The Sketch: Honesty is structurally impossible

We - by which I mean people - think morality is essentially emotional. We feel that behaving with integrity, with honour derives from the way we were brought up or taught or trained or had our selfish instincts brought under control.

But for them - that is, politicians - integrity may be more an intellectual thing. They set themselves such large tasks over such large fields of action (from the very small to the very large, from the banal to the transcendental), it's much harder for them than for us to be consistent. They have to behave within the structures that they created and which are apprehended by their intellects.

I'm trying to find a way of letting Andrew Lansley off. But it doesn't help. I'm saying that integrity in politics is largely intellectual, and that without clarity you can't be honest. Ouch, no, it's getting much worse for our friend.

It was an Opposition Day debate on hospital-acquired infections. I go to as many health debates as I can, enjoying as I do the sense of being overwhelmed by the spew of clashing statistics, wild assertions, false starts and mutual contradictions that come out of Mr Lansley's mouth. He doesn't need a doctor so much as an exorcist.

He has much to say. And after it's gone through the separator, some excellent opposition facts are revealed. Trusts are telling cleaning contractors not to quote on the basis of the Model Cleaning Contract because they can't afford the government-recommended rates. Every 25 beds need three isolation beds. Half our nurses can't change their clothes at work or shower there. Seven out of 10 have to launder their clothes at home. That sort of thing.

And because the very large part of hospital-acquired infection comes down to people not washing their hands, not keeping themselves clean, and bringing in infections from outside by sitting on patients' beds - however Patricia Hewitt may thrill at the idea - this reveals a fantastic failure at the most basic level of hospital management.

But what does Andrew make of these riches? He makes a mess. Lacking clarity, he can make nothing other than a mess. He denounces government targets that have caused the problem but then wants a target to reduce the rate of infection. But because he can see that is incoherent he calls it something else. He doesn't actually give it a name at all but demands reductions without nominating a level at all.

He has not revealed the core of his politics which is this: how is he going to make public service professionals do what he wants them to do? Without telling them what to do? What form of dianetic mind control is going to bring to bear on the NHS?

Without clarity, honesty is impossible. That's what all this "trust in politics" is about. It may not be too cynical to believe that, with public spending approaching half of GDP, clarity is tactically ridiculous, and honesty is structurally impossible.

sketch@simoncarr.co.uk