I do think, over the years, every government I have had dealings with thinks the NHS is a conundrum. Hence, every incoming administration has had a new plan to sort it out 'once and for all'.
Griffiths, sorting management. Thatcher, sorting structures. Blair flirting with the private sector and now Cameron. We have been spared the worst excesses of the Lansley debacle by the unwelcome arrival of austerity.
It is austerity that is at the heart of our woes.
The feeling that 'things have gone too far', is starting to dawn on Whitehall. A realisation, this time the wheels really are coming off. A sort-out is required.
My take is that this kind of thinking is behind the announcement of a big bung for GP services. GPs are the fulcrum point of the health service and the recognition that their share of the NHS cake has shrunk has suddenly dawned on policy makers.
The extent to which money is, of itself, an answer remains to be seen. If the solution is more people to do more of the same it won't work. There are no more people; you can't pop down the road and buy a box of GPs, or pharmacists, or nurses, or receptionists or any of the skills we are short of.
The pile up in primary care will not be triaged away, fobbing people off with a chat with a pharmacists when they really want to see a doctor won't work.
We know from our experiences in A&E; if patients are seen by the most skilled person first, the queues disappear quicker. Consultant led services work.
Austerity is at the heart of the other great problem of the day. The confluence of policies to create a world-first, seamless 7-day health service, the legacy of clunky employment and workforce planning policies and a reorganisation of a major part of the workforce, within the existing pay envelope. A mess of historic proportions.
On the back of an envelope I figure we must be about 140hrs away from making a different kind of healthcare history; an all-out-walk-out by junior doctors. They will be on strike.
The great and the good have written letters, made statements and palavered about. None of the Royal Colleges have any clout. They live in a past when people used to listen to them.
Patients groups have vacillated, professional organisation's have danced around their handbags, affinity organisation's have been at their ineffective best.
The GMC have issued guidance to junior doctors thinking of joining the walk-out. In brief it says JDs should be sure there is cover and their absence will do no harm.
Useless. How is an SHO supposed to sort that out. If there is a disaster, some poor soul can expect the roof to come in on their career.
If this is the best the GMC can do its hard to know why they still exists. They claim to be a guardian of patient interests. If this is, truly, the case they should be speaking to the reality; a strike is a risk, it could do immense harm and if it does... put your registration and career in the shredder.
The DH will not back down over the contract. If they do they will be a sucker-punch for all the other NHS professionals who will soon be facing contract changes to accommodate 7-day working.
The BMA dare not give up. They face reputation damage and an exodus of members of they did. The strike is about their survival.
The walk-out is no longer the issue. It's what happens afterwards. What comes next? Perpetual strikes? New doctors are already signing the contract, Trusts are implementing it, work-place Guardians will be in place. The die-hards will still be waving placards, the majority pleased to see the shemozzle fizzle out.
It's over. The DH has won and the GPs have done very nicely... sorted.