Not feeling so courageous, eh, minister?

William Hague is not the first MP to put loyalty to a local hospital before government policy, and h

The Sun reports today that William Hague is lined up to speak at a rally in opposition to the downgrading of a maternity unit at a small hospital in his Yorkshire constituency. A spokesman for the Foreign Secretary is quoted as saying this has nothing to do with the health reforms contained in besieged legislation currently causing tumult in parliament.

In technical terms, that might just about be true. The Health and Social Care Bill isn't on the statute books so it cannot directly have led to changes on the ground to which Hague is opposed. But politically the two cannot be separated. Partly, it just looks ridiculous. People conflate 'reform' and 'cuts' (the Sun's copy certainly does) and generally blame the government for everything bad that happens in the NHS so will wonder whose side the Foreign Secretary thinks he's on.

But the Hague conundrum also points to a more subtle, long-term problem. There is something approaching consensus in health policy circles that, eventually, for the sake of cost efficiency and coordination of care, specialist services need to be concentrated in centres of excellence, while routine procedures can be done more locally. What this means in practice is that the medium-sized district general hospital is an endangered species. There will be clinics, often based around GP practices, for the small stuff, and then fancy regional centres for the high-tech, complicated stuff. This dynamic appears to be what is behind the removal of certain services from Hague's constituency. Routine baby deliveries will stay; inpatient paediatric care is moving off 22 miles away to Middlesborough.

The problem with this trajectory - although it might make commercial and clinical sense on paper - is that it makes for atrocious politics. It always means stories of sick patients being forced to travel miles by taxi or ambulance when what they really want is just to stay local. Every constituency has an old-fashioned general hospital and every MP feels obliged to stand by it on the barricades. (Remember Hazel Blears getting into much the same pickle?)

Lansley's reforms are going to replicate this situation in constituencies up and down the country. The new GP-led commissioning structures and enhanced competition to provide care will, it is guaranteed, accelerate the process of 'rationalisation' away from general hospitals. That is partly the point of the reforms, albeit not one the government boasts about. Local surgeries will pick off the work that doesn't need in-patient beds, while specialist hospitals will be the obvious suppliers of more complex procedures. Plenty of Tory and Lib Dem MPs are worried about the dilemma this will create for them. It is a courageous politician indeed who turns up at a local town hall meeting to say 'actually,in the interests of overall NHS efficiency and in support of government policy, I'm here to defend the closure of our casualty/maternity ward.'

Hague isn't planning on doing it. The rest will follow his lead. This is just one of many reasons why Andrew Lansley's reforms are a political disaster. He can't seem to sell them to the public and no one else with a seat to defend containing a cherished local hospital is going to dare do it for him.

Rafael Behr is political columnist at the Guardian and former political editor of the New Statesman

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Voters are turning against Brexit but the Lib Dems aren't benefiting

Labour's pro-Brexit stance is not preventing it from winning the support of Remainers. Will that change?

More than a year after the UK voted for Brexit, there has been little sign of buyer's remorse. The public, including around a third of Remainers, are largely of the view that the government should "get on with it".

But as real wages are squeezed (owing to the Brexit-linked inflationary spike) there are tentative signs that the mood is changing. In the event of a second referendum, an Opinium/Observer poll found, 47 per cent would vote Remain, compared to 44 per cent for Leave. Support for a repeat vote is also increasing. Forty one per cent of the public now favour a second referendum (with 48 per cent opposed), compared to 33 per cent last December. 

The Liberal Democrats have made halting Brexit their raison d'être. But as public opinion turns, there is no sign they are benefiting. Since the election, Vince Cable's party has yet to exceed single figures in the polls, scoring a lowly 6 per cent in the Opinium survey (down from 7.4 per cent at the election). 

What accounts for this disparity? After their near-extinction in 2015, the Lib Dems remain either toxic or irrelevant to many voters. Labour, by contrast, despite its pro-Brexit stance, has hoovered up Remainers (55 per cent back Jeremy Corbyn's party). 

In some cases, this reflects voters' other priorities. Remainers are prepared to support Labour on account of the party's stances on austerity, housing and education. Corbyn, meanwhile, is a eurosceptic whose internationalism and pro-migration reputation endear him to EU supporters. Other Remainers rewarded Labour MPs who voted against Article 50, rebelling against the leadership's stance. 

But the trend also partly reflects ignorance. By saying little on the subject of Brexit, Corbyn and Labour allowed Remainers to assume the best. Though there is little evidence that voters will abandon Corbyn over his EU stance, the potential exists.

For this reason, the proposal of a new party will continue to recur. By challenging Labour over Brexit, without the toxicity of Lib Dems, it would sharpen the choice before voters. Though it would not win an election, a new party could force Corbyn to soften his stance on Brexit or to offer a second referendum (mirroring Ukip's effect on the Conservatives).

The greatest problem for the project is that it lacks support where it counts: among MPs. For reasons of tribalism and strategy, there is no emergent "Gang of Four" ready to helm a new party. In the absence of a new convulsion, the UK may turn against Brexit without the anti-Brexiteers benefiting. 

George Eaton is political editor of the New Statesman.