Michael White on NHS politics

That was a recipe for making the fate of Baby P the dominant theme of many exchanges. But not all. Dementia got a decent hearing on both sides, as well as the need to spend and save money sensibly from here on - as all wise NHS finance directors are already doing.

And both the health secretary and his Tory health stalker Andrew Lansley made a useful connection between unemployment and the expansion of mental health services. Where are the 10,000 extra cognitive behavioural therapists, which Lord "Happiness" Layard (he wrote a book on the subject) told ministers we needed in 2004? asked Lansley. We need them now! The health secretary reminded him some 3,500 are being trained and a rapid expansion of psychological therapies is under way within the NHS.

Almost half those on incapacity benefit - soon to become the employment and support allowance - suffer from depression.

Siobhain McDonagh

Job loss makes that worse, so it is a sensible connection to make, though politics being a "glasses half full or half empty" sort of trade, they express it differently. Not so Siobhain McDonagh, whose fighting speech also caught my attention - and cheered me up too.

Who is she? A Labour arch loyalist, MP for Mitcham and Morden since 1997. You may recall her 15 seconds of fame when she called for a leadership contest last September, just before Gordon Brown's economic package "saved the world", as he let slip at a recent prime minister's questions.

Ms McDonagh's starting point was that she wants more central government interference in the health service. Why? Because her constituency experience had left her mistrustful of the NHS steamroller.

I dimly remember a chat with cheerful Ms McDonagh a few years back when she told me she was going to help picket Prince Charles's visit to local Merton College. The royal crime? His design charity had got mixed up in work on a controversial new hospital - one which the then health secretary, John Reid, had just called in, she reminded me this week.

Something for everybody

Back in 1996 the local health authority decided in private conclave that the nearby St Helier Hospital - in Liberal Democrat Tom Brake's constituency - should be moved south into Belmont, Surrey (in Lib Dem Paul Burstow's Sutton and Cheam patch), though a large proportion of its customers are Ms McDonagh's voters.

The basic problem seems to have stemmed from the original creation of an Epsom and St Helier University Hospitals trust, yoking a poorer corner of London with well-to-do north Surrey, where folk live 10 years longer than on the huge-but-handsome St Helier estate.

In picking a halfway site the authorities must have thought they were "offering something for everybody when actually it was nothing for nobody", she told me.

Epsom's Tory MP Chris Grayling was not keen to lose Epsom Hospital either. Nor were Brake or Burstow pro-Belmont. But the juggernaut kept rolling despite public consultation in which even the good people of Belmont revealed no wish to see "flashing blue lights" or more bus services in their suburb.

Sticking with bad ideas

Why? McDonagh assumes it is because none of the 18 board members then serving Merton and Sutton primary care trust lived in her patch. Yet St Helier people would not have gone to Belmont - the attractions of St George's in Tooting being obvious to them.

"My gut feeling is passionately that when a large unaccountable bureaucracy like the NHS gets something into its head, even if it's financially or logically a bad idea, it sticks with it," she says.

Even when an instruction came from Patricia Hewitt in late 2005 to rebuild ageing St Helier instead the PCT pushed on. I am sure there is another side to the story but, when health inequalities and money-follows-patient doctrines are uppermost, I am not clear what it is. Yet this is meant to be a cheerful tale. Local opinion won and St Helier will be rebuilt.

"An excellent deal," says the MP. But it makes you wonder.