“All governments end in failure”.

That quotation is not entirely fair as the British governments of 1906 and 1945 are usually considered successful; but even these ended with political crises. Why then do most governments eventually implode upon themselves? I think there are two reasons. The first is simply down to bad luck; Harold Macmillan when asked about the toughest thing about being prime minister replied ‘events dear boy events’. Some prime ministers are just down right unlucky and events outside their control bring them down (Edward Heath and John Major are the two best recent examples). The second factor that does for governments is that they do ill-advised things and then pay a very heavy price. In other words these governments try to do things that are beyond their competency and control. For example, why did Eden think his Suez policy was a good idea in 1956? Or why did Thatcher think that the late 80s was a good time to reform local government finance? Most recently, why did Blair get so involved with Bush’s Iraq war? On each occasion these prime ministers received volumes of advice against their chosen paths, but they just chose to ignore it. In each case the political consequences proved to be catastrophic.

This week I listened to a speech by David Cameron defending his decision to embark upon the largest reform of the NHS since it’s foundation in the late 1940s. To date Cameron has been a politically astute prime minister and has deservedly maintained high approval ratings. However, I predict that with this attempt to ‘reform’ management of the NHS he may be sowing the seeds of his own demise. Waiting lists are at all time low and public satisfaction levels with the NHS are consistently high; our health service may not be perfect, but it is hard to see what political advantage Cameron will get from foisting yet another reform on the NHS.

David Cameron is apparently a fan of the ‘nudge’ theory, whereby reform is carried out incrementally – one small step at a time. Yet his NHS reforms will be on a massive scale and implemented within a year or two. I listened with care to his speeches and the interview on the ‘Today’ programme; somehow this was a David Cameron that did not sound as assured as usual or even that he fully believed in what he was saying. Perhaps he should have heeded that other political adage, ‘when in doubt, do nothing’.