Simon Carr: Everyone knew he was in the wrong, but no one managed to say why

Sketch: It's the grand illusion and all politicians subscribe to it – that they actually know what's going on

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Andrew Lansley stood up to that special cheer from his back benches. It was the sort of angry lowing that meant, "He may be a tosspot but he's a Tory tosspot so shove off." Naturally it produced sarcastic counter-cheers from Labour.

They all acted as if they knew what and why they were shouting. It's the grand illusion and all politicians subscribe to it – that with their privileged access to a higher knowledge, they actually know what's going on. Everyone knows Andrew Lansley's in the wrong (I did warn them) but equally no one quite managed to say why.

For instance, some weeks ago at PMQs, Ed Miliband had made much of the fact that EU competition law was a big part of the Bill and therefore the NHS was being marketised. Yesterday, Valerie Vaz repeated her boss's killer point only to be told there was no extension of competition law in the NHS at all. In such technicalities is the debate conducted.

Lansley caused a great laugh with the one remark that everyone understood. He declared a halt to the progress of his Bill for "a natural break". It's what television used to have in the 1950s to interrupt programmes. They'd show a cup of tea for three minutes. Over time the natural break became a commercial. Let's see what happens to Lansley's natural break.

There was much nose-pulling of the Health secretary. He'd been pushed into the Commons, so people say, by No 10 to announce this "pause for breath". John Healey said the pace wasn't the problem; "doing the wrong thing more slowly isn't the answer".

Lansley was saying such wild and whirling things that he was difficult to follow. It's how he's got away with it for the last five years.

Sajid Javid said this trend towards GP commissioning had been going on for 20 years supported by all parties. Healey said it was reckless, ideological chaos.

On the basis of their hair styles I reluctantly have to come down on Lansley's side. Or do I mean Healey? One thing did stick out – Lansley claimed 87 per cent of the country was now covered by his new arrangements, and that all the necessary GPs had opted into it. If that's true then you'd think the battle's over.

The doctors are being treated in the traditional way – they're having their mouths stuffed with gold. They've achieved parity with bankers: they'll be voting their own remuneration.

There'll be Bentleys at the back of the practice before the next election. At least there's that.



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