POLITICS

It was fascinating to read the weekend newspapers and see how different failures of NHS practice and governance prompted different responses, and in this instance - I am pretty confident - from their readers, the voters.

'Horrific toll of bungling killer surgeon' was the Daily Mail's take on Steven Walker, the ambitious 44-year-old surgeon who apparently wanted to put Blackpool Victoria Hospital 'on the map'.

He certainly did that. Colleagues refused to work with him, and when the General Medical Council finally caught up with him, it blamed him for four deaths and six maimings.

Contrast the Mail's shrill page one treatment of Mr Walker with its page 23 headline the following day, 'Free glasses fiddle of Robin Hood optician'. Gwyn Evans offered deprived children in Bridgend, Glamorgan, spare pairs of spectacles, more stylish spectacles (some kids refuse to wear NHS ones), prescription swimming goggles - even a pair of prescription sunglasses for a girl with a squint.

But he illegally claimed£23,000 from the NHS in doing so, some of which he kept himself.Mr Evans, 46, admitted 41 offences and asked for another 765 to be taken into account.

He had repaid£25,000.

Judge Gibbon gave him a ninemonth suspended sentence, accepting that 'you perceive the NHS rules to be restrictive'. The judge agreed and called for a review. 'But I accept the NHS has not got a bottomless pit.'

So It is OK to break democratically agreed rules and rob the NHS if you so decide - in contrast with arrogant surgeons playing God beyond their capacity.Coincidentally, a report from the deaf people's lobby suggested that senior NHS doctors are saving money by playing down the benefits of (costly) digital hearing aids.

Not very attractive, eh? But we know why it happens. I rang three MPs to give our moral map a reality check. First, Win Griffiths, Mr Evans' local Labour MP and a former Welsh health minister. 'I do not know him myself, but those who do say he's a nice bloke who was trying to help children who needed help but couldn't get it under the rules.'

So what did the MP feel? 'Broadly sympathetic. It is not a nasty crime - trying to do good - but he was breaking the law, 'Mr Griffiths said judiciously. Most people in the area felt the same way. He added that the Welsh Assembly almost certainly has the devolved power to vary the regulations governing opticians.

'It is complex, ' he added. Judicious again. So was a prominent right-wing Tory MP I consulted. 'Better not say; It is not part of my front-bench responsibility, ' he said. 'And I am just about to sit down to dinner.' Oh, go on, I said. 'All right, ' he replied. 'I can imagine a poor boy being bullied over his glasses in the school playground. I am not unhappy with what the optician did.'

I then tried Dr Jenny Tonge, community physician turned Lib Dem MP for Richmond Park. 'I suppose he shouldn't have done it, but my heart warmed to him. Didn't panel doctors do that in the old days before the NHS? My mother used to say the rich paid a bit more and the poor got treated by the doctor - a lovely system but not foolproof.'

None of the MPs had much time for overconfident surgeons. 'When I was a medical student I was horrified by the gung-ho attitude of some surgeons.

They'd take on cases and have a go because no-one else would touch the case.

There were some really incompetent havea-go people doing things far beyond their capability, ' said Dr Tonge.

But she had an interesting perspective to offer. 'We are on a cusp between general hospitals, general surgeons and general physicians all doing things close to people's homes and specialist centres.

'People haven't quite realised that they now need specialists to do things properly.'

The result is that patient expectations rise at a time when generalists are still trying to do what technology and changing attitudes suggest they should not be doing.

Local hospitals are still useful for low-tech, respite and intermediate care.

'But we have to change people's mindset in this country.

Meanwhile, the generalists are being caught out.' l