We are not going to represent you

In an "exclusive" interview in the Sunday Herald – exclusive because no one else wanted to interview him – deputy Conservative leader Michael Ancram has declared that the Tories' general election campaign would focus on "the usual suspects". That means a diet of "schools 'n' hospitals" and "law 'n' order". Neither "Europe" nor "Tony Blair's mistakes on Iraq" will feature prominently in their campaign.

Ancram also "revealed" something well known to readers of this Blog, that Conservative Central Office has all but dismissed the widespread Tory defections to UKIP as a transitory protest. He said there would be no change in Conservative policy to accommodate the scale of the anti-Europe protest, and dismissed any prospect of his party hinting at even a partial exit strategy from Europe.

This is all fine and dandy, but it effectively means that any voter who considers important the question of who rules their country is effectively disfranchised. The Conservatives are not going to represent them and, apparently, do not want the votes of people who are thus concerned. They can chose their government (what's left of it) on the basis of domestic issues, or not at all.

Oddly enough, those who believe that health care provision is solely a domestic issue should read Friday's edition of The Financial Times, which reported that the health service could face a continuing severe shortage of doctors in spite of the huge increase in medical students.

Part of the problem is the dramatic rise in the number of women doctors, who prefer to work part-time, but the greatest burden comes from the EU's working time directive, which is set to cut the number of hours trainee doctors can spend in hospital to 58 hours a week from August and 48 a week in 2009. The BMA has calculated that the shorter hours are the equivalent of needing 3,700 more junior doctors.

The outcome of this is that, despite massive increases in expenditure on the health service, and all the promises from politicians about better delivery and cutting waiting lists, according to Professor Peter Hutton, former president of the Academy of Medical Royal Colleges, "it is perfectly possible that there will not be more hours available to the NHS than there are now and - on a worst case scenario - there may even be less".

But, of course, if "Europe" is off the agenda at the next election, this issue cannot be discussed. Instead we will be assailed by a bunch of bleating politicians telling us how much better health care will be if they are elected, with none of them telling us that it will not be, and why that might be the case.

All of this leaves people who are really concerned about who runs their country – and indeed whether there are enough doctors to run the health service – with only one option. And it ain't voting Tory at the next general election.