'The key is persuading voters that many changes are driven by medical purposes, said Gordon Brown'
The relationship between doctors and journalists may be fraught, but they have one talent in common: the ability to bury their own mistakes, as two recent reports underline.
The Crown Prosecution Service's decision not to press charges against Blair aides in the alleged loans-for-honours affair was greeted with surprisingly little serious analysis. Yet newspapers had devoted tons of blameless newsprint to over-confident predictions of disgrace for the ex-prime minister.
By a not too dissimilar process, the recent National Patient Safety Agency study into avoidable patient deaths estimated numbers at 800-34,000 a year - an extraordinarily vague figure, partly attributed to staff reluctance to admit to various forms of medical error.
I remembered this when reading up on Dr Richard Taylor's micro-debate on NHS emergency care just before the recess. Strictly speaking, the independent MP for Wyre Forest (elected in 2001 as part of an anti-hospital closure revolt) was part-duplicating a Tory-led debate on NHS access a few days earlier.
But that debate, like assorted rivers this wet summer, spilled its banks and turned into a familiar North-South litany: southern Tory MPs protesting at closures, northern Labour praising new facilities. In the middle Quentin Davies, Labour's new Midlands defector from Grantham and Stamford, praised ministers for saving a local accident and emergency unit - clashing with Tory health spokesman Andrew Lansley, who condemned them for threatening it in the first place.
My own impression is that overall Mr Lansley has a fair point in asserting that there is confusion over the various access points - 'pathways' in current jargon - to the NHS; at least eight according to Dr Taylor, from GP to A&E via walk-in centres and NHS Direct. Even the phone numbers can be daunting. Ministers rightly assert the importance of specialist centres for major trauma (heart, head, chest, burns, etc) while admitting that local people want local services.
Too many people must travel past their local hospital in an emergency (I have done so twice this year) or get 'triaged' in the wrong direction - with sometimes fatal results.
Dr Taylor's debate had the merit of clarity. The NHS needs a 'standardised, well-proven telephone triage system' which lay people can use, the MP said. It also needs clarification - in effect, grading - of what local emergency/urgent care centres can actually do.
The Taylorian ideal (and the British Association for Emergency Medicine) would see five grades, with the middle tier providing A&E, CT scanning, critical care and surgical back-up. It may not be affordable, admitted the MP, though he has persuaded his own local trust to 'trial' a doctor at the minor injuries unit.
As health minister Ben Bradshaw stressed in reply, ministers are piloting clearer, simpler options for both patients and staff, notably ambulance crews. There will always be 'slight tension' between choice and clarity, he conceded.
I can quote higher authority because Gordon Brown was at The Guardian editor's July summer party and was drawn into this kind of chat within my hearing.
In next to no time the new PM was scribbling a flow chart on the back of someone's business card to show the ebb and flow of patient journeys - GP, hospital, diagnosis, tests, operation, etc. Not all necessary, he suggested. I agree.
The gist seemed to be that the NHS should, where possible, adopt the Lord Darzi model so that all phases can be done in a one-stop polyclinic. The key lies in persuading voters that many of the current changes which unsettle them - and the local MP - are driven by medical purposes, not by financial ones, so Mr Brown told us.
Ministers must take the medical professions with them, he added. It is something he has tasked health secretary Alan Johnson with. Early days, and Brownian health policy hints have been modest and mixed. But I was not alone in noticing that Mr Brown was as cheerful and outgoing as I have seen him in years. 'He's really enjoying being prime minister at last, isn't he?' more than one colleague observed. I can report that he was not discouraged when a sceptic (me) raised an old problem for emergency services: traffic jams. But it's nice he's thinking NHS.
Michael White is assistant editor (politics) of The Guardian.