Keep calm and carry on is the one piece of advice that President Obama does not need to be reminded of in the wake of the humiliating upset in the Massachusetts Senatorial vote. All the information that has emerged on his fight to become president and his first year in office stresses Mr Obama's ability to keep calm when all about him is division and uncertainty. Nonetheless he is right to feel the anger he has apparently expressed at this loss of a seat which the Democrats have held for nearly 40 years.

This was an election the Democrats should have won, could have won and could not afford to lose. Instead the party classically took a win for granted, fielded a poor candidate in a lacklustre campaign and failed to realise until it was too late to stop the tide of support that was surging for the Republican contender, Scott Brown. Mr Obama's supporters argue that the vote took place in unusually difficult circumstances of a recession, high unemployment and the heated divisions over the White House's healthcare plan. But none of these truly explain, let alone excuse, the loss of a seat which had become virtually a Democrat fiefdom. It is a bitter irony that the death of healthcare's greatest proponent in Congress, Teddy Kennedy, should now deprive the president of the absolute 60-seat majority he needs to get it finally enacted in to law.

That should cause the President and his party to take a hard look at the lessons of the loss. But it should not be allowed to divert him from his course. Massachusetts was a peculiar state in that well over 90 per cent of its population were covered by private health insurance. That is not true of most of America. Obama has a plan, and he has variations of that plan passed in both houses. There is still a chance, if he acts swiftly, that he can get a bill into law without needing to go back to the Senate.

If there is a lesson to be learned from this defeat, it is that his consensual approach when it comes to money and vested interests can lead to confusion of messages and uncertainty of purposes. Obama needs to come out fighting now for a cause which he made paramount in his election campaign and whose urgency the recession has only underlined.