Sometimes, quite despite our efforts to the contrary, things turn out very much for the better.  This is the email I received today from that excellent organisation 38 Degrees:

“I’ve seen the difference the work of 38 Degrees members has made to the debate on NHS changes. Today’s announcements seem like significant progress, but there are still big causes for concern and we all need to look carefully at the details as they emerge. Celebrate the success so far, 38 Degrees, but don’t stop speaking up for the future of our NHS!” Dr Clare Gerada, Chair, Royal College of GPs Dear Miljenko, Today, Nick Clegg and David Cameron admitted that the original NHS plans were wrong, and accepted the need for changes. We’ve not won yet – but we definitely have made progress. According to Andrew Lansley’s original timetable, the NHS changes would be law by now. We’ve helped stop that happen. Clegg and Cameron’s speeches included some steps in the right direction. But we can’t afford to drop our guard. For a start, these are just speeches – we haven’t seen the full text of the proposed laws. We will need to scrutinise the plans line by line as they pass through parliament. We have got this far by working together. 38 Degrees members voted to start the campaign because we know just how important the NHS is – we can’t trust it’s future to politicians. If we keep working together, we can keep the pressure on. But what should be our priorities? How can we push David Cameron to keep the promises he has made this week? How can push our MPs to vote down bits of the plans that still look dangerous? What could we do to challenge cuts to services we rely on? Help decide what we do next together by completing this two minute poll: http://www.38degrees.org.uk/nhs-what-shall-we-do-next Back in April, thousands of us took part in a vote to decide together which parts of the NHS plans we were most worried about. Today, hundreds of 38 Degrees members have been discussing the announcements and the media coverage on the 38 Degrees website and Facebook page. Here’s an attempt at a summary of what we decided to prioritise and where we seem to have got to:

What we decided together to focus on What David Cameron’s new proposals might mean Don’t force the NHS to promote competition between private health companies: rule out price competition and promote co-operation and quality of care instead Some Progress. It sounds like the role of the NHS regulator, “Monitor”, will now have an overall focus on promoting the interests of patients not price competition as originally proposed.  The devil will be in the detail of how this works, and there is probably still more talk of competition than lots of us would like. Lib Dem MP Andrew George has warned “Monitor” could act as a “trojan horse” allowing more of the original plans to be slipped “through the back door”. Don’t allow private companies to ”cherry pick” healthcare contracts in a way which could undermine local hospitals: put NHS services and hospitals first Progress. There will be “new safeguards” to stop private companies taking over the job of commissioning health services where hard-pressed GPs are unwilling. But the government wants to keep the policy of “Any Willing Provider” being allowed to run NHS services, including private companies.  Many experts say this policy means that in practice it will be extremely difficult to prevent “cherry-picking”. We will definitely need to look hard at this area of the legislation when it is published. Don’t take big decisions about health spending without experts and patients being involved as well as GPs A lot of progress. It sounds like patients, nurses, and hospital doctors will now be involved in taking decisions as well as GPs. Mental Health Charity Rethink is describing the revised plans as “a real step forward for patient power”. Don’t allow big decisions about health spending be taken behind closed doors and without democratic scrutiny Some Progress. It seems that local “health and well-being boards”, which include elected local people, will have a beefed up role in scrutinising what GP commissioning boards are up to. Don’t force any big changes without testing them properly first – trial any changes in one area for several years first, then give parliament a fresh vote A little bit of progress. The timetable for imposing the changes has definitely been slowed down, with many of the original deadlines dropped or softened. But the government still isn’t proposing a local trial, or a fresh vote once we’ve seen how all of the new systems work. Don’t remove the government’s “duty” to provide a comprehensive health service: keep that duty in law Success? It’s being reported that the Bill will be rewritten to reinstate this comprehensive duty. That would be a massive success – but we need to see it happen in practice before we can relax! What areas of David Cameron’s new plan are you most concerned about? What should 38 Degrees members do together next to stand up for the future of our health service? Have your say here: http://www.38degrees.org.uk/nhs-what-shall-we-do-next We won’t know exactly what the government is planning until they release detailed legislation. But we do know that some hardliners are angry that Andrew Lansley’s original plans have been changed and will be campaigning to revive them. If we keep working together, we can make sure that doesn’t happen. Two weeks ago, before this flurry of announcements, thousands of 38 Degrees members voted to decide what we should do next. So much has changed since then, but here are some of the most popular ideas we came up with: Aim to deliver copies of the Save our NHS petition to every single member of the cabinet in the next month Send lots of letters to local papers to make sure they hear how many people are worried about the NHS plans Hold birthday parties in July to celebrate the NHS’s 63rd birthday Do you think theses are still the best ideas? Should we do something else? Please take 2 minutes to help decide: http://www.38degrees.org.uk/nhs-what-shall-we-do-next Thanks for getting involved: David, Marie, Johnny, Hannah, Becky, Cian and the 38 Degrees team PS: if you completed the poll last week, then thank you, but please do this one too – so much has changed in the past two weeks! http://www.38degrees.org.uk/nhs-what-shall-we-do-next Notes: Here are a couple of summaries of the changes to NHS plans: Department of Health official response: http://healthandcare.dh.gov.uk/government-response-to-nhs-future-forum/ The BBC: Step-by-step guide to NHS changes: http://www.bbc.co.uk/news/health-13749880

It’s clear that both this organisation and initiatives such as False Economy, as well as a plethora of other evidence-based social media movements, are taking their toll on this government.

Or are they?

Whilst recent polls suggest that few people want to get involved in David Cameron’s Big Society in its most formal and prescriptive manifestations, it’s absolutely the case that through both online and related offline initiatives the voting public is beginning to radicalise itself in a way that, for example, the Labour movement’s leaders in other very different times would have found difficult to even imagine.  David Cameron as the Radicaliser Extraordinaire then?  The very best thing to happen to society in years perhaps?

Maybe so.  Maybe, indeed, this is the case.  Even despite himself.  Not quite the Big Society he was looking to engender – but a Big Society of sorts he may yet be able to take advantage of.

And whilst the Labour Party in crisis shows us the real weaknesses of pyramid politics as it begins to frustrate some of those who might in other circumstances have truly placed their confidence in it, the real force for change and for a dynamically continuous improvement in our economy, state and relationships – even where this is effected in a reactive and contradictory sense; that is to say, in opposition to our desires – is precisely constituted in those individuals who Carl, in the first story I linked to at the top of today’s post, slates thus:

Sir/Madame, look at these two. Clegg and Cameron. Are you surprised? Do you wince? Do you think their compassion consists in wanting to share, nay impose, the worst of the lifestyle of the ruling class upon us grounded, not landed, folk?

Sir/Madame, are these conservative men ripping down our institutions from inside? Did they not realise we must desist from change if its success rests upon luck?

Sir/Madame, did they not realise that it was private interest and interference that slowed down and frustrated the national health service during the terms of the last cabinet. Are they aware this service, free at the point of entry, is an inscription of welfare as a right of citizenry, there to stop anyone from falling through the net, commissioned only through donations of that grandest of traditions the state?

Sir/Madame, look at this one. Duncan-Smith. Does he not acknowledge welfare as a right of citizenry?

Sir/Madame, I am under little doubt these thugs understand nothing of what they are doing. But quite why we should tolerate them while they do it is beyond me. Are we yet fit for revolt?

Cameron & Co are so good for society because suddenly, after years of having it all handed out to us on a plate, we are having to define and fight for everything we believe in.  We are having to rediscover and assert what really matters to us.  We are becoming welfare guerrillas battling for the safety and security of our friends and families.  This has, all of a sudden, become a war not to the death – but, rather, on behalf of everyone’s lives.

Cameron & Co are destroying society as we know it – and, in so doing, are forcing us to recover the past: that is to say, the very society they aim to bury.  Therein lies the political tautology: they would see themselves as radicals but their impact on us will lead to an overall and net societal conservatism.  And even as we see ourselves essentially as radicals, we struggle to conserve the results of our ancient battles.

So does no one know how – or care any longer – to have a truly radical impact on our world these days?

Is the system we live under so absolutely pervading and powerful that there is nothing we can now do to disentangle us from its control?

Is it capitalism, then, which has led us all down the road of absolute conservatism?

I do, actually, wonder if this is the case.

Don’t you?