Alex Massie

Imagine the uproar if a Tory minister proposed a “do-it-yourself” NHS?

Imagine the uproar if a Tory minister proposed a "do-it-yourself" NHS?
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Consider these two stories. In the first the government approves new proposals to overhaul hospital outpatient care. For once there isn't even much of a pretence that this will improve healthcare. It's simply a question of saving money.

Assuming the new proposals are implemented, many outpatients who had hitherto enjoyed (or endured) hospital appointments will be told to stay at home. Indeed they will be advised to "treat themselves". What contact they have with a consultant will be of the "virtual" kind. Perhaps a quick telephone call if they are lucky. More likely, they will be told to download an app to their phone which will tell them how to manage their condition or affliction.

In other words, a DIY NHS. Or, if you prefer, some real privatisation. The NHS: contracted out to the patient. Patients will be expected, a government spokesman concedes, "to monitor and manage their own conditions".

Imagine the uproar! The BBC and Channel 4 News would lead on this, the papers would pile in. Columnists would be outraged. There would be a national "debate" and, by god, the service would be defended against the barbarians threatening the holy National Health Service in this fashion.

But today? Not a cheap. But this was Scotland on Sunday's splash yesterday. A good story, I thought. But the BBC didn't cover the story yesterday and you won't find it mentioned on the BBC website this morning either. There has, I think, been no significant follow-up.

Perhaps this is because a) it's only a Scotland story and b) it's an SNP government not a Conservative ministry proposing these cuts.

Nothing can be done about the latter but, as I say, I doubt a Tory government would be granted such a pass. Especially not in Scotland. As it happens, these proposals (probably) have considerable merit but that's a different and largely unrelated matter.

A reminder, then, that the perception of motive matters. Parties of the left can actually cut 10% of NHS outpatient appointments knowing that though such moves may be met by grumbling there will be no firestorm. And, in the devolved territories, even if there is a rumpus you can bet that said cuts will be blamed on, well, on George Osborne. We wouldn't do this, you understand, but evil George Osborne is making us do it. Heads the Tories lose and tails they lose too. They are responsible even for things that have nothing to do with them. After all, according to the Scottish health minister, Margaret Thatcher drove Scots to drink.

Contrast this with the entirely manufactured fuss over Michael Gove's decision not to reappoint Sally Morgan to a second term as head of Ofsted, the schools inspectorate in England. Gove is "playing politics" and "compromising" Ofsted's independence. Baroness Morgan is obviously being shunted aside because Gove would like to replace her with a more reliable - and pliant! - Conservative figure. And, of course, she's probably being denied a second term because Gove, like all other Conservatives, hates women.

Because, well, because obviously.

It doesn't seem to matter half a jot that Gove appointed Morgan, a Labour figure, to the post in the first place. You would think that might count for something but apparently not.

Well, fine, politics is often a deeply stupid and juvenile game. But the contrast between these two stories and, more significantly, how they are reported tells us something about how the game is played.

Of course Gove has plenty of supporters within the media (not least at the Spectator I'm pleased to observe) and of course the press - in Scotland - is not uniformly gentle with the SNP. But it is always useful to see which kinds of stories get "traction" and which do not and to wonder why that may be the case. Stories which confirm longstanding presumptions do well; those that contradict them do not.

As I say, imagine the uproar if a Tory minister proposed "self-care" as a means of cutting inefficiency and saving money? It might be a good idea but that wouldn't matter, would it?