Sometimes the political weather seems to follow the climatic version. So it was no surprise during the snow to read a mild-mannered press release about training patterns under the lurid headline that we face 'the demise of nursing' in Britain.

Having spent just one hour in accident and emergency at the weekend - the grandson dislocated his elbow again - I can emphatically confirm that nursing is not demised. On Saturday night accident and emergency was busy with distressed infants, all being treated with cheerful competence.

On the political cold front, Conservative spokesman Andrew Lansley hammered ministers ('Patricia Hewitt is getting her excuses ready') after HSJ reported shortcomings in the new dental contract.

A fellow Tory, Tiverton's Angela Browning, tormented Tony Blair over that tabloid favourite, the closure of maternity wards, especially in rural areas.

Does the PM want women 'giving birth in some far-flung motorway services area?' the Devon MP inquired. As a Cornishman, I nodded in agreement.

Even in London I remembered Mrs Browning's point when driving to hospital. How do anxious parents with no car or bus cope at night?

Our local hospital, just 10 minutes away, has stopped doing kids' A&E. It took us another 10 minutes to get to the next one. Lucky, eh? We have a friend facing surgery in Devon soon (they botched it in London). He won't get there in 20 minutes.

The snow was still on the ground in many places when the health secretary briefed the cabinet on 'safeguarding NHS values for another generation' and later engaged in a Downing Street 'webchat', a dangerous tactic Number 10 is now using to 'engage' with voters in the naive belief that folk who post on websites are typical voters.

In her webchat Ms Hewitt opined that better treatment, closer to home, will mean 'fewer emergency admissions, so you will need fewer beds. Fewer beds are a sign of success - not a sign of failure.'

She's right in theory, but I think she might have phrased it more carefully at a time when trusts facing financial pressure are closing expensive wards they opened under Labour. The tireless Mr Lansley said she must live in a 'fantasy planet'. Norman Lamb, the Lib Dem health spokesman, invoked that old favourite, 'cloud cuckoo land'.

It's the same with Ms Hewitt's latest injunction that doctors are entitled to tell people to lose weight or stop smoking before they treat them. It's 15 years since our GP asked our teenage son if he smoked: 'Yes? Well, come back when you don't', which was tactless but correct. But GPs don't run for election.

Ms Hewitt's pep talk to cabinet on the need to embed change by 'empowering patients through choice' was presented in some media quarters as part of a wider Blairite attempt to prevent chancellor Gordon Brown slipping back into Old Labour ways when his day comes.

The same interpretation was placed on weekend reports on the latest Hewitt statement explaining the limits on the private sector's role in NHS commissioning.

Only in 'exceptional circumstances' will primary care trusts be allowed to hand over the entire job of commissioning, as distinct from specialist niches like health data from Dr Foster.

I am constantly being told that Labour health policy has turned sharply towards pro-market solutions in the Hewitt era and repeatedly answer that it is Blair-Milburn policy.

Will Mr Brown sweep it away? No. He too signed Labour's pro-choice manifesto and knows reform must go on. On the same webcast Ms Hewitt dared hint that he will give her at least 3 per cent extra NHS funding a year when the spending round ends in 2008.

All this merely restates existing policy, officials tell me, sometimes to ram home to NHS unions that they cannot expect a reprieve under Gordon.

And the private sector will still only be providing less than 10 per cent of elective work when the second wave of independent treatment centres is complete.

That is 1 per cent of the NHS budget. Even Mr Old Labour John Prescott is reported to have said during the choice presentation: 'There must be something wrong, I am agreeing with all this.'

Michael White is assistant editor (politics) of The Guardian.

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