At the TUC’s big anti-cuts rally in Hyde Park a young NHS physiotherapist spoke with a passion and sincerity which characterised the day’s main event, if not the hooligan fringe rioting in nearby Piccadilly.

“Every job lost has an impact on the care we give patients,” she declared.

Big cheers, as there were for every mention of the urgent need to defend the health service from Tory ambitions to sell it off. At a gathering which brought together moderates and militants it was one of the day’s easiest applause lines. If the bankers don’t like it “they can leave the country – we say ‘good riddance’”, said even Dave Prentis, Unison’s amiable leader.

In reality we can’t do without the bankers quite yet. In a good year the top 1 per cent of companies pay 80 per cent of corporation tax, the top 1 per cent of earners pay 27 per cent of income tax. Sums like these virtually fund the health service.

But the post-New Labour narrative established on the progressive left is safely rooted in an idealised version of the Attlee era (1945-51) which created the “land fit for heroes” after the Second World War which eluded Britain in 1918. It did so despite hostility and great hardship. All true.

Never mind that, at the time it didn’t feel so heroic to many of the kind of people who joined the “March for the Alternative” on Saturday: public sector workers, teachers, council staff, Unison’s health members, all protesting over George Osborne’s 2010 Budget strategy, which he reaffirmed on 23 March this year. Or that few yet see New Labour’s rescue of the NHS in a heroic light.

So I was grateful to hear the young physio in Hyde Park adding: “the NHS isn’t perfect, it has to go on improving”.

Beneath the partisan rhetoric, that’s surely the bottom line and would have been the case if Labour had unexpectedly won the election.

The King’s Fund’s latest call for GPs to raise their game on “an industrial scale” would still have been published.

What did the second Osborne budget do for – or to – the NHS, its patients and staff? Little that was directly visible next day, although the devil is always in the small print. Thus, a Treasury-wise chum points out that before the chancellor cut corporation tax by 2 per cent he quietly paid for it by cutting tax allowances for buying machinery: banks don’t buy much machinery, industry does.

No cheers there or for that too clever by half wheeze (how he reminds me of Gordon Brown) to tax oil exploration (a good thing) to subsidise petrol prices (a bad one). But two cheers to Mr Osborne for embracing plans to create a unified health research regulatory agency which will make clinical trials – tests that save lives – cheaper and easier to run because medical ethics committees are nervous of randomised tests.

Not so many cheers for the latest twist of the knife on public sector pensions, on top of the pay freeze. Does that mean the government wants the NHS’s most talented staff to migrate to the private sector, some smart economists are wondering? This week’s tax rises, in the pipeline since last June, intensify the pressure.

The TUC’s rally may have hyped up the impact of the cuts, the worst of which are yet to be felt. By the same token its critics are wrong to argue that the pain of cuts in jobs and services is not real at all. Of course it is.

Where I am less sympathetic is in the sterile debate over whether or not the coalition has breached its pledge to protect the NHS budget.

With inflation edging 5 per cent and costs rising it’s certain to breach it in reality. That’s why (David) “Nicholson’s challenge” matters more than (George) Osborne’s budget.