The limitations on a government’s power in a liberal democracy....

.... are many, varied and often overlooked by political theorists. Since returning from France I’ve been intending to restart my fascinating postings about some of the differences between life over there and over here in Britain. But, to be frank, I’ve found more interesting things to do with my time. I’ll write them one day I promise and one of them will be on this same theme viz. 'the limitations on a government’s power in a liberal democracy' complete with illustrations thereof from both sides of la Manche. Gosh I know you’re excited.....

Meanwhile reports in today’s Times, and now elsewhere, alleging that Labour is trying to avoid too many controversial NHS closures in vulnerable seats, have returned my thoughts to the theme. There is a desperate need to move our health service forward; its natural development has been hampered from birth by political interference and stop-start investment. This reached a peak in the Thatcher/Major years during which the NHS developed and renewed itself hardly at all.

Medical practice has, meanwhile, been moving on at an increasingly rapid pace. Treatments, which would have been almost unimaginable in 1948 when the NHS started, are now commonplace. And developments in technology and medicines mean that procedures which would previously have required a hospital visit can now be carried out at a GPs surgery or even the lounge bar of a country hotel (which is where my mother-in-law had one of her cataracts done).

So we now need a few big regional hospitals and not very many medium sized ones. So we need to shut some and that’s where the difficulties get really big.

People have a sentimental attachment to their local hospitals even if they’ve never set foot in them. Unions have a duty to try and preserve the jobs of their members. Many health professionals don’t want their jobs to change especially if it means moving to a new location or disrupting a cushy number they’d hope would see them through to retirement. Opposition politicians are always eager to stir up anti-government feelings. Local papers love a ‘save our local anything’ campaign.

A heady mix potentially blocking progress. Governments can easily find themselves almost unable to move and the next election is never far away. It’s not easy.......