The world is ruled by aggressive simpletons. We have all met jobsworths and nice guys, people who run things according to the first thing that comes into their head, rather than thinking it through.

The first example of this I came across in the political arena was the monarchy debate. There are a number of British people who describe themselves as republicans, many of whom complain bitterly about the royal family. This seems to include a disparaging tone about the members of the family themselves, what they do or are perceived to do, the constitutional position they hold, and perhaps even how that position fits into the running of the British state. All of these things are delineable, but are never separated in the debate. Added to which, what republicans think it should be replaced with is at least as unclear. An elected head of state? How will they be elected, and by whom, and how often? Royalists are frequently no better. They do not complain of course, because they have their way. But rarely, if ever, do they put forward a coherent set of reasons for retaining a hereditary monarchy. So the debate, such as it is, falls apart – or never really starts in the first place. It just becomes a raging torrent of abuse from republicans up against slight bewilderment from royalists.

The NHS reform bill disagreement has many of the same characteristics. We have an elected government who are doing what they have said they will, but in a way that is making a lot of people bleat furiously. The bleating may be perfectly correct and justified, although we will not know that until it is far too late. As with most government policy, it is probably going to be a mixture of success and failure that is all too murky to pick apart. Certainly, we cannot tell exactly what will happen, not least because the NHS is far too big and complicated to be readily predictable. The anti-NHS-reform-bill campaigners do seem to include quite a lot of medical professionals, but despite their undoubted intellectual ability, they have failed miserably at putting forward any coherent argument against it. Their poster campaign is a perfect example: a picture of a photogenic woman physician and a strap line about a high percentage of medical professionals being against the bill because it will destroy the NHS.

Even if it will destroy the NHS – which seems unlikely, frankly – why is that the best way of getting the point across? Yes, the attractive female medic makes it look better, but why should she, or others at her level in the organisation, be seen as knowing what will and will not work in a public service health care system? To put it another way, why should a junior doctor be in a position to run the NHS? Compare it to the idea of a train driver being in charge of a railway or a post-doc running a University. It is just not realistic. More than that, there is no coherent argument from the self same people about what should be being done with the NHS. The opposition to the bill has become a stroppy barrage of loathing for both the proposal and its proponents.

As I say, they may turn out to be correct, but I think it is more likely to be only partly correct at best. In any case, surely, in order to deal with this benighted legislation in an effective way, the opposition to it needs a coherent and well-articulated set of arguments. Medics are not stupid people, why are they not fighting this on intellectual grounds? I cannot see why taking an intellectual approach would be ill-advised, provided you had lucid reason on your side, whether it be politically left, right or down the middle. But perhaps I am not intellectual enough to see its short-comings.