Published: 31/01/2002, Volume II2, No. 5790 Page 21

In the midst of the Rose Addis affair, I was taken to task in the Daily Telegraph for siding with the Downing Street spokesperson and the Whittington Hospital against some loutish attacks by or one two colleagues.

No complaints: I would have done the same for the Telegraph if the boot had been on the other foot. No, what worried me was a normally Labourish colleague who was furious with Number 10 that day.

Why so? Because my very down-to-earth colleague had spent a week in hospital and been appalled by dirty wards, lazy nurses, dreadful food and the treatment of the old man (It is often the old, is not it? ) in the next bed.

I know It is not typical, but I trust my friend.

All praise, incidentally, to the Sunday Telegraph, which printed a reader's eye-witness account of Mrs Addis's treatment that supported the Whittington version - not the family's. And while We are on the details, ministers and their staff did not (to the best of my knowledge) spread the 'racist' claim nor publish medical details not already published - whatever you may have read in the papers.

Nonetheless, I mention all this to underline how risky the Addis affair is for both sides in the political football match, but especially for ministers whom voters are more likely to blame. I think Alan Milburn knows that, though his natural instinct is never to walk away from a fight.

When Tony Blair spoke later in Newcastle, he tried to rally voters and health workers.

The kind words smothered some tough demands for change in pay and working practices, but the unions were pleased.

But when the PM said that Addis-style rows are 'tomorrow's fish and chip wrappings', I noticed that the family in the Jennifer's Ear row that rocked Mr Kinnock's 1992 election campaign (Jennifer's parents later divorced) took offence. So did Sharon Storer, the woman who bearded Mr Blair over her partner's cancer treatment (he got better) in 2001. By the weekend, Mr Blair was telling the Sunday Mirror that he expects to pay the price at the next election if he fails the NHS.Darn tootin' right, he will.

What wider lessons do we draw from the undignified scrap? Iain Duncan Smith and Dr Liam Fox think they're on a winner at last.

They may be right. One columnist wrote that IDS had been 'unscrupulous, irresponsible and brutally effective' in the row.

Touring the weekend TV studios, Dr Fox called for 'a proper mature debate' on healthcare, and we should, I think, take him at his word. But, as HSJ pointed out last week, European social insurance models are not a panacea, and they are very expensive.

Having heard Tory think-tank discussions on the subject, I can assure you that their pointy-heads are still all over the place. They may not want to 'demoralise and dismantle the NHS' as Blair loyalists claim, but some do want to go a long way in that direction.

Meanwhile, Dr Fox has nailed his colours to the proposition that Gordon Brown's billions can't do the job: It is the over-centralised system that is broke. The King's Fund discussion paper on the future of the NHS and Mr Milburn agree on the need to decentralise - at least in theory. The Addis row itself shows how hard that may prove in practice.

Finally, a cheerier thought for hard-pressed NHS professionals. That old war-horse, Frank Dobson, wrote in The Independent that Milburnian tinkering with NHS structures will distract from the urgent tasks of reform. I happen to know he would love to see the British Medical Association sue the newspaper which started the Addis row on behalf of libelled Whittington staff. 'That is what the Police Federation would do, 'murmurs Dobbo.