Watching delegates to the Royal College of Nursing giving Andrew Lansley the bird again at their Harrogate conference, albeit more gently than last year, I thought of the Spanish indignados in the streets of Madrid, of angry Greek voters and all those other protesters struggling with the unfolding consequences of the financial crash.

How do ordinary people, hit by job losses, wage and pension freezes, the rising cost of living, react realistically and effectively? By voting for extreme parties of left or right – as in Greece, ruined by decades of soft options? By electing Francois Hollande, the French Ed Miliband, to try to mitigate austerity without rejecting it, Greek-style? By going on one-day strikes as British public sector unions tried again the other day with diminishing impact?

Or by listening to Andrew Lansley politely, his mini-speech and extended Q&A session punctuated only by intermittent cries of “no” and “liar”? When it was over, the RCN’s chief executive, Peter Carter, much relieved by the absence of serious aggro, warned the secretary of state not to be misled by politeness. Do not take it that things are fine, there is a great deal of unhappiness. Listen to what RCN members are saying, Lansley was told.

I’m sure he will ponder it, though across Europe there is a serious mismatch between how the political elite perceive the crisis and how it is seen by the rank and file. The stats confirm that Lansley is right to insist there are more clinical staff in the NHS than in 2010 (fewer managers) but the nurses are right to complain of pressure on the wards. That’s down to trust decisions, he told them, which is only half the story.

Challenged to reveal what he says to his Celtic fellow health ministers who all reject his policy, Mr Lansley said he might well ask when Labour’s NHS Wales budget has been cut by 6 per cent and only 63 per cent of patients are treated (in England it’s 90 per cent) within 18 weeks. Fair point, but I lost count of the times questioners blamed him for what had been Labour policies – and he took credit or ducked blame for the same reason.

RCN activists, able to enjoy four days in affluent Harrogate, know they have jobs and pensions (modest but more secure than the private sector); luckier than most, I hope they realise. Greek hospitals are in real trouble, the poor scavenging bins and the middle class dangerously weakened by a 20 per cent economic contraction (the UK’s decline has been one third of that) since 2008. Hence the appeal of xenophobic, isolationist (“bring back the drachma”) and even fascist parties. It could happen here if hope and patience fade.

Interestingly, Greek doctors (top journalists, too) are sometimes included among the tax-dodging elite, though it was ministers and MPs getting it in the neck in Harrogate. In Liverpool last year Lansley promised the RCN that nurses would be included in clinical commissioning groups (did we still call them that in 2011?) and repeated the pledge. It may be happening in theory, but it’s not happening on the ground, they said.

Nowhere was the gap wider than on whistleblowing. Lansley told delegates to speak out fearlessly. They know it’s risky. Ministers know, too: even consultants fear for their careers. Peter Carter is telling members to complain to the RCN instead.

One other thing. Lib Dem health minister Paul Burstow is getting stick for resisting threatened service rationalisation at St Helier, his south London constituency hospital.

Yet Labour ministers did the same and up the road from Harrogate, at Northallerton’s Friarage hospital, a senior Tory is also backing protests against what sound like sensible changes. His name? William Hague.