private sector by the previous government. They saw reintroduction of an internal market in health care, an essential prerequisite for the current changes. This was the doing of Tony Blair.

The whole thing was continued by work on a national computer system, and the spurious agenda of ‘choice' driving healthcare towards excellence. All it needed was a few useful fools to be brought in to front this. There will always be doctors who will be prepared to do the Government's bidding, and sell their colleagues and the system for a mess of pottage - or a nice title of Baronet and a seat in the House of Lords. Doctors becoming politicians are not a principled lot.

The Jobbing Doctor has a pretty low opinion of politicians. Here I am pretty much in keeping with the rest of the general public who place them in the same category as estate agents, journalists and lawyers. My path has only really crossed with two politicians in the last few years - one at a professional level and one who grew up in the next street to us and was best friends with my sister. Both of these politicians were honest, principled and trustworthy. Needless to say, neither have remained in politics.

The essential decision is, does Nick stick to his principles and scupper the NHS bill, possibly the coalition, and trigger an election? Or does he support the Government, try for some cosmetic changes to the bill and argue that he is better affecting policy from within?

My guess is that the allure of the ministerial Bentley and the limelight will prove too much for young Nick, and despite his best efforts to spin this into a positive decision, he will take the craven view, and the NHS will be fundamentally damaged as a result.

The Jobbing Doctor is a general practitioner in a deprived urban area of England.

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